Thursday, January 5, 2017

Updated BEERS List

Hi readers, a serious issue is overmedication of older adults and/or taking medications that cannot be adequately metabolized by the older body.  Never assume that medical professionals know appropriate dosage or if the prescribed medication is appropriate for you.  Be proactive and ASK, “Is this aligned with the Beers list?”  Some medications on this list are over-the-counter medications, so pay attention to what you take and how much.  Below is a blurb about the Beers list and I have also attached the link for the updated list here.

What is the Beers List and Why Do I Need it?
“For more than 20 years, the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults has been the leading source of information about the safety of prescribing drugs for older people. To help prevent medication side effects and other drug-related problems in older adults, the American Geriatrics Society (AGS) has updated and expanded this important resource. The expanded AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults identifies medications with risks that may be greater than their benefits for people 65 and older. “
Why Experts Developed the Beers Criteria

“As you get older, your body changes. These changes can increase the chances that you’ll have side effects when you take medications. Older people usually have more health problems and take more medications than younger people. Because of this, they are also more likely to experience dangerous drug-drug interactions. Every year, one in three adults 65 or older has one or more adverse (harmful) reactions to a medication or medications. This is why it’s important for researchers to identify and help reduce use of drugs that are associated with more risks than benefits in older people. The Beers Criteria was last updated in 2003. The criteria need to be updated regularly because new drugs continue to be marketed and new studies continue to provide information on the safety of existing medications. In 2011, the criteria was updated by the American Geriatrics Society using a panel of healthcare and pharmacy experts. The AGS will continue to update the criteria on a regular basis.”

Wednesday, September 14, 2016

Successful Aging

What is “successful aging?”  It depends.  Scientists and scholars have been actively and robustly addressing this topic for over fifty years.  Recently, Dr. Leonard Poon’s distinguished multi-disciplinary team carefully reviewed the literature and conceded that we cannot agree on what it means to age “successfully,” as that is a relative term with cultural, religious, psychological, and biological factors to consider.   

While most of the earlier studies focused on identifying successful aging as maintaining optimum health and avoiding disease, more contemporary models have emerged.  For example, the MacArthur study defined optimum or positive aging as “freedom from disease and disability, high cognitive and physical functioning, and active engagement with life” (Martin et al.,  2015, p. 18).  Does the absence of these three criteria equate to unsuccessful or negative/undesirable aging?  Are older adults able to age successfully in spite of health declines?  The Poon study (Martin et al., 2015) is worth reviewing, as it is a comprehensive literature review that answers many questions but leaves us wanting more.  

Principle investigator of the Harvard Grant Study on Aging, George Valiant, identified a formula for successful aging from his longitudinal research that began in 1937 and is still in progress.   Maintaining strong social networks was an important finding in the Grant study, as lonely and toxic individuals have destructive relationships that negatively impact aging. Valiant identified the two groups of agers as, the Happy Healthy and the Sad Sick.  While absence of chronic diseases is important for optimum longevity, Valiant found that chronic conditions can be mitigated by adapting and maximizing strengths (Valiant, 2015).  

His findings included five elements for successful aging include; maintaining a healthy weight over the lifespan, low alcohol intake, regular mental and physical exercise, engaging in hobbies, and maintaining close relationships.  Having good people around you is key (Valiant, 2015). 
The two sources below are outstanding resources for learning more about successful aging.  

Martin, P., Kelly, N., Kahana, B., Kahana, E., Willcox, B.J., Willcox, D.C., & Poon, L.W. (2015).  Defining successful aging: a tangible or elusive concept?  The  Gerontologist, 55(1), 14-25.  doi: 10.1093/geront/gnu044

Valliant, G.E. (2015). Triumphs of experience: the men of the Harvard Grant Study.
Cambridge, MA: Harvard University Press.

Fluzone High-Dose Vaccine

Getting old is not all bad.  Now that I am 65, I am authorized a more powerful flu vaccine!  The Fluzone High-Dose Seasonal Influenza Vaccine is more powerful than traditional flu vaccines, as it has FOUR TIMES more antigen, promoting the body to make more antibody, thus providing superior protection.

And there is more good news…. Fluzone is a covered Medicare expense!  The providers typically run out of this vaccine early, and last year we had to wait until late November when stocks were replenished.  So, lesson learned: we got our vaccines today.  I recommend phoning in advance to make sure they have it in stock. 

Complications of the flu are more common in older adults, especially those with chronic conditions such as cardiovascular disease, diabetes, COPD, and compromised immune systems.  According to the CDC and Mayo Clinic, 90% of flu-related deaths are older people.  I want to do everything possible to avoid full-blown influenza so I get the flu vaccine annually.  Here are some details about Fluzone High-Dose.  

Monday, June 27, 2016

Tracking Devices for People with Autism and Alzheimer's Disease

Hi Readers, Last week on the Cooper and Company television show, Decatur police officer Sgt. Justin Lyon, Homeland Security/Community Resource Unit Supervisor, discussed the importance of tracking and locating wandering persons using technology. 
These devices are on the leading edge of technology and thanks to advancements in research, several options are available, as shown below.  The bracelet has benefits over the shoes and shoe inserts for persons who wander during the night.  However, people with Alzheimer’s Disease will do everything they can to remove any “foreign” object and they are clever and creative about it. 
If you are considering investing in a tracking device, purchase the one that best suits the needs of the individual.  Also, do your research first and find a reputable dealer.  Thank you.  AgeDoc

GPS Shoe:

If having a loved one carry a pendant or wear an extra device is worrisome to you, the GPS Shoe may be your solution. These tracking devices go back to the days of Get Smart and Agent 99 with a GPS tracking device located in the heel of the right shoe. The device is rechargeable and sends a signal to a central monitoring system so that caregivers can track them via website. Location is updated every 30 minutes on the basic plan and every 10 minutes on the premium plan. The shoes need to be charged every 48 hours and can be fully charged within two hours.

GPS Smart Sole:
Similar to the GPS Shoe and from the same designers, the GPS Smart Sole fits into most shoes and allows caregivers to track their loved one from any smart phone, tablet or web browser. The shoe insert is enabled with GPS technology and allows real-time syncing, a detailed report of location history, and allows users to set up a safe radius for their loved one.


SafetyNet Tracking Systems:

SafetyNet Tracking™ Systems technology enables public safety agencies to quickly find and rescue clients with cognitive disorders such as autism and Alzheimer’s. We train the authorities in our areas of coverage on how to find lost people using SafetyNet Tracking™ Systems equipment and on how to effectively communicate with people who have cognitive conditions.

Under the SafetyNet Tracking™ Systems program, your loved one wears a SafetyNet Tracking™ Systems Bracelet. Each Bracelet emits a signal on a channel used by law enforcement for tracking people at risk. Once your loved one is enrolled in the service, he/she is assigned a frequency and unique digital ID verification number.

Should a wandering event occur:

  1. You or another caregiver contacts local authorities.
  2. Trained search and rescue personnel use SafetyNet Tracking™ Systems Search and Rescue Receivers to track the Radio Frequency signal being emitted from the SafetyNet Tracking™ Systems Bracelet. Certified SafetyNet Tracking™ Systems agencies also have access to SafetyNet Tracking™ Systems’s secure database of key client information (such as physical description, medical condition, de-escalation techniques, etc.) to assist in the search and rescue operation.
  3. Once public safety officers locate your loved one, they would be able to rescue and return him or her home safely.

The SafetyNet Tracking™ Systems bracelet is easy to use—it only requires one battery change every six months and unlike GPS or cellular-based systems, SafetyNet Tracking™ Systems’s Radio Frequency technology can work in places such as a densely wooded area, buildings and shallow water. Because of the reliability of our technology and the SafetyNet Tracking™ Systems service’s direct integration with public safety agencies, it offers a way of quickly rescuing lost loved ones and bringing them home safely.





Thursday, June 2, 2016

Urban Legend ~ Dementia/Retirement

Dementia/Alzheimer’s Urban Legend Demystified and Exposed

Thank you, Dr. Harry “Rick” Moody, for forwarding this article to me about the dementia/retirement MYTH that has been perpetuated in the scholarly literature.  Just because it was printed in a scholarly, peer-reviewed journal or presented at a scientific does not make it truth.  There are unscrupulous and biased researchers with out of control egos who do not adhere to protocols of conducting scholarly research.  Sometimes, political bias or hidden agendas creep in.  I am a reviewer for two peer-reviewed publications and I can tell you that bias and flawed thinking is usually identified in the blind peer review and the study is not published until the bias and flaws are removed.  Unfortunately, some slip through.  This study is a perfect example of research gone awry and presenting biased, flawed findings.  These flawed findings made their way into CBS NEWS, USA Today, NBC News, Alzheimer’s Weekly, AARP News, Medical Daily, and numerous other news sources worldwide.  Problem is, it is not true!

After reading Dr. Moody’s article [below], I dug into the research myself.  I found the principal investigator, Dr. Carole Dufouil [France] presenting her findings at the 2013 Alzheimer’s Association scientific meeting on YouTube.  I then read the study by Dufouil et al. (2013) and I concur that the findings were biased and misinterpreted using faulty cause/effect.  Read Dr. Moody’s article below:


      Is it really true that delaying retirement will reduce your risk of Alzheimer's for each year that you continue working?  That claim attracted my attention because, retired at 71, I wondered what the truth of it was-- as I'm sure others did.

    When you go to the source of the claims you do find the article in a legitimate neurology journal.  But the article is entirely based on a correlational study, alleged to support the "lose-it-or-use-it" idea:  i.e., keep working, keep cognitively stimulated, keep engaged, and you lower your risk of dementia. There may be some truth to this, but the study in the journal doesn't prove it.

    Unfortunately, the old saying "Correlation is not causation" still remains true. Here's an example.  Suppose someone said that patients admitted to a hospital emergency room or ICU have a high death rate (true enough).  Would you conclude, if you were threatened by a heart attack, that it's a bad idea to go to the emergency room because of the correlation of admission with death rates?  It's an absurd example, but it makes the point about correlation and causation.

    This example shows why sloppy thinking can be dangerous to your health. It turns out that there are lots of factors associated with higher probability for dementia, such as cardiovascular diseases, which can be an independent cause of dementia.  Is it possible that people with such co-morbidities would be inclined to retire earlier than others in better health?  Is it possible that other socio-economic variables could also explain this difference?  Yes, it's not only possible, but likely: correlation is not causation.

     Is it a good idea to work longer and delay retirement?  The answer is, It all depends.  Keep in mind that a large body of research, going back more than 50 years, supports the finding that retirement itself is not bad for your health. People who don't like retirement don't want to accept this.  But they probably haven't read the vast body of research on the effects of retirement. The belief that "retirement causes dementia" must be dismissed as an urban legend, like belief that aluminum pots cause dementia.

     One of the more pernicious consequences of this urban legend is linked to the current campaign against retirement, a trend now gaining ground in political circles.  Specifically, there are proposals to raise the age of eligibility for Social Security.  I can hear the justification already:  "Yes, we're encouraging you to delay retirement, but it's for your own good.  You'll be healthier and have less risk of dementia."  Be suspicious, be very suspicious of people proposing to cut your benefits "for your own good."  Pay more attention to proven risk factors for dementia that may remain within our control.

For more details, see:     

Wednesday, June 1, 2016

Frailty Resources

Frailty ~ Preventable, Treatable, and Reversible

Do you want to learn about FRAILTY?  Here are two great resources.
First, has numerous credible resources on the topic of frailty.  Here is the website.

I found this talk from gerontologist and frailty expert Professor John Morley.  His presentation has been edited to a 4 minute video from the 8th International Conference on Cachexia, Sarcopenia, and Muscle Wasting held in Paris December 8 and 9 in 2015.

Check out this one-minute video produced by the Global Aging Research Network. 

Posted beneath their video:

”Common clinical manifestations of frailty are:
·       unintentional weight loss
·       loss of muscle strength [sarcopenia]
·       self-reported exhaustion
·       slow walking speed
·       low physical activity

“One of the challenges faced by our societies is to preserve physical function and independent living with advancing age. Frailty is a clinical syndrome frequently anticipating the onset of disability. Differently from disability, frailty may still be reversible. Frailty is highly prevalent at old age, and its early detection should be encouraged. Once frailty is detected and the underlying causes of it identified, an adapted multi-domain care program can be established.”

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