RI ARA April 14, 2019 E-Newsletter by RI ARA

Publication 2019 Issue 16 Published in house by the RI ARA

April 14, 2019 E-Newsletter April is National Social Security Month

April is National Social Security Month. This year, during National Social Security Month, we will focus on the online services we provide that help put you in control — with secure access to your information anytime, anywhere. National Social Security Month is a great time to create a my Social Security account at ssa.gov/ mysocialsecurity, and learn

how to:  Request a replacement Social Security card  Set up or change direct deposit  Get a proof of income letter  Change your address, if you get benefits  Check the status of your Social Security application  Get a Social Security 1099 form (SSA-1099)

 For more than 80 years, Social Security has helped secure today and tomorrow with information, tools, and resources to meet your changing needs and lifestyles. To help raise awareness, we are providing our partners with an attachment that includes web graphics, social media posts, and web banners to help us spread the word about the many online services we provide. We hope

we can count on you to share this information with your constituents. We encourage you to review the attachment and contact us by email to explor e how you can help. Thank you in advance for helping us make this campaign a success! We look forward to collaborating with you.

Letter to AFL-CIO State Federation Presidents by Robert Roach, Joe Peters and Rich Fiesta As you know, the Alliance has been the labor movement’s retiree organization since 2001, when the AFL-CIO Executive Council established it. We are writing to provide you with our 2018 Activities Report and express our eagerness to collaborate in support of your state federation goals. The Alliance now boasts 4.4 million members and 1500 chapters nationwide. We mobilize union retirees and community members to fight for greater retirement security, including strong Social Security and Medicare programs, labor rights, and affordable health care for all Americans. The enclosed report details

how Alliance members contributed to the successful Labor 2018 midterm elections program and helped deliver a pro-retirees, pro-working families U.S. House of Representatives as well as great gains at the state and local level nationwide. Alliance retirees were active in GOTV efforts across the country. Union retirees turned out in very high numbers and voted two-to-one in favor of our endorsed candidates. Our activists continued deep engagement in their communities, supporting affiliate priorities and holding more than 600 grassroots actions, events, and lobby visits.

In 2019, we will continue to advocate and build support for retirement security, including strengthening and expanding Social Security and Medicare and protecting earned pension benefits. The Alliance is growing as we join our participating unions and state federations to fight for retirees and working families. This year we will also continue our educational series on the pension crisis, convening government, union and private sector experts around ways to address current pension issues. And as 2020 approaches, we are laying the groundwork for a massive mobilization of seniors on behalf of labor-endorsed

candidates. This presidential election cycle is crucial and we will work for candidates up and down the ballot. We believe we are the most effective grassroots seniors and retirees organization fighting to ensure retirement security for working families. Our goal is to continue to partner and strengthen our work with your state federation. Please let us and our state Alliance know how we grow our strength. Together we can mobilize our members to fight for a stronger labor movement and country so that all Americans will have the secure retirement they have earned after a lifetime of work. Read the letter

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/

President Trump’s Budget Proposal Represents a Vision for the Country That Does Not Prioritize People with Medicare A shorter version of this post appeared in the New York Times as a letter to the editor written by Joe Baker, president of the Medicare Rights Center and Judith Stein, executive director of the Center for Medicare Advocacy, in response to the editorial board piece titled, “Not All Medicare Cuts Are Bad.“ The President’s annual budget request to Congress is a powerful document, as it represents the administration’s vision for the country—a roadmap for where it would like lawmakers to go. It reflects the administration’s fiscal and programmatic priorities, which again this year do not include people with Medicare. Further, because many older adults and people with disabilities look to a constellation of programs to stay healthy as they age, the budget’s Medicare cuts alone don’t tell the full story of how the Trump administration’s vision for the future would impact beneficiaries.

The Medicare Rights Center agrees that conserving Medicare resources to preserve the program for generations to come is an important goal. We support commonsense, meaningful reforms that would make Medicare more efficient and sustainable without jeopardizing beneficiary access to care—such as better aligning payment incentives, r educing program and out-ofpocket costs for prescription drugs, and improving program solvency. But achieving federal savings by impeding Medicare beneficiaries’ access to care is unacceptable—and some of the policies in the President’s 2020 budget request would do just that. Among the budget’s problematic Medicare provisions are changes to the Medicare Part D prescription drug program that would increase enrollee costs, efforts to curtail beneficiary appeal rights, and the proposed expansion of prior

authorization in Original Medicare—all of which could make it harder for people with Medicare to obtain needed care. We have similar concerns with some of the outlined cuts to Medicare providers. Though intended to control costs by reducing spending growth in provider payments rather than by cutting services directly, we are skeptical that reductions of the magnitude proposed could be implemented without negatively affecting beneficiaries. While it’s true that the Affordable Care Act (ACA) also made adjustments to Medicare reimbursements, these savings were coupled with reinvestment efforts to expand and improve health coverage. The Trump administration’s budget includes no such strategy. Instead, its Medicare spending reductions are recommended alongside significant cuts to other health care programs on which older adults and people with

disabilities rely—including Medicaid and the ACA. These changes echo prior legislative and administrative proposals to deeply cut and fundamentally restructure the Medicaid program, to the detriment of the 12 million older adults and people with disabilities who rely on both Medicare and Medicaid for their health and long-term care needs. They also reaffirm this administration’s commitment to eliminating the ACA— including the law’s consumer protections and Medicare reforms that have made the program more sustainable and its coverage more affordable. Importantly, these cuts are not hypothetical. The 115th Congress saw repeated attempts to repeal the ACA and dismantle Medicaid, and the administration has relentlessly pursued regulatory changes that would achieve similar goals. The political reality of split-party control in the current Congress appears to have only emboldened

Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries Oral health is an integral part of overall health, but its importance to overall health and well-being often goes unrecognized.1 Untreated oral health problems can lead to serious health complications. Having no natural teeth can cause nutritional deficiencies and related health problems.2 Untreated caries (cavities) and periodontal (gum) disease can exacerbate certain diseases, such as diabetes and cardiovascular disease, and lead to chronic pain, infections, and loss of teeth.3 Lack of routine dental care can also delay diagnosis of

conditions, which can lead to potentially preventable complications, high-cost emergency department visits, and adverse outcomes. Medicare, the national health insurance program for about 60 million older adults and younger beneficiaries with disabilities, does not cover routine dental care, and the majority of people on Medicare have no dental coverage at all. Limited or no dental insurance coverage can result in relatively high

out-of-pocket costs for some and foregone oral health care for others. This brief reviews the state of oral health for people on Medicare. It describes the consequences of

foregoing dental care, current sources of dental coverage, use of dental services, and related out-of-pocket spending….Read More

Enrollment, Coverage, and Prescription Drug Affordability Issues Continue to be Challenges for People with Medicare Today, the Medicare Rights Center released its annual helpline trends report, which outlines the top ongoing challenges facing people with Medicare. The report’s findings are based on thousands of calls to the Medicare Rights’ national consumer helpline and millions of visits to Medicare Interactive, the online Medicare reference tool developed by Medicare Rights. “Year after year, our findings from the analysis of our national helpline data show that too many older adults and people with disabilities have problems navigating the complexities of the Medicare program and affording their coverage. But there are straight-forward solutions for alleviating these challenges and strengthening the

Medicare program as a whole,” said Joe Baker, president of the Medicare Rights Center. “It’s time that the reallife experiences of people with Medicare who are trying to access needed health care are taken into account and acted on to improve the Medicare program.” The report, Medicare Trends and Recommendations: An Analysis of 2017 Call Data from the Medicare Rights Center’s National Helpline, examines the top three issues heard on Medicare Rights’ helpline and the most commonly searched for answers on Medicare Interactive. Each issue is demonstrated through stories heard on the helpline,

which the Centers for Medicare & Medicaid Services (CMS), state agencies, insurers, elected officials, and other stakeholders can use as a basis to strengthen the Medicare program for the 60 million people it serves. Out of more than 15,000 questions asked by older adults, people with disabilities, and their caregivers in 2017, and millions of visits to Medicare Interactive, a variety of trends highlighted in the past annual trends reports continue to stand out:  · navigating Medicare Part B enrollment;  · appealing Medicare Advantage denials of care; and  · affording prescription drug

coverage. “The problems heard each year on the Medicare Rights helpline show the need for practical policy solutions to address some of the challenges faced by people with Medicare,” said Baker. “Members of Congress and the Administration should view this report as a continuing call to action. With 10,000 people turning 65 every day, there is no time to wait to make Medicare easier to navigate and more affordable, so that it is an even stronger benefit.” Read the report. To contact Medicare Rights’ national helpline, call 800-3334114. For more information about Medicare, visit www.medicareinteractive.org.

How Much Does Medicare Spend on Insulin? The rising cost of prescription drugs is currently a major focus for policymakers. One medication that has come under increasing scrutiny over its price increases is insulin, used by people with both Type 1 and Type 2 diabetes to control blood glucose levels. Among people with Medicare, one third (33%) had diabetes in 2016, up from 18% in 2000. The rate of diabetes is higher among certain groups, including more than 40% of black and Hispanic beneficiaries. Although not all people with diabetes take insulin, for many it is a lifesaving medication and essential to maintaining good health. Three companies—Eli Lilly, Novo Nordisk, and Sanofi— manufacture most insulin products, and ther e ar e no generic insulin products currently available, despite the fact that insulin was discovered in the 1920s. Committees in both the House and the Senate recently convened hearings on

prescription drug costs that focused on rising insulin prices and affordability concerns for patients, and congressional investigations are underway. This data note examines spending on insulin by Medicare and beneficiaries enrolled in private Part D drug plans, based on data from the Centers for Medicare & Medicaid Services (see Data and Methods). Because drug-specific rebate data for Medicare are proprietary, the analysis examines Medicare spending without rebates, but also uses average Part D rebates reported by Medicare’s actuaries to illustrate the potential effects on total Part D insulin spending. While rebates may help to lower Part D premiums, they do not lower enrollees’ out-of-pocket drug costs, which are based on list prices. With rising prices and the introduction of more costly insulin products over time, average total Medicare Part D

spending per user on insulin products increased by 358% between 2007 and 2016, from $862 to $3,949. Aggregate out-of-pocket spending by Part D enrollees on insulin quadrupled between 2007 and 2016, from $236 million to $968 million, reflecting both an increase in the number of users and price increases for insulin. Among enrollees without low-income subsidies, average per capita out -of-pocket spending on insulin nearly doubled between 2007 and 2016 (from $324 to $588; an increase of 81%). Among all insulin products, Lantus Solostar, a

long-acting insulin manufactured by Sanofi, accounted for the largest share of both total Part D spending and out-of-pocket spending by enrollees who used insulin. Spending on Lantus Solostar, which was used by 1.1 million Part D enrollees in 2017, accounted for 20% of total Part D spending on insulin therapies in 2017 and 25% of out-ofpocket spending on insulin by non-low income subsidy enrollees in 2016….Read More

Consumers Rejected Drug Plan That Mirrors Trump Administration Proposal Unraveling how much of a prescription drug price gets swallowed by “middlemen” is at the forefront of Tuesday’s drug price hearing in the Senate. One thing bound to come up: rebates. Both major political parties have shown interest in remedying high drug prices, and drugmakers have bemoaned how rebates to middlemen keep them from reaping every dollar associated with those price tags. Pharmacy giant CVS Health criticized the Trump administration’s proposal to

end these posttransaction discounts as they apply to Medicare. Yet, in January the company rolled out a Medicare drug plan that experts say is similar “in spirit” to the administration’s proposal. The CVS Caremark plan wasn’t popular with customers, and CVS Health, which owns CVS Caremark, was quick to point this out as evidence that consumers prefer the current rebate system.

“We had a very, I would say, small number of seniors enroll in that program,” Larry Merlo, CVS Health’s CEO said on a February earnings call with investors. “And we think one of the barriers to that was the increase that we saw in the monthly premium.” The CVS plan’s premium was $80 a month, which is about double the average Medicare Part D monthly charge. But since it is designed to pass on a portion of rebates

directly to patients at the pharmacy counter, certain patients would wind up with smaller out-of-pocket costs than they previously paid. “Even very well-informed consumers would not necessarily understand that a higher premium plan in this case means that they’re incurring smaller amounts at the point of sale,” said Rachel Sachs, an associate law professor at Washington University in St. Louis who specializes in health care….Read More

Don’t trust your health plan’s provider directory Traditional Medicare’s “one size fits all” approach offers a wide choice of doctors and hospitals at a predictable cost, for which you can budget. With commercial insurance, be it through a Medicare Advantage plan, a state health care exchange, or your employer, your choice of doctors and hospitals can be quite limited; and you may not be able to see the doctors you want to see. Beyond that, you can’t trust your health plan’s provider directory to reflect accurately the doctors you can use or the locations at which you can get care. If you’re looking to see

certain doctors, a plan’s provider directory may list them as part of their network, but the doctors may not be in your health plan. And, if the doctors are in your health plan, they may not be taking new patients from your health plan. Or, the doctors may only be seeing patients from your health plan at a location that is inconvenient for you, which is different from the location listed in the directory. (Here are two tips to help you choose a health plan.) To address problems with health plan provider directories and help people make better

decisions about their health plans, CMS imposed rules on health plans that became effective in 2016. Both Medicare Advantage plans and plans in the state health exchanges must publish up-to-date provider directories, including which doctors are seeing new patients, their locations, contact information, specialties and hospital affiliations. And, in addition to making them easily accessible, they must keep them updated each month. Three years later, the rules are not working. CMS may impose penalties on Medicare Advantage plans

up to $25,000 per person enrolled if they violate the rules and up to $100 per enrollee on health plans in the state exchanges. These penalties should deter plans from listing doctors in their directories who have left their plans as much as ten years back, as some have been doing, but they have not. (In November 2014, California levied penalties of $250,000 each on Blue Cross of California and Anthem Blue Cross because 25 percent of the doctors they listed said they did not accept these plans or did not offer services at the listed locations.) ...Read More

Understanding Older Patients On this page:  Use Proper Form of Address  Make Older Patients Comfortable  Take a Few Moments to Establish Rapport  Try Not to Rush  Avoid Interrupting  Use Active Listening Skills  Write Down Take-Away

Points  Demonstrate Empathy  Avoid Jargon  Reduce Barriers to Communication  Be Careful About Language  Ensure Understanding  Compensating for Hearing Deficits

 Compensating for Visual Deficits What was once called "bedside manner" and considered a matter of etiquette and personal style has now been the subject of a large number of empirical studies. The results of these studies suggest that the interview is integral to the

process and outcomes of medical care. Effective communication has practical benefits. It can:  Help prevent medical errors  Lead to improved health outcomes  Strengthen the patientprovider relationship Make the most of limited interaction time...Read More

Elder Abuse On the Rise in America As the American population ages, elder abuse rates are increasing, particularly among men, federal health officials reported Thursday. Between 2002 and 2016, the rate of assaults among men 60 and older jumped 75%, while it rose 35% among women between 2007 and 2016. Among older men, the homicide rate increased 7% between 2010 and 2016, according to the U.S. Centers for Disease Control and Prevention. "We are still examining the circumstances that appear to be associated with the increase in violence against this age demographic," said lead researcher Joseph Logan, from the CDC's National Center for Injury Prevention and Control. "We have identified that many of the assailants were known to the victims and in a position of trust," Logan noted. Dr. Ronan Factora, chair of the Special Interest Group on Elder Abuse and Mistreatment at the American Geriatrics Society, thinks the problem is probably even worse than the report suggests. "These data underestimate the extent of elder abuse in America," he said. "We

probably underestimate the amount of physical violence, because this study only used records from emergency departments." Many more cases of abuse were probably seen by private doctors or not reported at all, said Factora, who had no part in the study. "This is really a small fraction that represents a larger problem that has been growing," he added. The biggest issue is that most elder abuse isn't recognized, Factora said. That's because there isn't a standard way to screen for it or recognize it. Factora believes, however, that elder abuse is gaining more visibility, which may be part of why it's seen as increasing. "As the years have gone by, elder abuse has become more highlighted and thus better detected," he said. "But the increase is not just a demographic issue." Factora said that much of the abuse among people who are physically or mentally impaired is perpetrated by caregivers who are stressed out by the demands of caring for a loved one. Still, "abuse can have lasting effects that aren't reversible after

a certain point," he said. "People who need help with transportation, finances and medication put a lot of burden on caregivers," Factora said. According to the CDC report, it's family members who commit most of the violence. "A lot of this is because of the demands placed on them for care, which really puts a stress on them," Factora said. Unfortunately, many seniors are in jeopardy because of their physical or mental condition, and can't defend themselves, he said. Abuse is really related to dependency, Factora explained. Help in finding ways to cope with the burden of caring for someone is available. Perhaps if more people took advantage of programs for family caregivers, a lot of elder abuse could be stopped before it starts, he suggested. "The resources are there. The problem is connecting the caregivers who are burned out with the resources that can help them," Factora said. The best way to deal with elder abuse is through awareness of all its forms. This study deals with physical abuse

and murder, he pointed out, but abuse also includes neglect and financial exploitation. Often a person is the victim of several kinds of abuse. Someone who is physically abused can also be neglected and financially exploited. Factora believes that if you see or suspect someone is a victim of elder abuse, you should report it to adult protective services. "We need to find these cases, and once we find how big this epidemic is, that may be a push to identify the abuse we don't see," he said. "What we are seeing is the tip of the iceberg." For the study, researchers used data from the U.S. National Electronic Injury Surveillance System -- All Injury Program and National Vital Statistics System to look for trends in assaults and murders among men and women aged 60 and older. The report was published April 5 in the CDC's Morbidity and Mortality Weekly Report. More information For more on elder abuse, visit the U.S. National Institute on Aging.

Americans' Pets Help Ease the Aging Process, Poll Finds Richard McIntosh hadn't had any pets since his childhood farm dogs, but then he started a relationship with a competitive dog trainer and found his life filled with Golden Retrievers. Now McIntosh, 59, of Cornelius, Ore., can't imagine growing old without a dog or two by his side. "There was a little something missing from my life," McIntosh said. "These dogs give me activity, they give me joy, companionship. When I'm not feeling good, they're there for me. When I am feeling great, we're playing and

running. I get a lot out of it." According to a new poll, McIntosh is one of many aging pet owners who swear that their animal buddies help them better cope with the physical and mental issues that come with age. About 55% of U.S. adults aged 50 to 80 have a pet, and an overwhelming majority of them say that their pets bring a host of positive benefits to their lives, the new National Poll on Healthy Aging found.

"Most people who have pets perceive that they are beneficial to their physical and emotional health," said Mary Janevic. She is an assistant research scientist with the University of Michigan School of Public Health, who helped design the poll. The benefits of pet ownership for older folks included:  Helping them enjoy life (88%)  Making them feel loved (86%)

 Reducing their stress (79%)  Providing a sense of purpose (73%)  Connecting them with other people (65%)  Helping them stick to a routine (62%) It's long been shown that loneliness can strongly detract from healthy aging, and pets are a way to combat that, explained Dr. Alice Pomidor, a professor of geriatrics with the Florida State University College of Medicine. ...Read More

Lethal Plans: When Seniors Turn To Suicide In Long-Term Care A six-month investigation by KHN and PBS NewsHour finds that older Americans are quietly killing themselves in nursing homes, assisted living centers and adult care homes. When Larry Anders moved into the Bay at Burlington nursing home in late 2017, he wasn’t supposed to be there long. At 77, the stoic Wisconsin machinist had just endured the death of his wife of 51 years and a grim new diagnosis: throat cancer, stage 4. His son and daughter expected him to stay two weeks, tops, before going home to begin chemotherapy. From the start, they were alarmed by the lack of care at the center, where, they said, staff seemed indifferent, if not incompetent — failing to check on him promptly, handing pills to a man who couldn’t swallow. Anders never mentioned suicide to his children, who camped out day and night by his bedside to monitor his care. But two days after Christmas, alone in his nursing home room, Anders killed himself. He didn’t leave a note. The act stunned his family. His daughter, Lorie Juno, 50, was so distressed that, a year later, she still refused to learn the details of her father’s death. The official cause was asphyxiation. “It’s sad he was feeling in such a desperate place in the end,” Juno said. In a nation where suicide continues to climb, claiming more than 47,000 lives in 2017, such deaths among older adults — including the 2.2 million who live in long-term care settings — are often overlooked. A six-month investigation by Kaiser Health News and PBS NewsHour finds that older Americans are quietly killing themselves in nursing homes, assisted living centers and adult care homes. Poor documentation makes it

difficult to tell exactly how often such deaths occur. But a KHN analysis of new data from the University of Michigan suggests that hundreds of suicides by older adults each year — nearly one per day — are related to long-term care. Thousands more people may be at risk in those settings, where up to a third of residents report suicidal thoughts, research shows. Each suicide results from a unique blend of factors, of course. But the fact that frail older Americans are managing to kill themselves in what are supposed to be safe, supervised havens raises questions about whether these facilities pay enough attention to risk factors like mental health, physical decline and disconnectedness — and events such as losing a spouse or leaving one’s home. More controversial is whether older adults in those settings should be able to take their lives through what some fiercely defend as “rational suicide.” Tracking suicides in long-term care is difficult. No federal regulations require reporting of such deaths and most states either don’t count — or won’t divulge — how many people end their own lives in those settings.

Briana Mezuk, an associate professor of epidemiology at the University of Michigan, found in 2015 that the rate of suicide in older adults in nursing homes in Virginia was nearly the same as the rate in the general population, despite the greater supervision the facilities provide. If You Need Help If you or someone you know has talked about contemplating suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255, or use the online Lifeline Crisis Chat, both available 24 hours a day, seven days a week. People 60 and older can call the Institute on Aging’s 24hour, toll-free Friendship Line at 800-971-0016. IOA also makes ongoing outreach calls to lonely older adults….Read More

in and out of bed) and they kept a brief on me day and night. and gave me a water pill every day. Physical therapy consisted of 40 minutes a day. The rest of the time I was in bed. Unlike hospitals where if you press a call button someone answers over a two way system, at SNF when you press a call button it only lights a light outside your room. You can wait as much as 20-30 minutes for someone to come see what you need. That could mean the difference between life and death. What use to be very good SNF are being purchase by big groups and the bottom line is more important than patient care. They have cut back on staff to keep cost down. In my case, three CNA’s and two nurses for 31 patients. Each CNA was responsible for taking breakfast orders, On a personal note. I have putting up the orders and experienced what nursing serving them, picking up the homes can do to you. breakfast trays then getting After my Gallbladder surgery patients up, cleaned and I was sent to a SNF for rehab. dressed. I spent 31 days at a SNF and If you have a loved one in a what my surgery didn’t take out SNF, make sure they are being of my body, the SNF did. treated with dignity . I was hoyered (The Hoyer John A. Pernorio, Lift is a mechanical device President, RI ARA designed to lift patients safely

RI ARA HealthLink Wellness News

For your mental health, feed your brain The New York Times reports on nutritional psychiatrists who advise people to eat as little processed foods, meat and dairy products as possible in order to ease anxiety and mild depression. Instead, for your mental health, they recommend a rainbow of natural foods, including lots of fresh fruits and vegetables. Is it possible that how you feel turns on what you eat? Dr. Drew Ramsey, a nutritional psychiatrist, recommends eating oysters because they have vitamin B12 and omega-3 fatty acids. According to some studies, B12 can keep your brain from shrinking. And, you are at risk for suicide and depression without adequate omega-3 fatty acids. Keep in mind, however, that there is no good evidence to suggest taking B12 or omega-3 fatty acids in supplement form

has any health benefit. Moreover, Cochrane.org, the gold star for analyzing the research data, says the evidence is not conclusive that eating omega-3 fatty acids treats depression. Dr. Ramsey also believes that eating unhealthy foods contributes significantly to depression. Amer icans eat a lot of calories but do not eat a lot of micronutrients found largely in fruits and vegetables that help our brains to thrive. We need to eat between 12 and 16 ounces of fruit and between 16 and 24 ounces of vegetables every day. Yet, just 10 percent of adults eat that much fruit and vegetables. To treat depression, Dr . Ramsey appreciates that talk therapy can be beneficial, as are prescription drugs in many cases. He and others believe that supplementing those treatments

with whole foods can be invaluable. In addition to fruits and vegetables, they recommend fatty fish, whole grains and legumes. Foods high in phytonutrients promote the generation of new brain cells and reduce the risk of harmful inflammation. There are a few studies to support Dr. Ramsey’s view. One 2016 study of 12,000 Australians found that those who ate more fresh fruits and vegetables were happier and had a greater sense of well-being than those who did not do so. A 2017 study of 422 young adults from the US and New Zealand had similar findings. Canned fruits and vegetables did not deliver the same results. A 2017 randomizedcontrolled trial also showed that a 12-week Mediterranean diet improved people’s moods

and reduced their anxiety levels. The Mediterranean diet apparently delivers good gut bacteria. And, good gut bacteria has been found to help process serotonin, a mood elevator. Dr. Lisa Mosconi, who directs the Women’s Brain Initiative at Weill Cornell in New York City, has found, based on imaging studies, that people who eat Mediterranean diets typically have brains that look younger and are more active metabolically than people who do not. These people may have a lower risk of dementia. In short, it appears wise to pay attention to what you feed your brain. Your brain needs a lot of nourishment; it consumes more energy than any other organ in your body. Avoiding processed and fried foods is a good beginning. It may improve your mood and make you feel better.

PPIs found to increase risk of kidney failure Routine use of proton pump inhibitors, common over-thecounter medications used to treat acid reflux, can increase the risk of kidney failure four-fold. Researchers examined health data on more than 190,000 patients over a 15-year period in a retrospective study. None of the patients had existing kidney disease at the start. Researchers compared patients who were eventually given a PPI and those

who weren’t ever given one. Common PPIs include Prevacid (lansoprazole), Prilosec (omeprazole) and Nexium (esomeprazole). Results, published in Pharmacotherapy, found that those on a PPI had a 20% increased risk of chronic kidney disease compared with those not on the drug. In addition, those on a PPI were four times as likely to

experience kidney failure. The study authors noted that the risks were highest in those 65 and older. Although PPIs are only meant for short-term use, overuse of the medications are as high as 70% of patients. Lead author David Jacobs, PharmD, PhD, assistant professor of pharmacy practice at the University of Buffalo

School of Pharmacy and Pharmaceutical Sciences, noted that doctors need to be educated on the dangers of overuse of PPIs and deprescribing initiatives developed. Last month, a study that analyzed adverse events reports sent to the FDA found that PPIs were associated with an increased risk of kidney disease.

Brain 'Zap' Might Rejuvenate Aging Memory It's common for folks to minds, a new become less sharp as they age, laboratory study taking a little longer to do math in suggests. their heads or work out a knotty The memory problem. But scientists might performance of people have a potential solution. aged 60 to 76 equalled that of Brain stimulation using twenty-somethings after they got extremely weak electrical current 25 minutes of electrical might be able to reverse this and stimulation to specific regions of restore youthful vigor to aging their aging brains, researchers

found. Working He's an assistant professor of memory is the ability psychological and brain sciences to temporarily retain at Boston University. information needed for The results were also similar processing. to those seen in a group of The effect lasted for at least 50 people in their 20s, the study minutes after the brain authors said...Read More stimulation stopped and likely extends for hours longer, said lead researcher Robert Reinhart.

Why Do Older Heart Attack Patients Get Worse Care? If you're over 65 and have a heart attack, your care may be compromised, a new study finds. In fact, you're less apt than younger patients to receive a timely angioplasty to open blocked arteries. You're also likely to have more complications and a greater risk of dying, researchers say. "Seniors were less likely to undergo [angioplasty] for a heart attack and if they do receive the procedure it's not within the optimal time for the best possible outcome," said lead researcher Dr. Wojciech Rzechorzek, a resident at Mount Sinai St. Luke's and Mount Sinai West Hospital in New York City. "Their prognosis is worse than for younger patients with the same conditions, and this lack of treatment or delay in treatment could be a factor," he noted. But a New Jersey heart specialist said the delays in care are not neglect, but necessary. "One of the most important things to keep in mind is that the older population is often sicker," said Dr. Barry Cohen, who was

not involved in the study. "Their conditions are often much more complicated, and for providers, that can mean treatment can't be given right away." Older patients are more likely to have conditions such as kidney disease, as well as heart failure, diabetes or past heart problems. Before taking any patient for an angioplasty, it's important to do a risk assessment, said Cohen, who is medical director of the cardiac catheterization lab at Atlantic Health System Morristown Medical Center. "We're not stalling, we're strategically thinking about what is best for the patient, despite the desire to be under 90 minutes for door-to-angioplasty time," he added. For the study, Rzechorzek and colleagues reviewed 2014 data on more than 115,000 heart attack patients nationwide. Of those, 54 percent were over 65. Their review found that seniors were 34 percent less likely than younger patients to have an angioplasty. In the

procedure, special tubing is inserted into a narrowed or blocked artery, where a balloon is inflated to open the blockage. Sometimes, a stent is also placed to keep the vessel open. The study found seniors were 36 percent less likely to receive a stent, and 34 percent less likely to have one placed within 48 hours. Although both groups received the same drugs and surgical treatments, older patients had worse results, researchers said. Compared to younger patients, older ones were 62 percent more likely to develop heart failure, and 28 percent more likely to go into shock. They were also 21 percent more likely to have a cardiac arrest, and 10 percent more likely to need a ventilator to help them breathe, according to the study. Though older patients stayed in the hospital longer, the cost of their care averaged about $3,231 less than that of younger patients. Researchers suspect

that's because many didn't have angioplasty, a costly treatment. Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said there is a real problem in how older heart attack patients are treated. "While the investigators found that older patients had lower adjusted total hospital charges despite lower quality care and worse outcomes, this finding further illustrates how misleading and counterproductive it is for Medicare to be using cost data as a hospital level metric of quality and value," said Fonarow, who was also not part of the study. These findings highlight how important it is to improve the quality of care, particularly for older patients with heart attacks in U.S. hospitals, he said. The study was scheduled to be presented Saturday at a meeting of the American Heart Association, in Arlington, Va. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Concerns over direct-to-consumer online prescriptions The paradigm of the doctorpatient relationship is changing. Companies like Hims and Roman allow people to order prescription drugs for conditions like hair loss and erectile dysfunction without seeing a doctor face-toface. Customers simply pick out what medicine they want, fill out an online questionnaire, and then submit it for review by a doctor. After answering about 20 questions, a "CBS This Morning" producer was able to order generic Viagra from Roman in a couple of hours, without ever talking with a doctor. About an hour later, the drugs had shipped.

Dr. Arthur L. Caplan, a medical ethics professor at New York University School of Medicine, has called such online drug services "restaurant-menu medicine." Dr. Tara Narula, a CBS News medical contributor, said, "We are living in a whole new world where people want things on demand; we want our Uber on demand, our food on demand. And now we want our prescription meds on demand. And there are companies that have millions of dollars backing them saying that this will work because it's easy, it's discreet,

it's affordable, and it's streamlined, and they're betting on conditions that people want to maintain privacy around things like erectile dysfunction, hair loss, skin care, libido." She said it is turning the practice of medicine on its head: "In the past it was the doctor prescribing and diagnosing; now, it's the patient self-diagnosing and selfdescribing. The doctor is [merely] a gateway." Another concern is when medications are prescribed for reasons that are not included in the drug's FDA-approved labeling, known as "off-label

use." For example, "propranolol, a beta blocker sometimes used for blood pressure, they're marketing in an off-label way, which is for social performance anxiety," Narula said. "Drug companies and distributors cannot market off-label — it is illegal. But these companies are getting around this, they're flying under the radar, because they're saying, 'We're not a drug company, we're a platform.'" Narula sees definite problems with self-prescribing. "First and foremost, it erodes the whole nature of a doctor-patient relationship, that trust-building, time you had together to work on things like prevention," she said. ….Read More

What are probiotics and should you take them? These days, it seems that everyone is recommending particular diets to improve your health. And, lots of people, including Consumer Reports, are recommending probiotics, such as dark chocolate, greek yogurt, kimchi and sauerkraut. What are probiotics and should you take them? According to the National Institutes of Health, pr obiotics are microorganisms similar to good bacteria in our guts. It warns that the U.S. Food and Drug Administration (FDA) has

not approved any health claims about the benefits of probiotics. There is some evidence that probiotics can benefit people with diarrhea and irritable bowel syndrome. But, there is more research needed. Benefits have not been shown conclusively, and it’s not clear which, if any, probiotics are beneficial. The data suggest that side effects of consuming probiotic foods and drinks are few for

people who are relatively healthy. But people who are critically ill with weak immune systems or post surgery could experience severe side effects, including infections. The NIH warns against taking probiotic dietary supplements, marketed like vitamins as capsules or tablets, without first talking to your doctor. They are not regulated by the FDA and it’s not always clear what ingredients they contain.

[Editor’s note: New studies reported in StatNews continue to warn against taking probiotic supplements. They also suggest probiotics may not be good for your immune system. Findings from one small study show that people taking probiotic supplements who were also getting cancer immunotherapy treatment for melanomas were far less likely to respond to the treatment. Eating more fiber appeared to help people respond to the immunotherapy treatment.]

Blood test shows promise in predicting presymptomatic disease progression in people at risk of familial Alzheimer’s Finding early-stage biological markers of Alzheimer’s disease to predict who will and won’t progress to dementia is an evolving area of research. A blood test for the protein neurofilament light chain (NfL) predicted disease progression and brain neurodegeneration in cognitively normal individuals at risk for familial Alzheimer’s disease (FAD), a rare, earlyonset form, a recent study shows. It is unknown if NfL in blood might help predict onset of the more common, late-onset form of Alzheimer’s dementia,

as well as other neurodegenerative diseases. Specialized brain scans and lumbar punctures are used to measure certain changes in the brain and cerebrospinal fluid that occur years before dementia symptoms begin. But these procedures are relatively invasive and expensive, leading researchers to pursue other methods such as blood tests. To date, the few experimental blood tests most often measure the amyloid protein. In a study

published Jan. 21 in Nature Medicine, researchers led by the German Center for Neurodegenerative Diseases examined a different protein, NfL, as a potential blood biomarker. The researchers analyzed data from 405 participants in the Dominantly Inherited Alzheimer Network (DIAN), an NIA-supported, global study of families affected by genetic mutations that cause FAD. Participants included 243 people with a genetic mutation and 162

without it. For a given mutation, symptoms tend to start at about the same age, allowing researchers to calculate the estimated years to symptom onset. Following the participants over a median of 3 years, the researchers found that in mutation carriers, NfL levels in blood began to rise up to 16 years before the estimated age of onset of Alzheimer’s symptoms. NfL rate of change accelerated as these individuals got closer to this age…..Read More

High cholesterol, other factors shown to increase risk for ALS We’ve long known that high cholesterol levels are bad for our cardiovascular health. The largest genetic data analysis to date of risk factors for amyotrophic lateral sclerosis (ALS) found that higher cholesterol also raised the risk of developing the neurodegenerative disease. The research, a collaboration between investigators from the Laboratory of Neurogenetics in the NIA Intramural Research Program and a global team of colleagues, was published in the Feb. 1 issue of Annals of Neurology. ALS—a fatal

neurodegenerative disease with no known cure— impacts the brain and nerves. Its symptoms usually include muscle weakness or cramps, slurred speech, trouble swallowing, and involuntary movements. ALS is more common in people over age 50 and is usually fatal within 2 to 5 years once symptoms develop. The number of global ALS cases is expected to nearly double in the next 20 years, due to an aging world population. In addition to the low-density lipoprotein (LDL, the “bad”

cholesterol that can build up to blockages in blood vessels) cholesterol hazard, the investigators found that smoking and having lower levels of education were also associated with higher risks for ALS. Interestingly, they found that light exercise, such as walking, protected against the chance of developing the disease, but more intense exercise was related to an increased risk. Analyzing statistics from publicly available genome-wide association studies, the research

team explored data from nearly 21,000 ALS cases and over 59,000 controls. The scientists explored genetic markers for overlaps and connections among over 700 traits and habits, such as education, physical activity, and smoking status, with the risk of developing ALS. The team included scientists from the United Kingdom, Spain, Italy, United States, and Finland. Combined, they pulled data from about 25 million people worldwide. ….Read More