Report: Alzheimer’s Poses Greater Risk for Older Women than Men

Published in Pawtucket Times, May 11, 2014

According to the Alzheimer’s Association 2014 Alzheimer’s disease Facts and Figures report released last Month, a woman’s estimated lifetime risk of developing Alzheimer’s at age 65 is 1 in 6, compared with nearly 1 in 11 for a man. As real a concern as breast cancer is to women’s health, women age 60 and over are about twice as likely to develop Alzheimer’s over the rest of their lives as they are to develop breast cancer, says the this years’ report.

The Facts and Figures report, an official report of the Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, is a comprehensive compilation of national statistics and information on Alzheimer’s disease and related dementias. The 75 page report conveys the impact of Alzheimer’s on individuals, families, government and the nation’s health care system. Since its 2007 inaugural release, the detailed report has become the most cited source covering the broad spectrum of Alzheimer’s issues.

“Through our role in the development of The Shriver Report: A Woman’s Nation Takes on Alzheimer’s in 2010, in conjunction with Maria Shriver, we know that women are the epicenter of Alzheimer’s disease, representing majority of both people with the disease and Alzheimer’s caregivers. The recently released Alzheimer’s Association Facts and Figures examines the impact of this unbalanced burden,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association. “Well-deserved investments in breast cancer and other leading causes of death such as heart disease, stroke and HIV/AIDS have resulted in substantial decreases in death. Geiger calls for comparable investments in research to reach the same levels of successfully preventing and treating Alzheimer’s as the other leading causes of death.

Adding to women’s Alzheimer’s burden, there are 2.5 times as many women as men providing intensive “on- duty” care 24 hours for someone living with Alzheimer’s disease, says the report, also noting that among caregivers who feel isolated, women are much more likely than men to link isolation with feeling depressed (17 percent of women verse. 2 percent of men).

Also noted in the 2014 Alzheimer’s’ Facts and Figures report released on March 19, 2014, the strain of caring for someone with Alzheimer’s is also felt in the nation’s workplace, too. Among caregivers who have been employed while they were also care giving, 20 percent of women verse. 3 percent of men went from working full-time to working part-time while acting as a caregiver. The report also noted that 18 percent of women versus. 11 percent of men took a leave of absence while 11 percent of women verses 5 percent of men gave up work entirely. Finally, 10 percent of women verse 5 percent of men lost job benefits.

Far Reaching Fiscal Human Impact of Alzheimer’s

Meanwhile the Alzheimer’s Association Facts and Figures report noted that there are more than 5 million Americans living with this devastating disorder, including 3.2 million women and 200,000 people under the age of 65 with younger-onset Alzheimer’s disease (see my May 9, 2013 Commentary). However, Alzheimer’s has far-reaching effects by impacting entire families. Also, it was reported that there are currently 15.5 million caregivers providing 17.7 billion hours of unpaid care throughout the nation, often severely impacting their own health. The physical and emotional impact of dementia care giving resulted in an estimated $9.3 billion in increased healthcare costs for Alzheimer’s caregivers in 2013.

The total national cost of caring for people with Alzheimer’s and other dementias is projected to reach $214 billion this year, says the 2014 Facts and Figures report, not including unpaid care giving by family and friends valued at more than $220 billion. In 2014, the cost to Medicare and Medicaid of caring for those with Alzheimer’s and other dementias will reach a combined $150 billion with Medicare spending nearly $1 in every $5 on people with Alzheimer’s or another dementia.

The Facts and Figures report predicts the cost numbers to soar as the baby boomers continue to enter the age of greatest risk for Alzheimer’s disease. Unless something is done to change the course of the devastating disorder, there could be as many as 16 million Americans living with Alzheimer’s in 2050, at a cost of $1.2 trillion (in current dollars) to the nation. This dramatic rise includes a 500 percent increase in combined Medicare and Medicaid spending and a 400 percent increase in out-of-pocket spending.

The country’s first-ever National Plan to Address Alzheimer’s disease has a goal of preventing and effectively treating Alzheimer’s disease by 2025. Ensuring strong implementation of the National Alzheimer’s Plan, including adequately funding Alzheimer’s research, is the best way to avoid these staggering human and financial tolls.

Lack of Understanding of the Alzheimer’s’ Disease

“Despite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain — male or female, family history or not — is at risk for Alzheimer’s,” said Geiger. “Age is the greatest risk factor for Alzheimer’s, and America is aging. As a nation, we must band together to protect our greatest asset, our brains.”

In 2010, the Alzheimer’s Association in partnership with Maria Shriver and The Shriver Report conducted a groundbreaking poll with the goal of exploring the compelling connection between Alzheimer’s disease and women. Data from that poll were published in The Shriver Report: A Woman’s Nation Takes on Alzheimer’s, which also included essays and reflections that gave personal perspectives to the poll’s numbers. For the first time, that report revealed not only the striking impact of the disease on individual lives, but also its especially strong effects on women — women living with the disease, as well as women who are caregivers, relatives, friends and loved ones of those directly affected.

Realizing the impact Alzheimer’s has on women — and the impact women can have when they work together — the Alzheimer’s Association is launching a national initiative this spring highlighting the power of women in the fight against this disease. To join the movement, visit http://www.alz.org/mybrain.

Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island and Coordinator of the Rhode Island Older Woman’s Policy Group, concurs with the findings of the Alzheimer’s disease Facts and Figures report. She calls for the education of elected officials on the facts about Alzheimer’s disease and its greater prevalence among women. “It is clearly a tragedy for the women effected with the disease, and can be devastating for their caregivers, mostly daughters, trying to keep them at home,” she says.

Maigret says that Alzheimer’s disease and other dementias at the state level have tremendous implications for this state’s budget. “Data show that in Rhode Island, about three-quarters of persons in nursing homes paid for by Medicaid are older women. An overwhelming number of them have some cognitive decline or dementia, she notes.

“We must do more to ensure that quality long-term care is available for persons with dementia and that robust caregiver support services are in place for the many families dealing with parents, spouses and other loved ones suffering from this disease,” says Maigret, stressing that government funding on research must also be greatly increased in the hopes of finding a cure or ways to prevent its onset.

Director Catherine Taylor, of the state’s Division of Elderly Affairs, believes that the Alzheimer’s’ Association’s released 2014 Facts and Figures report, about a woman’s lifetime risk of developing the devastating cognitive disorder verses breast cancer “really help us understand, in stark terms, what a public health crisis Alzheimer’s disease is, especially for women.”

Taylor notes that the Ocean State is in the implementation phase of its State Plan on Alzheimer’s disease and Related Dementias (see my November 13, 2013 commentary), where state officials are working to improve information, care and supports for every family that confronts Alzheimer’s disease. “The work will continue until there’s a cure,” she says.

“It’s important to note that new research findings also indicates that up to half of the cases of Alzheimer’s disease may be linked to risk factors “within our control,” states Taylor, adding that reducing the risk of developing Alzheimer’s disease may be a simple as eating a healthy diet, staying active, learning new skills, and maintaining maintain strong connections with family, friends and community.

For those concerned about their risk of developing Alzheimer’s disease, join Prevent AD, Rhode Island’s Alzheimer’s disease Prevention Registry. Prevent AD volunteers will learn about prevention studies for which they may be qualified to participate in, as well as the latest news on brain health. For more information, call (401) 444-0789.

The full text of the Alzheimer’s Association 2014 Facts and Figures can be viewed at http://www.alz.org/downloads/facts_figures_2014.pdf. The full report also appeared in the March 2014 issue of Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association (Volume 10, Issue 2).

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

Senior Centers, Not Just a Place to Play Bingo

Published February 1, 2013, Pawtucket Times

Today’s senior centers are not the places our parents once visited to knit or play bingo. Established in the 1980s by the U.S. Administration on Aging, the centers programming has slowly evolved to encompass activities that encourage healthy aging and wellness, says Mary Lou Moran, who oversees Pawtucket’s Leon A. Mathieu Senior Center. Established in 1980, last year over 15,000 clients took advantage of programs and social services offered, or to eat a nutritious meal, she notes.

At Rhode Island’s 47 Senior Centers, “We are now looking at the whole person, the body, mind and spirit,” notes Moran, a former Program Coordinator who now serves as Director of Senior Services. “It is very important that we encourage individuals to live independently and safely in their communities.”

At the Leon Mathieu Senior Center, health screenings, specifically taking blood pressure readings, are performed by nursing students from Rhode Island College and URI Pharmacy students, notes Moran. “Proper nutritional counseling is a very big deal, too,” she adds, noting that a nutritionist is available to provide individual counseling.

Through the Eyes of Clients

Linda Slade discovered the Leon Mathieu Senior Center after retiring from working in retail for over 38 years. Initially, attending a few exercise activities in October 2010, she was forced to stop attending, taking care of her terminally ill husband. After his passing she came back four months later “to just be with people again.”

Slade, initially had misconceptions about Pawtucket’s Senior Center. “I was a young sixty-two and not really sure what to expect,” she said, expecting to be surrounded by very old people. That first visit totally changed her mind, seeing younger people. Besides knitting, playing cards or cribbage, the Pawtucket resident participates regularly in arthritis class, stretch exercises and Tai Chi.

Before attending the Senior Center’s exercise classes, Slade’s son had given her a gym membership. “Basically I was intimated to go because of the younger people,” she says. Now Slade is more comfortable working up a sweat with her Senior Center exercise companions.

According to Slade, the City’s Senior Center offers something [activities] for everyone, her involvement even gave her an opportunity to develop new social bonds. “I had a work family that I truly adored, but now I adore my Senior Center family, too” she said. Just like the fictional bar, Cheers, Slade knows everyone’s name in all her activity groups.

“Going bonkers” and feeling a need to get out of her home propelled Nancy Connor, 79, a former Secretary to the CEO of Citizens bank, to the doors of the Leon Mathieu Senior Center. Aortic valve surgery forced the Pawtucket resident into an early retirement in her early seventies from a job she loved and found intellectually challenging.

Once the Pawtucket widow, who lives with her companion, Mave, a 60 pound Royal Standard Poodle, found the Leon Mathieu Senior Center in the Yellow Page Directory, she went to see what it was all about. She’s been going daily ever since.

The Grand Dame of the Literary Circle

Like Slade, before attending, Connor had a misconception about Senior Centers, thinking that she would see “a bunch of old people doddering along.” Now the enthusiastic participant has found out that this was not the case.

According to Connor, not as many men come into the Center. “We really do outnumber them,” she quips, noting that they “usually appear out of thin air when there is a high-low jack game.

Walking with a cane keeps Connor from exercising but she hopes to some day explore the Chinese practice of Tai Chi. However, she gets activity involved in other pursuits. Never published, she took up writing, participating in the Book and Drama Clubs, and now considers herself the “Grandma Moses” of the Senior Center’s literary circle.

Meanwhile, Connor and a few other older participants meet monthly with third year Brown Medical students to teach them the art of speaking to the “geriatric crowd,” she says. At Friday coffee hours, invited guests come into the Senior Center’s large activity room to entertain, teach or educate, she says. If a cancellation happens, she’s drafted to play piano for the crowd in the activity room.

Like in Senior Centers across the Ocean State, every day Connor can eat lunch, only paying a minimal fee. “It is wonderful stuff, from soup to nuts,” she remarks.

A Medical Model

Jill Anderson, Executive Director of Senior Services Inc., a private nonprofit corporation established in 1975, manages the Woonsocket Senior Center. Each day over 100 clients (around 500 annually) participate in exercise activities and health and wellness programs at her site. A day care program in her building handles 35 people who have limitations in their daily living.

Reflecting its medical model philosophy, the Woonsocket Senior Center’s registered nurse, who also serves as the Wellness Director, counsels people on how to change behaviors to maintain better health. Health screening, including blood pressure checks, diabetic and bone density testing are also part of a Wellness program.

About 20 retired volunteers regularly help out each day serving lunch and assisting staff, notes Anderson. “These individuals create a friendly atmosphere for the new clients, making sure they don’t sit by themselves.”

Although many of Rhode Island’s Senior Centers have an annual membership fee or charge registration fees to participate in activities, Anderson’s nonprofit does not. “We just ask people to make a voluntary weekly contribution of one dollar to fill the gap that fundraising, grants and memorials don’t cover.”

Like in many other Senior Centers, computer courses in a computer lab is offered, says Anderson. “We would like to do more with computers, maybe we can some day offer both Intermediate and Advanced computer classes, too,” she adds, because the older clients are interested in embracing new technology, like I-pads, and smart phones.

“A Benefits Councilor also is on site to identify benefits and programs our clients are entitled to receive, states Anderson, this ultimately helping to lower the cost of supplemental Medicare plans, and make other economies.

Pumping Weights

Robert Rock, Director East Providence Senior Center, on Waterman Ave., provides all the typical exercise programs that Senior Centers offer. But through a $96,000 grant received from the U.S. Administration on Aging, his Senior Center now houses the only fitness center in the Ocean State.

“The [fitness] program promotes attitude change and development of appropriate exercise skills and reduces the risks of a sedentary lifestyle. It also improves the quality of life for our senior population,” Rock says.

According to Rock, a client can gain privileges to using the fitness room for a very minimal fee of $40 for single membership, $60 for couples. Equipment includes three treadmills, two recumbent bikes, an elliptical stepper, hand weights and six dual weight machines. Other features include a matted floor, mirrored walls, water, stereo, and cable TV.

Rock notes that 90 percent of the 258 people, mostly in their 60s, are taking advantage of this fitness center room, an attachment to the Senior Center. “They come to work out and then leave,” he says, noting that the oldest, a 91-year old man comes to work out three days a week.

Rock believes that once aging baby boomers come to us for the fitness room, they will choose to come back for other programs and services offered by his Senior Center.

Walking is also an important exercise, too, says Rock. Many clients take advantage of using the Senior Center’s half mile walking track.

Finally, Rock adds that the East Providence Senior Center is also a Rhode Island state-certified site for diabetes education. Both classes and individual counseling are offered.

In conclusion…

Starting in church basements, many as small social clubs, the passage of the Older Americans Act in 1965, propelled Senior Centers into a key provider in the nation’s long term care continuum of care.

Today, 11,000 senior centers serve one million older adults every day. In Rhode Island, 47 agencies, serving 208,000 persons, are geographically spread out from Westerly to Woonsocket and from Foster to Tiverton. Some are managed by municipalities, others by nonprofit groups. While catering to serving the state’s burgeoning elderly population, some have expanded their mission to offer programs for young and middle age adults.

While the average age is age 75, many of Rhode Island’s Senior Centers are adjusting their programming and services to attract the state’s aging baby boomers by focusing on health and wellness, recreation and life long learning.

According to Rhode Island’s Division of Elderly
Affairs (DEA), over 14 percent of Rhode Island’s population is age 65 and over. By 2030, its projected to grow to over 21 percent. Rhode Island’s senior centers are a key provider to keep the aging baby boomers, healthy, independent and at home.

Yes, today’s Senior Centers are not your parent’s bingo hall, as some mistakenly believe. Why not visit your local senior center you may even be surprised with what you find. Call DEA for a complete listing of the state’s senior centers at 401/462-3000.

Herb Weiss, LRI ’12, is a freelance writer covering aging, health care and medical issues. He can be contacted at hweissri@aol.com.