Tag Archives for Alzheimer’s Disease

Efforts to Revise State Alzheimer’s Plan are in Full Swing

Published in Woonsocket Call on February 25, 2018

By Herb Weiss

Lt. Governor Dan McKee is gearing up Rhode Island’s fight against the skyrocketing incidence of Alzheimer’s disease, called by some as one of the ‘biggest epidemics in medical history.’ Last Wednesday, he announced $30,000 in grants secured by his office and the Rhode Island chapter of the Alzheimer’s Association to hire a consultant to update the state’s five-year plan on Alzheimer’s Disease and Related Disorders. Tufts Health Plan Foundation and the Rhode Island Foundation each pledged $15,000 to support the rewriting of the initial State Plan.

Updating the State’s Alzheimer’s Plan

The updated State Plan, to be created by a collaborative effort of the Rhode Island chapter of the Alzheimer’s Association, the Division of Elderly Affairs and the Office of the Lt. Governor, will provide state lawmakers with a road map for the state, municipalities and the health care system, to confront the continuing Alzheimer’s crisis. It will take a look at the current impact of Alzheimer’s disease on a growing number of Rhode Islanders and outlines what steps the state must take (legislatively and regulatory) to improve dementia-capable programs and services for people with Alzheimer’s and their family caregivers.

Lt. Governor McKee and the Executive Board of the Alzheimer’s Disease and Related Disorders, a working group of comprised of distinguished researchers, advocates, clinicians and caregivers, are now beginning their efforts to meet their deadline by the end of 2018 of having a completed state plan to submit to the Rhode Island General Assembly.

With financial support provided by the Rhode Island Foundation and Tufts Health Plan Foundation, the Alzheimer’s Association, Rhode Island Chapter, as fiscal agent, can now hire a consultant to assist in updating the initial state-five-year plan approved by the Rhode Island General Assembly in 2013. Once the updated report is completed and approved by the Rhode Island General Assembly, the Executive Board can will seek legislative and regulatory changes to carry out its recommendations to ensure that it is more than just a document—that it comes to shape the state’s public policies on Alzheimer’s.

“Rhode Island has been a national leader in Alzheimer’s research. Each day, we make great strides in expanding clinical trials and innovating treatments. Over the last few years alone, the local landscape of prevention and treatment has changed dramatically and positively. The updated State Plan will be an invaluable tool for local leaders, researchers, physicians, advocates and families as we work together to build momentum in the fight against Alzheimer’s,” said Lt. Governor McKee.

“A Living Document”

“We face an emerging crisis with the prevalence of Alzheimer’s disease projected to increase to as many as 27,000 Rhode Islanders by 2025. Alzheimer’s disease is a pivotal public health issue that Rhode Island’s policymakers cannot ignore. With the rapidly growing and changing extent of the Alzheimer’s crisis, it is essential that Rhode Island’s State Plan becomes a living document that stakeholders regularly consult and re-evaluate,” says Donna McGowan, Executive Director of the Alzheimer’s Association, Rhode Island Chapter.

“Communities have greater interest in age-friendly initiatives. There’s a growing understanding of the critical role older people play. They are an asset to community, and their voices and insights are invaluable to the public discourse on what communities need,” said Nora Moreno Cargie, vice president, corporate citizenship for Tufts Health Plan and president of its Foundation.

“A coordinated, strategic approach to Alzheimer’s will lead to better outcomes and healthier lives. Working with generous donors, we’re proud to partner with Tufts to fund this crucial work,” said Jenny Pereira, the Rhode Island Foundation’s vice president of grant programs.

Put Older Woman, Older Veterans on the Radar Screen

The updated state plan must address the growing needs of older woman and the state’s aging veterans population.

Maureen Maigret, Vice Chair of the Long Term Care Coordinating Council and Chair of its Aging in Community Subcommittee, suggests zero in on the special needs of older woman. “Alzheimer’s disease and related dementias is of special concern for older women as the they are more likely to suffer from the debilitating disease due to greater longevity, more likely to need long term care services and supports and are more often than men to be caregivers either unpaid or paid of persons with Alzheimer’s disease. The Aging in Community Subcommittee of the LTCCC has several pieces of legislation to strengthen support for caregivers and to enhance home and community based services,” says Maigret.

Last year, the USAgainstAlzheimer’s, (UsA2), released the issue brief, “Veterans and Alzheimer’s Meeting the Crisis Head on,” with data indicating that many older veterans will face a unique risk factor for Alzheimer’s as a direct result of their military career.

“Forty nine percent of those aging veterans age 65 ((WW2, Korea, Vietnam and even younger veterans, from the Iraq and Afghanistan conflicts in the coming decades), are at greater risk for Alzheimer’s compared to 15 percent of nonveterans over age 65,” say the authors of the issue brief.

UsA2’s issue brief pulled together research findings released by the U.S. Department of Veteran’s Affairs (VA). On study estimates that more than 750,000 older veterans have Alzheimer’s disease and other dementias, another noting that the number of enrollee with Alzheimer’s grew 166 percent from roughly 145,000 in 2004 to 385,000 in 2014.

The minority communities are at even greater risk for Alzheimer’s and minority veterans are predicted to increase from 23.2 percent of the total veteran population in 2017 to 32.8 percent in 2037, says a cited VA study.

The issue brief also cited one study findings that indicated that older veterans who have suffered a traumatic brain injury (TBI) are 60 percent are more likely to develop dementia, Twenty-two percent of all combat wounds in Afghanistan and Iraq were brain injuries, nearly double the rate seen during Vietnam – increasing these younger veterans’ lifetime Alzheimer’s risk.

The Rhode Island Foundation and the Tufts Health Plan Foundation grant funding was key to the Lt. Governor McKee being able to update its state’s plan to battle Alzheimer’s disease. It provides state policy makers with a roadmap o effectively utilize state resources and dollars to provide care for those afflicted with debilitating cognitive disorder. It is money well spent.

The Alzheimer’s Association will shortly issue a Request for Proposal (RFP) seeking a research consultant to assist in revising and updating e the State Plan. For details about the RFP of the State’s Alzheimer’s Plan, email Michelle La France at mlafrance@alz.org.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Does Exercise Aid Brain Health?

The Debate’s Yet to be Decided

Published in Woonsocket Call on August 01, 2016

According to AARP’s latest health aging survey findings, age 40 and over respondents who regularly exercise rate their brain health significantly higher than non-exercisers. They also cite improvements in their memory, ability to: learn new things, managing stress, and even making decisions. On the other hand, the findings reveal an overwhelming majority of these respondents see the benefits of exercise, but only 34 percent are meeting the Global Council on Brain Health’s (GCBH) recommended 150 minutes of moderate to vigorous exercise per week.

These findings in the 37 page Survey on Physical Activity report, conducted by GfK for AARP, directly align with AARP’s Staying Sharp program, a digital platform that promotes brain health though holistic advice supported by science.

“With Staying Sharp, we sought to empower consumers with the tools needed to create a holistically brain healthy environment for themselves—along with a way to track and measure their progress,” said Craig Fontenot, VP of Value Creation. “The results of this survey only further validate the advice suggested on the platform and give us confidence that we’re providing our members with helpful, impactful information.”

The AARP survey findings, released on July 26, found that more than half (56 percent) of the age 40 and over respondents say that they get some form of exercise each week. However, only about a third (34 percent) of these individuals actually achieve the recommended 2 ½ hours of moderate to vigorous activity each week. There was little difference in reported amounts of exercise by age or gender.

The AARP online survey, with a represented sample of 1,530 Americans age 40 and over, found that walking is the most common form of physical exercise reported with 53 percent of the age 40 and respondents saying that they walk for exercise. A smaller percentage is engaging in more vigorous activity such as strength training/weight training (15 percent) or running/jogging (8 percent).

According to the survey’s findings, most of the age 40 and over respondents see the benefits to engaging in physical activity and do not find it particularly unpleasant or difficult. For example, three quarters believe exercise would improve their health, physical fitness, and quality of life.

Having willpower, enjoying exercise, identification as an “exerciser,” lack of enjoyment and feeling like you have the energy to exercise or lack money to exercise are the key factors that differentiate exercisers from non-exercisers, the researchers say.

The study found that the largest share of non-exercisers are “contemplators” in that they see the benefits and are considering taking up exercise (34 percent). About one-quarter (24 percent) are considered “non-believers” and see no need for exercise and were satisfied being sedentary. However, two in ten (19 percent) are “preparers” and say they have a firm plan to begin exercising in the near future.

Finally, the most common leisure activity that age 40 and over respondents would give up if they were to engage in exercise is watching TV/streaming movies (65%).

Removing the Barriers to Exercise

Colin Milner, CEO at the Vancouver, BC-based International Council on Active Aging, says, “These findings demonstrates the amazing and ongoing benefits of regular exercise. Our challenge, to get more people to actually move. By doing so the country and millions of individuals would improve their physical and mental health,” he notes.

Adds Milner, “The most important thing is to remember is that our bodies and brains were meant to be used. If we fail to do so they will cease to perform at the level we need or desire, and that is detrimental to our overall health and well-being.”

“Part of our challenge [to not exercising] is to remove the barriers that prevent us from leading an engaged life. A recommendation would be to list out the reasons you are not exercising or eating well, why you are feeling stressed or are not socially engaged, then set out to replace these with reasons to exercise and eat well, to be stress free and socially engaged. Once you have done this consider what steps you need to take to make this a reality,” he says. ICAA’s Webpage, “Welcome Back to Fitness” (http://icaa.cc/welcomeback.htm) gives the basics to help people begin exercising.

An avid squash player, Richard W. Besdine, MD, Professor of Medicine and Brown University’s Director, Division of Geriatrics and Palliative Medicine, preaches the importance of physical activity to all his colleagues and friends. “There are a large number of research studies documenting that exercise is good for all organs in your body,” he says, adding that that regular exercise can also reduce cancer rates, control diabetes, improve one’s emotional health and even reduce depression.

When asked about AARP’s survey findings about the impact of exercise and brain health, Besdine says he applauds the survey’s objectives of examining the relationship between physical exercise and brain health, but its findings are self-reported at best, not empirically derived.

Besdine points out that there is a growing body of studies that empirically study the relationship between exercise and brain health and findings indicate a positive impact on brain functioning. People who exercise are less likely to be cognitively impaired and those who are mildly impaired may even slow or stop the progression of their mental disorder, he says.

“Although AARP’s survey is very interesting it is very limited because it is self-report and cross-sectional, says Deborah Blacker, MD, ScD, Director of the Gerontology Research Unit at Massachusetts General Hospital who is also a Professor of Psychiatry at Harvard Medical School.

AlzRisk, part of the AlzForum, a website that reports the latest scientific findings on the advancement of diagnostics and treatments for Alzheimer’s disease, posts a scientific review of 16 scientific articles reporting on the relationship of exercise habits to the later development of Alzheimer’s disease. Blacker, AlzRisk’s leader, says that this more solid body of evidence suggests that exercise may play a modest role in protecting a person from Alzheimer’s disease, but further scientific research is required.

Like Besdine, Blacker still sees the positive benefits of exercise even if the scientific data is still coming in. “We know that physical exercise is good for preventing cardiovascular disease and diabetes. If it may also help to prevent cognitive decline, for me that is an even better reason to exercise,” she says.

The Bottom Line

“Staying physically active is one of the best things that someone can do for their physical health and mental health. Physical activity can help you lose weight, lower your blood pressure, prevent depression, and, especially for older adults, promote memory and help you think clearly,” said Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Department of Health. “We are working hard to make sure that people from every zip code throughout Rhode Island have access to our state’s wonderful parks, beaches, and other natural resources and are getting the amount of physical activity they need to live long, full, productive lives.”

The Growing Incidence of Alzheimer’s

Published in Pawtucket Times on April 26, 2016

While Congress and states are nation grappling with how to put the brakes to one of the largest public health crises in recent times, the escalating Alzheimer’s disease (AD) epidemic, the Chicago-based Alzheimer’s Association releases its annual snap shot detailing statistics on the impact of Alzheimer’s and dementia on caregivers and health care costs..

According to the 2016 Alzheimer’s disease Facts and Figures, released on March 30, 2016, this year nearly 16 million Alzheimer’s caregivers will provide 18 billion hours of unpaid care to 5.4 million afflicted with this devastating disorder. That care had an estimated value of $221.3 billion, says the report.

But that’s not all, this recently released report notes that two out of three people believe that Medicare will help them over costly nursing facility costs. Sorry it won’t. AD also has a direct impact on a caregiver’s pocketbook, too, the researchers found. More than one-third of those surveyed say they were forced by caregiving duties to reduce their hours at work or just quit their job entirely. As a result of these actions their income dropped by $15,000 compared to the previous year. Eleven percent of caregivers were forced to cut back on spending for their children’s education in order to provide support.

The 79 page Alzheimer’s Association report notes that both physical, emotional and financial support required by a person with AD may ultimately deprive family and friend care givers basic necessities, such as food, transportation and medical care. The Facts and Figures report reveals that these caregivers were 28 percent more likely to eat less or go hungry while contributing care to someone with AD, and one-fifth even sacrificed their own medical care by cutting back on doctor visits. Overall, nearly half of the caregivers say they cut back on their own expenses to afford dementia-related care for their family member or friend.

“The devastating emotional and physical effects of caring for a person with Alzheimer’s disease has been well-studied,” said Beth Kallmyer, MSW, Vice President of Constituent Services for the Alzheimer’s Association. “However, this new report shows, for the first time, the enormous personal financial sacrifices that millions of care contributors must make every day. These sacrifices jeopardize the financial security of individuals and families, as well as their access to basic needs and health care.”

This year’s Facts and Figures report found that 13 percent of family or friend caregivers sold personal belongings, such as a car, to help pay for costs related to dementia, while nearly half tapped into savings or retirement funds. On average, caregivers, many of whom do not live with the person they’re caring for, spent more than $5,000 a year of their own money to care for someone with AD; however, amounts varied with many spending tens of thousands of dollars per year.
Incidents of AD is Fast Growing

The Facts and Figures report says that out of the 5.4 million (of all ages) afflicted with AD, an estimated 5.2 million are age 65 and over. Yes, one in nine people having the cognitive disorder. Approximately 200,000, having early onset AD, are under age 65.

Also, the recently released Facts and Figures report warns that we are truly in the midst of an AD epidemic as the baby boomers grow older. By 2050, researchers say that someone in the United States will develop AD every 33 seconds. Without a medical breakthroughs to prevent or cure, the age 65 and over population with AD, the incidence is expected to nearly triple, from 5.2 million to a projected 13.8 million. Some say may be even as high as 16 million. It’s the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed. .

Additionally, this year’s Facts and Figure report notes that AD is officially listed as the sixth-leading cause of death in this country. It is the fifth-leading cause of death for people age 65 and older. With the graying of America, AD will become a more common cause of death. At age 70, 61 percent of those with AD are expected to die before the age of 80 compared with 30 percent of people without the cognitive disorder — a rate twice as high, says the report.

The Typical Care Giver

The Facts and Figures report puts the face on a typical caregiver. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty one percent have a household income of $50,000 or less.

AD takes a devastating toll on the health of caregivers, says the Facts and Figures report. Nearly 60 percent of those taking care of loved ones with Alzheimer’s and dementia report that their emotional stress being high or very high. About 40 percent suffer from depression. One in five care givers cut back on their own physician visits because of their caregiving responsibilities. And, among caregivers, 74 percent report they are “somewhat” to “very” concerned about maintaining their own health since becoming a caregiver.

A Huge Cost on the Health Care System

The report’s researchers warn that the AD epidemic might just bankrupt the nation’s Medicare program. In 2016, total payments for health care, long-term care and hospice are estimated to be $236 billion for people with Alzheimer’s and other dementias, with just under half of the costs paid by Medicare. Nearly one in every five Medicare dollars is spent on people with Alzheimer’s and other dementias. In 2050, it will be one in every three dollars

Medicare and Medicaid are expected to cover $160 billion, or 68 percent, of the total health care and long-term care payments for people with Alzheimer’s disease and other dementias.

Seeing a huge rise in AD over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

A Call to Action

Yes, the AD epidemic is here, right in Rhode Island. Everyone is personally touched by either caring for a family member with the cognitive disorder or knows someone who is a caregiver or afflicted.

Following the efforts of Congress to create a national strategic plan to address the rapidly escalating AD crisis and to coordinate resources across federal agencies, the Rhode Island General Assembly passed a joint resolution enacted into law to direct the Lt. Governor’s Long Term Care Coordinating Council (LTCCC) to be the vehicle to develop a state plan to address this growing public health crisis in the Ocean State. Ultimately, for over a year former Lt. Governor Elizabeth Roberts along with LTCCC members, former Division of Elderly Affairs Director Catherine Taylor, the state Chapter of the Alzheimer’s Association, universities and health care organizations with the public input gleaned from 8 listening events hammered out the 122 page battle plan with over 30 pages of recommendations.

In 2016, Lt. Governor Daniel J. McKee has picked up the ball and convened a meeting of the Executive Board on Alzheimer’s Disease and Related Disorders, consisting of researchers, advocates, clinicians and caregivers, to begin efforts to implement recommendations from the State’s Alzheimer’s Plan. The group will determine which recommendations are outdated.

With a rising population of Rhode Islander’s with AD, state policy makers must act swiftly and lose no more time in addressing this terrible disease and public health issue.