The Far-Reaching Effects of a Fall – NYTimes.com

Statistics among older people are indeed daunting. Dr. Laurence Z. Rubenstein, chairman of geriatrics at the University of Oklahoma College of Medicine, reports that those 65 and older constitute about 13 percent of the population but account for three-fourths of all deaths caused by falls. About 40 percent in this age group fall at least once a year; one in 40 of them ends up in the hospital, after which only half are still alive a year later.

via The Far-Reaching Effects of a Fall – NYTimes.com.

Neurotoxicity with Antimicrobials in the Elderly: A Review – Clinical Therapeutics

Yikes!

Neurotoxicity with Antimicrobials in the Elderly: A Review – Clinical Therapeutics.

Findings

Various antimicrobial classes are implicated with neurotoxicity. The classes with the most reported cases include fluoroquinolones, macrolides, sulfonamides, nitrofurans, and β-lactams. A higher risk of developing various symptoms of neurotoxicity was found in the elderly with use of piperacillin and tazobactam, cephalosporins, carbapenems, aminoglycosides, trimethoprim and sulfamethoxazole, nitrofurantoin, linezolid, and possibly the fluoroquinolones. Potential mechanisms of neurotoxicity differ between the agents. The etiology of neurotoxicity with some agents is not fully elucidated. Incidence may increase with reported risk factors, renal dysfunction, or drug interactions.

Many Meds Taken by Seniors Can Raise Risk of Falls

Many Meds Taken by Seniors Can Raise Risk of Falls.

After adjusting for the number of medications a person was taking, the researchers found men and women taking opioid painkillers as well as men taking antidepressants were more than twice as likely to have a fall injury as seniors who were not taking those drugs. Women taking antidepressants were 75% more likely to have a fall injury.

More on Sleeping Pills and Older Adults – NYTimes.com

More on Sleeping Pills and Older Adults – NYTimes.com.

Now the C.D.C. has reported that a high number of emergency room visits are associated with psychiatric medications in general, and zolpidem — Ambien — in particular. They’re implicated in 90,000 adult E.R. visits annually because of adverse reactions, the study found; more than 19 percent of those visits result in hospital admissions.

Boomer Report – NIH-commissioned Census Bureau Report

Email received and reproduced in its entirety.

NIH-commissioned Census Bureau report highlights effect of aging boomers

Data on individual, economic, social changes linked to dramatically aging population

While rates of smoking and excessive drinking have declined among older Americans, prevalence of chronic disease has risen, and many older Americans are unprepared to afford the costs of long-term care in a nursing home, according to a report from the U.S. Census Bureau commissioned by the National Institutes of Health.

The report highlights those trends and others among America’s older population, now over 40 million and expected to more than double by mid-century, growing to 83.7 million people and one-fifth of the U.S. population by 2050. Population trends and other national data about people 65 and older are presented in the report, 65+ in the United States: 2010 (PDF, 12.0M). It documents aging as quite varied in terms of how long people live, how well they age, their financial and educational status, their medical and long-term care and housing costs, where they live and with whom, and other factors important for aging and health.

Funded by the National Institute on Aging (NIA), part of NIH, the report draws heavily on data from the 2010 Census and other nationally representative surveys, such as the Current Population Survey, the American Community Survey and the National Health Interview Survey. In addition, data from NIA-funded research was included in the report.

“The National Institute on Aging is pleased to support this 65+ in the United States report,” said Richard Suzman, director of the Division of Behavioral and Social Research at NIA. “This report series uniquely combines Census Bureau and other federal statistics with findings from NIA-supported studies on aging. The collaboration with Census has been of great value in developing social, economic and demographic statistics on our aging population with this edition highlighting an approaching crisis in caregiving — since the baby boomers had fewer children compared to their parents.”

A key aspect of the report is the effect that the aging of the baby boom generation—those born between 1946 and 1964—will have on the U.S. population and on society in general. Baby boomers began to reach age 65 in 2011; between 2010 and 2020, the older generation is projected to grow more rapidly than in any other decade since 1900.

The report points out some critical health-related issues:

 

  • Rates of smoking and excessive alcohol consumption have declined among those 65 and older, but the percentage of overweight and obese people has increased. Between 2003-2006, 72 percent of older men and 67 percent of older women were overweight or obese. Obesity is associated in increased rates of diabetes, arthritis, and impaired mobility, and in some cases with higher death rates.
  • Research based on NIA’s Health and Retirement Study suggests that the prevalence of chronic diseases, such as high blood pressure, heart disease, chronic lung disease, and diabetes, increased among older people between 1998 and 2008. For example, in 2008, 41 percent of the older population had three or more chronic conditions, 51 percent had one or two, and only 8 percent had no chronic conditions.
  • The cost of long-term care varies by care setting. The average cost of a private room in a nursing home was $229 per day or $83,585 per year in 2010. Less than one-fifth of older people have the personal financial resources to live in a nursing home for more than three years and almost two-thirds cannot afford even one year. Medicare provides coverage in a skilled nursing facility to older and disabled patients for short time periods following hospitalization. Medicaid covers long-term care in certified facilities for qualifying low-income seniors. In 2006, Medicaid paid for 43 percent of long-term care.

“Most of the long-term care provided to older people today comes from unpaid family members and friends,” noted Suzman. “Baby boomers had far fewer children than their parents. Combined with higher divorce rates and disrupted family structures, this will result in fewer family members to provide long-term care in the future. This will become more serious as people live longer with conditions such as cancer, heart disease and Alzheimer’s.”

Other areas covered in the report include economic characteristics, geographic distribution, social and other characteristics. See highlights below.

“We hope this report will serve as a useful resource to policymakers, researchers, educators, students and the public at large,” said Enrique Lamas, the Census Bureau’s associate director for demographic programs. “We sought to develop a comprehensive reference with up-to-date information from a variety of reliable sources.”

About the National Institute on Aging (NIA): The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go to www.nia.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery into Health

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65+ in the United States: 2010 (PDF, 12.0M)
Highlights

Population Characteristics

  • In 2010, there were 40.3 million people aged 65 and older, 12 times the number in 1900.
  • The percentage of the population aged 65 and over among the total population increased from 4.1 percent in 1900 to 13.0 percent in 2010 and is projected to reach 20.9 percent by 2050.
  • From 2010 onwards, the older dependency ratio—the number of people aged 65 and over per 100 people aged 20 to 64—is expected to rise sharply as the baby boomers enter the older ages. In 2030, when all baby boomers will have already passed age 65, the older dependency ratio is expected to be 37, which translates into fewer than three people of working age (20 to 64) to support every older person.
  • The older population has become more racially and ethnically diverse, with those identifying their race as white alone comprising 84.8 percent in 2010, down from 86.9 percent in 2000.

Health and Long-term Care

  • Over 38 percent of those aged 65 and over had one or more disabilities in 2010, with the most common difficulties being walking, climbing stairs and doing errands alone.
  • The share of the older population residing in skilled nursing facilities declined from 4.5 percent in 2000 to 3.1 percent in 2010. The share in other long-term care facilities, such as assisted living, has been growing.
  • Medicaid funds for long-term care have been shifting away from nursing homes with funding for home- and community-based services increasing from 13 percent of total funding in 1990 to 43 percent in 2007.
  • Changing marital trends, such as the rise of divorces, as well as the increase in living alone among the 65-and-over population, will likely alter the social support needs of aging baby boomers.

Economic Characteristics

  • Labor force participation rates rose for both older men and older women in the first decade of the 21st century, reaching 22.1 percent for older men and 13.8 percent for older women. In contrast, the labor force participation rates for the population aged 25 to 34 fell from 2000 to 2010 for both men and women.
  • The older white alone population was less likely than the older black alone and Asian alone populations to live in poverty. Older Hispanics were more likely to live in poverty than older non-Hispanic white alone residents.
  • Following the housing price peak in 2006, homeownership rates declined for the population under age 65 but remained flat for older householders.
  • Housing costs were slightly less of a burden in 2009 compared with 2001 for older householders.
  • Many older workers managed to stay employed during the recession. The population aged 65 and over was the only age group not to see a decline in its employment share from 2005 to 2010. In 2010, 16.2 percent of the population aged 65 and over were employed, up from 14.5 percent in 2005.

Geographic Distribution

  • Eleven states had more than 1 million people aged 65 and older in 2010.
  • States with the highest proportions of older people in their populations in 2010 included Florida, West Virginia, Maine, and Pennsylvania (all above 15 percent).
  • The West and South regions experienced the fastest growth in their 65-plus and 85-plus populations between 2000 and 2010.
  • In 2010, more than 7 out of 10 older Hispanics lived in four states: California (26.9 percent), Texas (19.2 percent), Florida (15.7 percent), and New York (9.0 percent).
  • The vast majority of older people do not move, but their moving rates remained stable between 2000 and 2010, in contrast to the slowdown in migration among younger populations.

Social Trends

  • The population aged 65 and over was the only age group to see an increase in voter participation in the 2012 presidential election compared with the 2008 presidential election.
  • In 2010, Internet usage among the older population was up 31 percentage points from a decade prior.
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Johns Hopkins Health Alert – Updated Guidelines for Knee OA

Updated Guidelines for Knee Osteoarthritis

Many nonsurgical treatments are touted as being able to ease the symptoms of knee osteoarthritis, but which ones really work? Last year, the American Academy of Orthopaedic Surgeons (AAOS) issued revised recommendations, updating its 2009 guidelines. The group made two important changes that may affect the way you manage knee osteoarthritis.

  • First, if you use acetaminophen (Tylenol) for osteoarthritis pain relief, take no more than 3,000 mg per day. The AAOS formerly advised not exceeding 4,000 mg daily. The change was made to reflect the Food and Drug Administration’s current guidelines for safe use of acetaminophen.
  • Second, the AAOS found insufficient evidence that intra-articular hyaluronic acid provides significant symptom relief for knee osteoarthritis so the organization no longer recommends the therapy.

The AAOS continues to give a thumbs-up to some familiar commonsense strategies, such as exercising and a minimum 5 percent weight loss for people whose body mass index (BMI) is greater than 25.

Other highlights: The AAOS is unable to recommend for or against the use of bracing, growth factor injections and/or platelet-rich plasma knee osteoarthritis. In addition, although acupuncture continues to grow in popularity, there is not sufficient scientific evidence to support its use in patients with knee osteoarthritis.

Published online in Treatment of Osteoarthritis of the Knee. Evidence-Based Guideline, 2nd Edition, May 18, 2013

Click to access TreatmentofOsteoarthritisoftheKneeGuideline.pdf

Here’s the link if you want to download the entire set of guidelines in pdf format.