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November/December 2004
DHEA Lessens Depressive Symptoms, NIMH Study Shows
by Arline Kaplan In many preliminary studies, including one presented at the recent 2nd World Congress on Women's Mental Health, DHEA has been shown to be an effective treatment for mild-to-moderate midlife depression. Questions remain, however, as to its mechanism of action, the risk of side effects and its interactions with medications.
See Full Story
September/October 2004
Palliative Care Seeks Structure for Growth
by William Kanapaux Modern medicine has extended the lives of people with chronic illnesses, but has it improved the quality--especially of their final years? There is a dire need for health care professionals trained in palliative care and a health care structure that recognizes its worth.
See Full Story
July/August
Gaps in Coverage Create Health Insurance Instability for the Elderly
by Richard A. Sherer New studies show that people may cycle in and out of insurance coverage. As people age, this can lead to poor health outcomes as chronic disorders are neglected during times when insurance is lacking. Is true health care reform finally on its way?
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May/June
Oncologists, Geriatricians Team Up To Close Research Gaps on Cancer Care
by William Kanapaux People 65 and older account for 70% of all cancer deaths. Research grants from the National Cancer Institute/National Institute on Aging and the American Society of Clinical Oncology/Hartford Foundation are currently being used to study the relationship between aging and cancer, create more effective ways to treat older patients with cancer, and provide more fellowship opportunities for physicians to become specialists in geriatric oncology.
See Full Story
March/April
Coronary Artery Disease: What's Different for Women?
by Arline Kaplan Although coronary artery disease is the leading cause of death in women, there is a general misconception shared by both health care providers and patients alike that it is not a woman's disease. Explore the differences in CAD symptoms between men and women, risk factors specific to women, new guidelines for prevention, screening techniques and the effects of hormone replacement therapy on CAD.
See Full Story
New Guidelines for CVD Prevention in Women
by Arline Kaplan With the recognition that CVD develops over time in women, the American Heart Association joined with 11 other professional and government organizations in sponsoring new evidence-based guidelines to help physicians individualize treatment for their female patients. Aggressiveness of treatment is based on each patient's level of risk for CVD.
See Full Story
January/February 2004
Who Will Care for the Elder Orphans? by Richard Sherer
More than 2 million people between the ages of 70 and 85 will be without the support of immediate or extended family by 2030. This article provides a glimpse into this invisible but growing problem.
See Full Story
November/December 2003
Homosexual Seniors Face Stigma by William Kanapaux
Gay and lesbian seniors face the stigma of hetero-centric health care systems. What is the homosexual population doing with the frail elders?
See Full Story
September/October 2003
Anemia is Risk Factor for Physical Decline
A recent study published in the American Journal of Medicine showed that anemia increases the risk of physical decline in older people. Researchers studied 1,146 participants and aged 71 and over in a four-year, prospective cohort study and assessed various physical tasks.
See Full Story
Caregivers Show Distress-Related Dysregulated Immune Systems
A recently published report showed that caregivers had increased levels of the proinflammatory cytokine IL-6 compared to controls. The researchers found that many age-related conditions may be influenced by proinflammatory cytokines, which can be stimulated by stressful experiences.
See Full Story
Survey Seeks Better Doctor-Patient Relationship in Treating Menopaus
A recent survey sought to learn about women's experiences with menopause as patients, the effect of symptoms on their lives, and the steps they are taking to treat them. A total of 851 women, between the ages of 45 and 59, were surveyed.
See Full Story
July/August 2003
Litigation and Increased Liability Devastate Long-Term Care
Two reports published this year show liability costs for long-term care facilities have sky-rocketed. Some insurance carriers have stopped doing business in the states with the most legal activity. Is this compromising the quality of care residents in nursing homes and other long-term care facilities receive?
See Full Story
May/June 2003
The Debate Over New Medications: What's Best for Your Patients?
The ALLHAT study raised more questions than it answered. Research is open to interpretation, health care costs are soaring and patients are using complementary products: How can you and your patients decide what's best for them? See Full Story
March/April 2003
Complications of Type 2 Diabetes in the Elderly
Due to physiologic changes associated with aging, the diagnosis and treatment of type 2 diabetes in older patients present unique challenges. Review which symptoms older patients present with most often, which medications are recommended for older patients, and which complications can be expected when treating this population. See Full Story
January/February 2003
Latest Anti-Aging Elixirs Lack Proof of Safety and Efficacy
Touted as anti-aging solutions, human growth hormone, testosterone and other elixirs are finding new life in the consumer market. Are these products harmful, and what methods do companies use to circumvent government restrictions? See Full Story
November/December 2002
Confronting Ageism: The Maturing of Medical School Curricula
Medical schools have improved their curricula by exposing students to elderly patient care. Nonetheless, students still have misperceptions of elderly patients due to misguided stereotypes, lack of information from professors and resident staff, and minimal contact with healthy elderly people. What can be done to confront ageism in medical schools and young doctors? See Full
Story
Is There a Formula for Funding a Seniors' Prescription Drug Benefit?
Without a Medicare prescription drug benefit, seniors struggle to pay for the cost of medications. As a result, a staggering number of seniors gamble with their dosing schedules.See Full Story
September/October 2002
Hormone Replacement Therapy: Trials, Turmoil, Trust
With the early termination of the Women's Health Initiative's study of hormone replacement therapy, physicians and patients were left scrambling for answers. As professional organizations and government agencies further review and interpret the results, one thing is clear: Communication between health care professional and patient is crucial to delivering quality health care. See Full Story
July/August 2002
Trouble Ahead: Lack of Insurance Leads to Poorer Health Among Aging Americans
According to the Institute of Medicine and AARP, a lack of insurance leads to poorer health. Aging Americans enter Medicare with more advanced chronic conditions than their insured counterparts. See Full
Story
Innovations
Liquid dietary supplements can help ensure patients are receiving the necessary nutrients to remain healthy. Also aimed at maintaining good health and preventing poor outcomes, a new non-invasive body mapping system has been developed to be significantly more sensitive than standard ECG for detecting heart attacks. See Full
Story
May/June 2002
Healthy Aging: A Worldwide Challenge
The Second U.N. World Assembly on Ageing, held in April in Madrid, hopes to bring the needs of the worldwide aging population to the forefront. Concentrating on the idea of "healthy aging," the Assembly calls on countries to enact policies and programs that enhance the health, independence and productivity of older people. See Full
Story
Innovations
Tracking systems are becoming increasingly available to help care for patients with Alzheimer's disease. Residents in South Florida are the latest to follow this trend. Also new is the U.S. Food and Drug Administration's approval of a medical device that, when implanted in the brain, delivers electrical impulses to control some symptoms of Parkinson's disease. See Full
Story
March/April 2002
Anti-Aging Products: A Health Hazard?
While it is illegal for manufacturers of over-the-counter supplements
to make unproven claims about their products, the marketing of these
products on the Internet is difficult to police and leaves the door open
to unwary consumers, many of whom are elderly. A variety of
frequently used dietary supplements can have serious health
consequences for seniors, making it increasingly important to ask
patients about their supplement use. See Full
Story
January/February 2002
States Step In With Plans To Lower
Prescription Drug Costs for Seniors
For months, states have been quietly working to reduce seniors' drug costs
through a variety of legislation. Will programs that include providing drug
subsidies, forming multi-state groups to increase buying power, and enforcing
rebates be approved and effective? See Full
Story
Payment Act Tries To Prevent Cut in
Physician Fees
With the announcement of the reduction of Medicare's conversion factor,
legislators are working to limit the cut. Will the Sustainable Growth Factor be
corrected and will your specialty be impacted? See Full
Story
Pharmaceutical Companies Offer Discount Plans to
Seniors
While legislators debate ways to reduce medication costs for seniors, some
pharmaceutical companies are offering discount program options. Who is eligible
and will these options help control prescription drug prices? See Full
Story
Innovations
November/December 2001
Innovations
This month, learn more about new technology, treatment guides and exam
preparation kits for use with your older patients See Full
Story
How Will Your Patients Respond to
September 11?
Most older adults have the experience and resiliency needed to recover from
their emotional responses to the attacks of Sept. 11. Health care professionals
should pay extra attention to those groups most at risk for increased physical
and emotional disorders, including shut-ins, cognitively impaired patients,
veterans, emigres from wartorn countries and already overburdened
caregivers. See Full
Story
Treating the Whole
Patient
This article focuses on the recognition and treatment of depression that can
co-occur with cardiovascular disease, stroke and Parkinson's disease. See Full
Story
September/October 2001
Are Men an Endangered
Species?
The suicide rate is reaching epidemic proportions in the United States. Among
those most at risk are older white men, data for whom are lacking. A risk
factor for suicide is depression, and a distinct subtype of depression in late
life may be related to vascular disease. Are specific treatment options
necessary for this type of depression in older males? See Full
Story
Washington Report
Will there be enough geriatricians to care for older patients? Legislation is
being suggested to offer new educational and professional opportunities to help
decrease the shortage of elder care experts. What new legislation is on the way
for prescription drug benefits for the elderly? See Full
Story
Preventing Falls, Improving
Outcomes
Falls among older Americans result in 10,000 deaths a year and are the sixth
leading cause of death in this population. What are the risk factors for falls?
What role does the health care provider play in prevention? Are there
therapeutic approaches to avoid this common yet potentially fatal
problem? See Full
Story
Pharmacology in the
News
This Geriatric Times feature offers updates on the medications available
for treating the older patient. This month, drug warnings and recalls,
treatment options, and foreshadowing of vaccine availability are among the
topics reviewed. See Full
Story
July/August 2001
How Can a Nursing Shortage Be
Prevented?
According to the Bureau of Labor Statistics, 450,000 additional registered
nurses will be needed in the United States by 2008. With the number of nursing
program applicants steadily declining, how can we ensure quality care for our
patients? See Full
Story
Innovations
Technological advances are very important in the treatment of the older
population. This month, read about advances in sharing and updating patient
information, comfort chairs, and enhancing hearing abilities. See Full
Story
Panel of Experts Looks at the Health
Care Labor Crisis
A report just released by the Nursing Institute at University of Illinois,
Chicago, examined the current health care labor status. What did they predict
for the future? Learn about their recommendations for improvement. See Full
Story
May/June 2001
Innovations
Technological advances are very important in the treatment of the older
population. A grab bar, a glucose monitor, hip protector undergarments and a
device for monitoring sleep-disordered breathing are a few of the newly
approved devices for use in geriatric care. An overview of each of these
products is given. See Full
Story
Pharmacology in the
News
This new feature of Geriatric Times offers updates on the newest
medications available for treating the older patient. This month, discover
newly approved medications beneficial to your patients with osteoporosis and
Alzheimer's disease. See Full
Story
Detecting and Treating Geriatric
Depression
Approximately 15% of American seniors are depressed. That figure jumps to 25%
among patients with chronic illness and is especially prevalent in seniors with
either stroke, Parkinson's disease, cancer, arthritis, Alzheimer's disease or
ischemic heart disease. As many as 50% of elders who live in institutionalized
settings meet diagnostic criteria for depression. The somewhat atypical
clinical presentation of depression in geriatric patients can pose significant
diagnostic challenges, even for seasoned clinicians, underscoring the need for
greater collaboration between primary care physicians and mental health
specialists. See Full
Story
Geriatric Patients in the Emergency
Department Aren't "Just Another..."
It can be all too easy to misdiagnose elderly patients in the emergency
department, as they often present challenges. Here are several pitfalls of
misdiagnosing elderly patients in an acute care setting and how to avoid
them. See Full
Story
Medical Devices, Communication and
Patient Safety
Alarmed by the Institute of Medicine's finding that tens of thousands of people
die each year due to medical errors-mostly involving medical devices-watch-dog
agencies took a look at ways to prevent such adverse events. Most found that
errors were not due to defective devices, but rather to human error, lack of
training and a lack of coordinated programs for purchasing health care
technology. Reports such as these have led to increased efforts to improve the
delivery of care. See Full
Story
The Needs of the Dying
Death is inevitable, no matter how advanced medical treatments become. David
Kessler, R.N., shares his principals, "The Needs of the Dying" to help us
understand and honor the process of living and dying. See Full
Story
March/April 2001
Cavities to Cancer: The Silent
Epidemic of Oral Disease
A "silent epidemic" of dental and oral diseases plague older adults. According
to the surgeon general's first report on oral health care issued in May,
non-dental health care practitioners can help by including the often overlooked
oral-pharyngeal cavity in patient assessments. See Full
Story
Washington Watch
Updates on the new federal rule protecting patients' medical records and new
additions to Medicare and Medicaid benefits are reviewed. See Full Story
Treating Incontinence
Incontinence affects an estimated 10% to 30% of the community-dwelling elderly
and 60% to 70% of nursing home dwellers. Jonathan Vapnek, M.D., spoke recently
about this common problem and offered an overview on evaluating different types
of urinary incontinence and providing treatment. See
Full Story
January/February 2001
AIDS May Escape Diagnosis in Older
People
The stereotypical myth that seniors are not sexually active may be a
contributing factor to the misdiagnosis of AIDS in patients over 50 years old-a
group that represents 10% of the AIDS-infected population. It is difficult to
determine which cases of dementia in the elderly are HIV-related or a sign of
Alzheimer's disease, and health care professionals may not have an HIV/AIDS
diagnosis on their radar screens when examining seniors. See Full Story
Editorial Apocalypse! Crisis!
Disaster!
Mr. Johnson describes the work he does as a physician assistant and urges
physicians to embrace a team approach to patient care, utilizing the skills of
physicians, PAs, nurses, and physical and occupational therapists. See Full Story
November/December 2000
Older Drivers on the Road: How Can We
Insure Their Safety?
Recent studies show that older drivers are not necessarily less safe, but that
they are more likely to be injured if involved in an accident. To make our
highways safer for older drivers, federal and state agencies are redesigning
signage to accommodate the loss of visual acuity that often comes with aging,
and automakers are improving seatbelt and airbag design to better protect
fragile drivers. In addition, researchers are designing training modules that
have improved older drivers' ability by as much as 300%. See Full Story
Broader Medicare Reimbursement for
Providing Telemedicine Seems Doubtful
Less than 6% of telemedicine physician-patient visits provided in 1999 to
Medicare recipients qualified for Medicare reimbursement. A new bill proposes
broadening the number of CPT codes that could be billed and making more
patients eligible. See Full Story
September/October 2000
Alternative Medical Treatments May
Put Elderly Patients at Risk
A 57-year-old woman reported that she had been experiencing nausea, abdominal
pain, watery diarrhea, sweating and weakness intermittently for about two
months. The attacks, she said, lasted about 24 hours but left no residual
effects. Her physical findings were unremarkable. Clinicians were puzzled by
the unaccountable symptoms. Questioning revealed that the attacks had begun
after she started taking capsules containing milk thistle (Silybum
marianum) that were supposed to promote liver cleansing and cure headaches.
Not surprisingly, the attacks ceased when she was persuaded to discontinue
using the herbal preparation. See Full Story
Collaborating on Care: Patients Join
Health Care Team
A study released in August presents evidence that patients who are involved in
managing their own health care-especially patients with heart disease, asthma,
diabetes and arthritis-use fewer health care resources. Interviews with health
care experts support these findings and encourage a closer look at the benefits
of providing disease management programs. See Full
Story
Thyroid Disease More Common Than
Previously Suspected
Study results confirm that thyroid dysfunction is common, may often go
undetected and may be associated with adverse health outcomes that can be
avoided by serum thyroid-stimulating hormone (TSH) measurement. According to
Gay Canaris, M.D., et al., more than 13 million Americans may have an
undiagnosed thyroid condition.
Treating Suicidal Elders
Given that people over age 70 are at the highest risk for suicide, how should
the general practitioner screen patients? A prominent expert in the field
discusses four disease-prevention guidelines to help avert this needless
tragedy. See Full Story
July/August 2000
Drugs Online: Are Your Patients
Gambling With Their Health?
The advent of the Internet has made it more convenient for patients to purchase
prescription drugs. The rule of 'Caveat Emptor' still applies, however, with a
sharp increase in questionable Web sites that may be selling prescription drugs
illegally. See Full Story
Making a Difference: The Janssen
ElderCare Lifetime Achievement Award
Issues we never dreamed of in youth become terribly real as we age: physical
problems, financial worries and a complex, building regimen of medications; the
terrifying prospect of needing long-term care whether at home or a nursing
home. It's not a very nice picture is it? These remarks opened the presentation
of the Janssen ElderCare Lifetime Achievement Awards at the U.S. Geriatric
& Long-Term Care Congress this past June in Las Vegas. The award was
created by Johnson & Johnson to honor those whose lives exemplify the
profession of caring for older adults.See Full
Story
May/June 2000
Health Care Without
Borders
The interdisciplinary approach is a critical element for appropriate geriatric
care, which often involves treatment of complex and chronic conditions. What
will be the role of the interdisciplinary team be as the health care landscape
continues to evolve? See Full Story
Medication Developments for Diseases
of the Elderly
More than 450 new medications are under development for treating the three
leading causes of death in older Americans-heart disease, cancer and stroke.
Advances in medications with not only reducing death rates from heart disease,
cancer and stroke, but also with increasing the quality of life in older adults
by reducing the disability associated with major illnesses. See Full Story
Prescription Politics: The New Drug
War
The need for prescription drug coverage for Medicare recipients has become a
certainty. But, in this election year, it's still not clear what coverage will
consist of, who will be eligible and who, ultimately, will pay the price. See Full Story
Nursing Homes Persist As
Gerontology's Greatest Challenge Nursing homes are among the most
challenging environments in which physicians deliver care. The appalling
conditions, neglect and below-standard care in some homes have resulted in
lawsuits and a re-evaluation of standards by government agencies responsible
for their oversight. See Full Story