An aspirin a day may keep cancer at bay...

People who take a low-dose aspirin daily may not only be helping their hearts, but also reducing their odds of dying from cancer, according to American Cancer Society researchers.

The lower risk of dying from cancer associated with aspirin, however, may not be as great as previously thought, say the authors of the large new study.

And aspirin's possible side effects -- notably the higher risk of bleeding episodes -- need to be taken into account when considering its use, they added.

"Expert committees that develop clinical guidelines will consider the totality of evidence about aspirin's risks and benefits when guidelines for aspirin use are next updated," said lead researcher Eric Jacobs, the society's strategic director of pharmaco-epidemiology.

Jacobs said, until there are new guidelines, he doesn't recommend taking aspirin for cancer prevention.

"Although recent evidence about aspirin use and cancer is encouraging, it is still premature to recommend people start taking aspirin specifically to prevent cancer," he said.

Even low-dose aspirin can substantially increase the risk of serious gastrointestinal bleeding, Jacobs pointed out.

"Decisions about aspirin use should be made by balancing the risks against the benefits in the context of each individual's medical history. Any decision about daily aspirin use should be made only in consultation with a health care professional," he added.

The study was published in the online issue of the Journal of the National Cancer Institute.

To look at the potential effect of daily aspirin use on cancer deaths, Jacobs' team used data from the Cancer Prevention Study II Nutrition Cohort, part of a larger long-term study on the effects of lifestyle factors on mortality.

This study included more than 100,000 men and women without a history of cancer, some of whom were taking aspirin daily. Of the study participants, 5,138 eventually died from cancer.

Aspirin use was associated with an up to 16 percent lower risk of dying from cancer, which, however, was less than seen in another recent study, the researchers noted. In that analysis of randomized trials (where people were randomly assigned to either take aspirin or not take aspirin), aspirin use reduced cancer deaths by 37 percent during five years of follow-up and 15 percent during 10 years of follow-up, the authors noted in the report.

Nevertheless, "even a relatively modest benefit with respect to overall cancer mortality could still meaningfully influence the balances of risk and benefits of prophylactic [preventative] aspirin use," Jacobs' team concluded.

A limitation of the study is that it was an observational study, not a randomized trial. This could mean that the reduction in cancer deaths tied to aspirin use may be over- or under-estimated, the researchers noted.

Dr. John Baron, a professor of medicine at the University of North Carolina at Chapel Hill School of Medicine, who authored an accompanying journal editorial, said, "It's a remarkable idea that something that's in medicine cabinets around the world, and has been around for more than a century, can prevent cancer."

However, Baron is not recommending that people start taking aspirin to cut their odds for malignancy.

Why it works against cancer isn't known, Baron said, and he noted that the effect of aspirin is seen over time. For example, aspirin might start preventing colon cancer after a person had taken it for about 10 years.

During that time, however, that person might have gastrointestinal or brain bleeding caused by aspirin. So those risks and benefits need to be balanced, he noted.

The question is no longer whether aspirin prevents cancer, according to Baron, but rather whether the risks associated with aspirin are overshadowed by its benefits, he suggested. "But even the most pessimistic study shows a meaningful reduction," he added.

But while the new study found an association between aspirin use and reduced cancer risk, because it is not a randomized, controlled trial -- the "gold standard" for research -- it did not prove a cause-and-effect relationship.

Multiple chronic conditions increasing among the elderly

The Centers for Disease Control and Prevention (CDC) finds a dramatic increase in the number of older adults with two or more chronic conditions. The increase was seen across genders, race, and socioeconomic status.

The CDC studied the prevalence of hypertension, heart disease, diabetes, cancer, stroke, chronic bronchitis, emphysema, current asthma, and kidney disease among adults age 65 and older over ten years. Researchers found that the number of seniors with two or more of the selected chronic conditions increased from 37.2 percent in 2000 to 45.3 percent in 2010. This change was particularly dramatic for men. In 2000, 39.2 percent of senior men had two or more chronic conditions. In 2010, this number jumped to 49 percent.

The most common combinations of chronic conditions were hypertension and diabetes, hypertension and heart disease, and hypertension and cancer. Seniors with these combinations of conditions were also likely to suffer from other chronic conditions. For example, of the 21.2 percent of seniors who suffered from hypertension and heart disease in 2010, 63.7 percent had at least one of the other seven chronic conditions as well.

Researchers believe these results are likely understating the prevalence of chronic conditions, since the study relied on respondent-reported information, not physician data, and many chronic conditions are undiagnosed. The report also emphasized the effects of this increase on our healthcare system. “Persons with multiple chronic conditions are more likely to be hospitalized, fill more prescriptions and have higher annual prescription drug costs, and have more physician visits. Out-of-pocket spending is higher for persons with multiple chronic conditions and has increased in recent years.

Read full report:

More evidence that poor dental hygiene leads to dementia

Researchers who followed close to 5,500 elderly people over an 18-year period, found those who reported brushing their teeth less than once a day were up to 65 percent more likely to develop dementia than those who brushed daily.

"Not only does the state of your mind predict what kind of oral health habits you practice, it may be that your oral health habits influence whether or not you get dementia," said Annlia Paganini-Hill, who led the study at the University of California.

Inflammation stoked by gum disease-related bacteria is implicated in a host of conditions including heart disease, stroke and diabetes.

And some studies have found that people with Alzheimer's disease, the most common form of dementia, have more gum disease-related bacteria in their brains than a person without Alzheimer's, said Paganini-Hill.

It's thought that gum disease bacteria might get into the brain causing inflammation and brain damage, she told Reuters Health.

So she and her team wanted to look at whether good dental health practices over the long term would predict better cognitive function in later life.

The researchers followed 5,468 residents of a Californian retirement community from 1992 to 2010. Most people in the study were white, well-educated, and relatively affluent. When the study began, participants ranged in age from 52 to 105, with an average age of 81.

All were free of dementia at the outset, when they answered questions about their dental health habits, the condition of their teeth and whether they wore dentures.

When the researchers followed-up 18 years later, they used interviews, medical records and in some cases death certificates to determine that 1,145 of the original group had been diagnosed with dementia.

Of 78 women who said they brushed their teeth less than once a day in 1992, 21 had dementia by 2010, or about one case per 3.7 women. In comparison, among those who brushed their teeth at least once a day, closer to one in every 4.5 women developed dementia. That translates to a 65-percent greater likelihood of dementia among those who brushed less than daily.

Among the men, the effect was less pronounced, with about one in six irregular brushers developing the disease - making them 22 percent more likely to have dementia than those who did brush daily. Statistically, however, the effect was so small it could have been due to chance, the researchers said.

There was a significant difference seen between men who had all, or at least most, of their teeth, or who wore dentures, and those who didn't - the latter group were almost twice as likely to develop dementia.

That effect was not seen in women, though.

Paginini-Hill could only speculate on the reasons for the different outcomes among men and women. Perhaps women wear their dentures more often than men, and they visit the dentist more frequently, she suggested.

The new findings, published in the Journal of the American Geriatrics Society, cannot prove that poor dental health can cause dementia.

Neglecting one's teeth might be an early sign of vulnerability to dementia, for instance, or some other factor could be influencing both conditions.

Still, this report "is really the first to look at the effect of actions like brushing and flossing your teeth," said Dr. Amber Watts, who studies the causes of dementia at the University of Kansas and was not involved in the research.

The new study does have some limitations. Paganini-Hill and her team looked at behavior and tooth count as a kind of proxy for oral health and gum disease. They didn't carry out any dental exams so they couldn't determine if people had gum disease or not.

And tooth loss isn't always related to gum disease, Watts noted. Head injury and malnutrition are also important causes of tooth loss in adults, and any of those might increase risk for dementia, she said.

"I would be reluctant to draw the conclusion that brushing your teeth would definitely prevent you from getting Alzheimer's disease," Watts said.

Yet despite the limitations, Watts said the study is an important step toward understanding how behavior might be linked to dementia.

"It's nice if this relationship holds true as there's something people can do (to reduce their chances of developing dementia)," said Paganini-Hill. "First, practice good oral health habits to prevent tooth loss and oral diseases. And second, if you do lose your teeth, wear dentures."

Caregivers responsible for the bulk of elder abuse

A new study confirms that financial elder abuse has reached the point of epidemic,with 65% of more than 750 interviews with experts who work with older Americans revealing victims of investment fraud or financial exploitation.

Of those who commit elder financial fraud, family members and caregivers are among the most common offenders, followed by strangers.

“Our new survey shows that financial swindles targeting older Americans are a bigger problem today than ever before and that seniors need more help.” said Don Blandin, president and CEO, Investor Protection Trust. “…Of course, there is no ‘silver bullet’ that will end the financial abuse of America’s seniors. Putting a major dent in the problem will require new and innovative collaborative efforts by many different experts and organizations, both public and private.”

Education is seen as the No. 1 way to combat the problem, through counseling or personal finance management programs tailored to the needs of older Americans. These programs are most effectively delivered through local professionals, protective service workers, law enforcement agencies and health care professionals, as well as senior centers, the study finds.

The magnitude of the problem and lack of effective ways to identify elder financial abuse has led it to become a health issue in addition to a national concern, says Dr. Mark Lachs, Director of Geriatrics, New York-Presbyterian Healthcare System.

“Elder financial abuse is not only about financial exploitation: It is a major public health problem. When older Americans are financially exploited and there are no resources left for their care, these individuals effectively become wards of the state. In these cases, all Americans end up paying.

Read full study...

Struggling With an Abusive Aging Parent

The following is an excerpt from an article, written by Marc E. Agronin, MD, that appears in the New York Times New Old Age Blog.

Some new residents come into the nursing home like lions, roaring at staff members and fighting admission at every turn. Others come in like lambs, including an 84-year-old woman who arrived quietly after a complicated hip fracture ended her ability to live alone.Her presence on the unit raised little attention and no suspicion of a troubled past. But her son, when I eventually reached him, told a different tale: “My mother,” he said, “is a monster.”
Sensing my incredulity, he sighed heavily and detailed her sordid life as a boozing and gambling beast of a person who beat her son. He expressed hope that her arrival to our institutional purgatory would bring a minimum amount of care and attention as a slow but steady form of retribution.
She was thus bereft of all family contact, left abandoned in a bare room without even a single personal photograph. The son grudgingly agreed to intermittent contact with me, but not with his mother.
This woman joined a motley crew of other similarly accused characters in the nursing home — abusers, addicts, family outcasts and even a few psychopaths. Staff members are often unaware of the past sins of these residents, as they may be veiled by a lack of information, the presence of Alzheimer’s disease or other forms of memory impairment.

Read full article...

Top Ten Things a Caregiver Needs from a Health Care Provider

Excellent insight from our friend Gary Barg of Today's Caregiver.

1. Attention: The caregiver's loved one may be the 27th similar case you've seen today; but to the caregiver, this is Mom or Dad, Sister or Lover.

2. Compassion: Be diligent in its application.

3. Time: A few moments of your undivided time is some of the strongest medicine you'll ever administer—and it costs so very little.

4. Respect: The person pushing the wheelchair is also part-time bookkeeper, psychologist, dietitian, insurance and incontinence expert, and a full-time general in the war they are waging with this illness. They not only need your respect, they DESERVE it.

5. Dedication: Be relentless in your devotion to your craft. The caregiver has entrusted you with their most valuable asset—their loved one. You earn that trust with your skill, knowledge base and ability. 

6. Honesty: The caregiver is your partner in this endeavor; they deserve (and can handle) the truth.

7. Prudence: The graceful administration of the truth is a true test of a caring professional.

8. Advocacy: Never accept less than the best your system has to offer their
loved one.

9. Understanding: The caregiver plays a pivotal role in the well-being of your patient; understanding the needs, wishes and fears of the caregiver improves your patient's care.

10. Your well-being: Know your emotional limit and learn when to ask for help. Your loved ones as well as the caregiver's loved one need you to remain well.

Gary Barg
Editor-in-Chief
Today's Caregiver

7 Myths about Growing Old

The graying of America.

Our country is getting grayer. The number of senior citizens in the U.S. has increased in the past decade to the point where baby boomers — those born between 1946 and 1964 — now account for a quarter of the population. And life expectancy, along with what doctors describe as our “active lifespan,” is predicted to increase by another two years in the next decade.

There are also more seniors in the workforce as boomers elect to continue working past retirement age, although this is due in part to the recent economic downturn, as well as the financial shortcomings of Social Security. The welcome presence and valuable contributions of elderly Americans is helping to debunk some common myths regarding seniors and the aging process. Here are seven such myths that have been disproved.

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Heart disease is more deadly for women

Here's who should be taking aspirin regularly, according to the American Heart Association: People at high risk of heart attack should take a daily low-dose of aspirin (if told to by their physician) and heart attack survivors should regularly take low-dose aspirin.

But new research published in the Journal of Women's Health found more than half of women who should be taking aspirin to prevent heart attack and stroke do not.

Heart disease is the No. 1 killer of women in the United States. And while slightly more women die from heart disease every year than men (432,709 women compared to 398,563 men in 2006, the most recent year for which data is available), many Americans (women especially) still mistakenly perceive heart problems as a "man's disease." There are too many women who don't know their risk for heart disease — or what to do about it.

In total, 217,987 women took the survey. Of that pool, 29,701 met the national guidelines for daily aspirin use. Only 41 percent of those who met the recommendation for primary prevention (before heart attack or stroke) reported taking aspirin on a daily basis, the researchers found. Additionally, only 48 percent of those who met the criteria for secondary prevention (after heart attack or stroke) responded "yes" to daily aspirin use.

Researchers also noticed some interesting patterns, among them that women with high cholesterol or a family history of heart disease were more likely to take aspirin.

In the Journal of Women's Health article, the researchers also note a need for more heart disease education programs for women: "This study provides direct evidence for the need for education about aspirin among clinicians and women for increased awareness and prevention of cardiovascular disease events," they write.

That doesn't mean you should go out and buy the family-size bottle of low-dose aspirin just yet. Regular aspirin use doesn't come without its own risks, such as bleeding or eye disease — and there's no hard-and-fast rule declaring aspirin a magic bullet for heart disease. Don't start (or stop) taking aspirin regularly without talking to your doctor first. He or she can help you find the right dosage. If you're healthy and have no risk for heart disease, you probably don't need the extra preventive measure.

Symptoms of Alzheimer's disease

No one experiences Alzheimer's disease in exactly the same way. As memory loss occurs, it affects cognition, coordination, personality, and standard of living very differently from person to person. However, researchers have identified some patterns in the way the disease progresses, allowing doctors to group Alzheimer's symptoms into three specific stages. This classification can help people to better understand how symptoms might unfold after an Alzheimer's diagnosis and can assist families in making plans for the future.

It's important to keep in mind, though, that while Alzheimer's symptoms have been clustered into stages, there's no way to tell how long any one stage or symptom will last or how quickly others will progress. People with Alzheimer’s die on average about four to six years after their diagnosis, but the disease can also take its relentless toll for as long as 20 years before death occurs.

Alzheimer's Symptoms:

You've forgotten where you've placed your keys. Or you can't remember the name of an actress in a particular movie. Or maybe you are relying more and more on notes to remind yourself you need to do important tasks. Are you suffering from Alzheimer's?

In most cases, the answer is probably not. Most of us experience some “normal” loss of memory, those annoying “senior moments,” as we age. Experts say that misplacing your keys isn’t the issue; forgetting what the keys are used for, however, can be. With this in mind, if you or a loved one is having memory problems that seem to be getting worse more rapidly or happening much more frequently than before, it might be time to pay your doctor a visit.

The following are some early warning signs of Alzheimer's, along with caveats you should keep in mind:

Forgetfulness -  People with early Alzheimer's often find themselves regularly forgetting important information they've just recently learned. On the other hand, there’s probably no need to worry about occasional lapses, such as misplacing your wallet or forgetting names — these types of memory lapses are normal and happen to most people as they get older.

Difficulty completing tasks - People with early Alzheimer's might not be able to remember the steps needed to cook a meal, balance a checkbook, or use a computer program. However, forgetting what you were just going to say or why you went into a particular room isn't unusual when it happens every now and then.

Disorientation - If you've found yourself getting lost in your neighborhood, or ever feel as if you suddenly don't know how to get home because you've forgotten where you are and how you got there, these are signs that could indicate the presence of Alzheimer's. But remember, both of these issues are much different than simply forgetting where you were headed, which can happen to anyone from time to time.

Misplacing objects - Putting objects in strange places — like your car keys in the microwave, or your hair dryer in the washing machine — can be a sign of early Alzheimer's disease. Don't worry if you or your loved one temporarily misplaces keys or a purse, though.

Lapses in judgment - If you notice that you or your loved one has started exhibiting some strange behaviors — like putting on several heavy layers of clothing on a warm day, wearing the same clothes day after day, or giving lots of money away to telemarketers or scam artists, there's reason to suspect Alzheimer's might be present.

Saving for retirement...there's an app for that

The following is an interesting article that appeared in Employee Benefit News.

Amid mounting concern about the nation’s savings rate and financial illiteracy, employers face enormous pressure to move the needle on retirement preparedness. One possible solution is to tap the wildly popular gaming trend, which, in turn, can actually help make retirement planning fun and more engaging than traditional approaches to employee education.

Among the financial providers looking to make a mark, ING U.S., has released a new mobile game app designed to help build investment and retirement planning awareness for consumers of all ages. Available for free on the App StoreSM for iPhone, iPod touch and iPad, the “Struct” application leverages the power of “gamification,” which integrates game elements such as points, levels and a leader board. It also exposes players to fundamental investing concepts and terms.

The premise of the game is for players to work with various building materials that symbolize different investment categories – steel (cash), wood (bonds) and glass (stocks) – as they build increasingly complex towers or “structs.” Three main characters, called the build crew, correspond to a unique investor style: aggressive, moderate and conservative. A fourth crewmember is a wild card, representing both market opportunity and risk.

Through crew selection and game objectives, metaphors about saving and investing are conveyed that parallel the concepts of risk, diversification, goals and achievement. Crew selection, a diversified strategy and material handling are critical to a player’s success.

“We know many individuals need to do more when it comes to preparing for their retirement,” said Rick Mason, president of corporate markets for ING U.S. Retirement, which hopes to promote financial literacy. “Gaining greater awareness about accepted investing and saving principles is a critical part of that process.”

Nielsen research shows game apps are the most downloaded items by smartphone owners, and iPhone users are playing games an average of 14.7 hours a month. Moreover, data from the Employee Benefit Research Institute and Newzoo suggests that there are more people in the U.S. who meet the definition of active gamers than who save for retirement. 

Players of Struct are introduced to each of the 12 game levels by an instruction guide, which provides tips that challenge the player to work with different building material and crewmembers. Each level brings new complexity, and the right combination of crew, material placement and speed helps the player score points and unlock achievements.

There are also surprise moves one can discover as they engage in play, including breakage, bonus points and the ability to discard a crewmember’s building material. The “Build School” brings the metaphors to life, demonstrating how investor style and asset classes can affect the outcome, while the game’s glossary helps to build knowledge of key financial terms.

Foster care for Vets

With increasing options in health care for the aging population, some American war veterans who could live in nursing homes for free are choosing to use their own money to fund their stays in medical foster homes through the Department of Veterans Affairs Medical Foster Home Program, reports a New York Times article.

Since the program’s beginning in 2000, nearly 1,500 veterans have been placed with voluntary caregivers who receive monetary compensation from veterans for care they provide. Most veterans using the program, with an average age of 70, remain in their medical foster homes until they pass away, according to the article.

The program was established to promote better better quality care of for veterans and currently operates in 36 states.

The New York Times reports:

It costs a site about $260,000 a year to introduce the program; each site can serve up to 30 vets. The V.A. finances each place for two years, after which the program is expected to be self-sustaining, said Dr. Thomas Edes, national director of geriatrics and extended care operations at the V.A.

Though medical foster homes are intended to provide better care, not to reduce costs, they operate for half the cost of nursing homes. “It is quite likely that it will save V.A. money and taxpayer money and veterans’ money,” Dr. Edes national director of geriatrics and extended care operations at the V.A said.

Given the vulnerability of the older veteran population, the V.A. approval process is rigorous. Only one in 10 to 15 applicants are selected. People with no formal training can apply, however, and many with family caregiving experience do. Once a veteran is placed in a home, the V.A. provides training for tasks like cleaning wounds, managing incontinence and safely transporting the new residents.

Veterans pay $1,800 to $3,000 a month for care, depending on their medical needs, often using their combined V.A. and Social Security benefits.

A national V.A. study measuring veterans’ satisfaction and costs won’t be completed until 2013 and 2015. But 30 percent of veterans who would qualify for V.A.-paid nursing homes choose instead to pay out of pocket for medical foster homes — evidence, Dr. Edes. said, that they prefer a home setting.

Read full NY Times article...