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People with congestive heart failure often receive warfarin to prevent blood clots, but a large randomized double-blinded trial concludes that aspirin works just as well, according to a study from The New England Journal of Medicine.
Researchers studied 2,305 patients with heart failure and normal heart rhythm. They gave half of them regimens of warfarin and dummy aspirin, while the other half took aspirin and dummy warfarin. The scientists followed them for up to six years, tracking incidents of stroke, hemorrhage and death, The New York Times reports.
While there was no significant difference between the two drugs overall, patients who took warfarin were significantly less likely to have a stroke, but that advantage was canceled out by an increased likelihood of gastrointestinal bleeding and other hemorrhages. There were no significant differences in heart attacks or hospitalizations for heart failure.
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Older adults who exercised and used computers reduced the risk of memory loss, whereas doing either activity by itself did not, according to a study from the May issue of Mayo Clinic Proceedings.
Participants who performed moderate physical activity and used a computer were 64 percent less likely to experience mild cognitive impairment compared to those who did not use a computer and who did not exercise, MyHealthNewsDaily.com reports.
For more information, click here for the article from MSNBC.com.
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Eating berries could ward off the cognitive decline and memory loss that comes with aging, according to findings from the April 26 issue of the Annals of Neurology.
For the study, Harvard researchers examined data from the long-running Nurses' Health Study of almost 122,000 RNs between the ages of 30 and 55 who completed health questionnaires starting in 1976. Every four years the nurses were surveyed on their eating habits. Then, researchers began testing memory in 16,000 of the nurses who were over 70 between 1995 and 2001, according to this article from CBS News.
By testing memory every two years, the researchers found nurses who ate the most blueberries and strawberries delayed their memory decline up to 2.5 years compared with those who did not report eating berries.
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Any kind of daily physical activity can reduce the risk of Alzheimer's disease even in people older than 80, according to a forthcoming study from Neurology.
Even chores like washing dishes and cooking or tasks like moving a wheelchair with your arms count as physical activity--and can help lower risk for Alzheimer's disease, according to this article on WEBMD.com.
Researchers asked 716 elderly people, who were an average age of 82 and who did not have dementia, to wear a device called an actigraph that monitors activity for 10 days. The device recorded all physical activity. Participants also took several mental tests each year to measure memory and thinking abilities.
After three-and-a-half years, 71 people developed Alzheimer's disease. Those in the bottom 10 percent for daily physical activity were more than twice as likely to develop Alzheimer's disease as those in the top 10 percent, the study shows.
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Reviewing medications regularly is important for people of all ages, but especially for nursing home residents, who take multiple medications, and are at heightened risk for adverse drug reactions.
This article, from The Washington Post and Consumers Union of United States Inc., suggests everyone should review their medications every four to six months, and always after a hospitalization.
The article suggests asking your doctor the following six questions--for every medicine you're taking. Using a list like this could also be useful for nursing home staff--to help residents avoid the risks of polymedicine.
Here are the questions:
1. Do I really need this drug?
2. What should this drug do for me?
3. Will this drug interact with other medication or supplements I take?
4. Could I take a lower dose?
5. What side effects should I be on the lookout for?
6. Are there nondrug alternatives?
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A study found that consuming an alcoholic drink a day may be good for a man's health following a heart attack.
During the study, which was published recently in the European Heart Journal, researchers followed 1,818 men who survived heart attacks for up to 20 years. The men reported on their health every two years. Every four years, they completed a detailed diet questionnaire that recorded their alcohol consumption and several other factors, according to this article from The New York Times.
While 468 participants died during the course of the study, the researchers found that after controlling for several factors, men who drank one or two glasses of beer or wine daily, or one or two shots of liquor, were 34 percent less likely to die from any cause and 42 percent less likely to die of cardiovascular disease.
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I used to be in charge of the buyers guide for ADVANCE for LTC Management. I remember an array of products being listed in that directory--some more unusual than others. I recall how one of the companies listed products related to bidets. I often wondered how useful those types of products might be for the elderly. It turns out they could be very useful, or at least according to this post from The New York Times' Old Age Blog.
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Less than 10 percent of people with heart failure receive supportive or palliative care beyond basic medical services, according to a news release from the Penn State Newswire. Penn State's School of Nursing aims to change that via a new research project, funded by a $1.7 million grant from the National Institute for Nursing Research.
The study will examine the needs of patients with advanced heart failure in patient/caregiver (pairs). Researchers will study these pairs using the Seattle Heart Failure Model, which calculates projected survival at baseline and after interventions for patients with heart failure. After identifying critical variations in care needs, the investigators will develop an algorithm to guide targeted palliative care interventions for various situations.
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Need a primer on medication management in the elderly? If so, The American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults was released March 1 in the online edition of the Journal of the American Geriatrics Society.
The criteria, last revised in 2003, identify medications that are potentially harmful for older adults, and can help clinicians more safely prescribe for older patients. The 2012 criteria lists 53 medications and classes of medications as potentially problematic in older adults.
See the AGS site for complete details.
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ADVANCE for LTC Management regularly features articles on infection control. Many of those articles have mentioned C. difficile infections in the past. And C. diff, as it's known in the infection control vernacular, is in the news yet again: In fact, the CDC has issued a report that C. diff infections are at record-high rates in health care facilities.
The report indicates that C. diff infection rates rose from 3,000 deaths per year during 1999-2000 to 14,000 deaths per year during 2006-2007. Much of that increase is due to the emergence of a highly virulent, drug-resistant strain of C. difficile bacteria. More than 90 percent of those who died from C. difficile infection were 65 or older.
To guard against the spread of C. diff infections, the report urges health care facilities to coordinate efforts to combat the bacteria in the region, as infection often begins in one facility, but gets transferred--along with patients--to other facilities, according to this article from The Washington Post.
To keep C. diff infections at bay, the report recommends judicious use of antibiotics and prevention efforts, which include handwashing and always wearing gloves and changing them in between patients.
It's also important to thoroughly clean surfaces with an agent specifically designated as effective against C. difficile because many strains are resistant to commonly used disinfectants, according to the report.
Health care communities that have used these prevention efforts reduced C. diff infection rates by 20 percent, according to the report.
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New research suggests that knee replacement surgery can actually save the lives of some patients, according to this report from The New York Times.
Researchers studied Medicare records to examine the effects of joint replacement among almost 135,000 patients who were newly diagnosed with knee osteoarthritis from 1997 to 2009. About 54,000 had knee replacements, while 81,000 did not.
Three years post-diagnosis, the patients who had knee replacements had an 11 percent lower risk of heart failure. After seven years, their risk of dying for any reason was 50 percent lower.
The study, financed by a grant from a knee replacement manufacturer, was not randomized so patients may have been healthier and more active to begin with.
But the researchers attempted to control age and overall health differences. The findings support data from large Scandinavian studies of knee replacements and mortality. Due to the study's large numbers and the size of the effect, the data indicate that knee replacement may improve health and longevity.
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Vision loss-caused by macular degeneration, glaucoma and diabetic retinopathy-can be life altering for many seniors. While treatments are available, far too many people still experience vision decline regardless of medical intervention. Still, there is hope for these people, according to this article on Penn State Live.
Low vision rehabilitation, a multidisciplinary approach to providing visual assistance for people with acquired vision loss, helps people maximize their remaining vision. For example, the approach includes using magnifying aids or other devices to perform daily tasks, such as reading, watching TV, using a computer, cooking and pursuing hobbies.
Optometrists who specialize in low vision rehabilitation evaluate a person's current visual function and recommend devices to achieve a desired goal. For instance, reading the newspaper again might require a stronger bifocal prescription, an illuminated hand-held magnifier or even a high-tech video magnifier/closed-circuit TV. Helping a person watch TV, attend a concert or watch his grandchildren play soccer could involve a hand-held monocular telescope or telescopic glasses.
While learning to use low vision devices takes motivation, practice and patience, the rewards are worthwhile. Although the rate of depression increases sharply in those with recently acquired vision loss, low vision rehabilitation helps increase independence and self-worth, thereby decreasing depression.
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The Penn State Newswire recently published a report on peripheral arterial disease (PAD), which occurs when the legs do not receive enough blood or oxygen due to blocked arteries. PAD may cause discomfort or pain--in hips, buttocks, thighs, knees, shins, or upper feet--during walking.
A person may feel healthy and still have leg artery disease or similar blockages in other arteries, according to the report. Treating this disease is critical because it may place you at a greater risk for limb loss, heart attack or stroke.
To read more about the ways PAD is treated, click here for the article from Penn State Live.
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Regularly drinking green tea may keep elderly adults more agile and independent than their peers over time, according to a Japanese study that appeared in The American Journal of Clinical Nutrition.
Attempting to determine if people who drink green tea have a lower risk of frailty and disability as they grow older, Yasutake Tomata of the Tohoku University Graduate School of Medicine and his colleagues studied almost 14,000 adults aged 65 or older for three years.
They found those who drank the most green tea were the least likely to develop problems with daily activities or basic needs, such as dressing or bathing. They also found that almost 13 percent of adults who drank less than a cup of green tea per day became functionally disabled, compared with just over 7 percent of people who drank at least five cups a day.
For more, see the article from MSNBC.com here.
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A new study suggests that surgery can be very dangerous for the frail elderly, and even more so for nursing home residents, Paula Span reports in an article on the "New Old Age" section of The New York Times.
In fact, even "routine" operations, like appendectomies, become high-risk for nursing home residents, according to a study published in The Annals of Surgery.
The study compared mortality risks and subsequent interventions for four types of major abdominal surgery. Researchers found that even compared with adults of similar age who had the same number of chronic illnesses-but who weren't in institutions-nursing home residents fared sharply worse.