Forging Stronger Social Connections for a Longer Life – NYTimes.com.
Read those senior questionnaires very, very carefully.
Forging Stronger Social Connections for a Longer Life – NYTimes.com.
Read those senior questionnaires very, very carefully.
Looking for a Job When You’re No Longer Young – Anne Kreamer – Harvard Business Review.
I present the link without further comment.
During the past three decades there has been a dramatic, 130-fold increase in knee replacement surgeries, particularly among individuals in their 50s, a Finnish study found.
Knee replacement cost – cost of knee replacement surgery.
After reading about the dramatic increase in the number of knee replacements I did a Google search for “average cost knee replacement” without the quotation marks in the search string. At the top of page one was the second link above.
Taiwan anyone?
A study in the British Medical Journal lit up the Internet last week with the conclusion that cognitive decline begins at age 45. While it’s true that some innate skills like memory and speed of reasoning fall off as we age, other aspects of intelligence related to learning and experience actually improve.
via Patricia Cohen: The Advantages of the Middle-Age Brain | TIME Ideas | TIME.com.
Positive proof the older brain improves with time. I found an article on some positive aspects of the aging brain.
Now if I could only remember where I put my car keys…
Markers of B12 insufficiency all predicted lower global cognitive scores over nearly five years of follow-up, Christine C. Tangney, PhD, of Rush University Medical Center in Chicago, and colleagues found.

Older women who experience a hip fracture have a twofold increase in mortality risk in the first year after the fracture, researchers found.
During the 12 months following the fracture, 16.9% of the women died, compared with 8.4% of controls, for an odds ratio of 2.3 (95% CI 1.9 to 2.8), according to Erin S. LeBlanc, MD, of Kaiser Permanente Northwest in Portland, Ore., and colleagues. They researchers adjusted for potential confounders such as age, bone mineral density (BMD), and coexisting conditions such as diabetes, hypertension, and stroke.
And the increased mortality risk during the first year remained after further adjustment for specific hip fracture risk factors such as total hip BMD (OR 2.4, 95% CI 1.9 to 3.1), the researchers reported online in Archives of Internal Medicine.

Mild cognitive impairment denotes abnormal cognitive decline
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
I actually got this one right.

The NEJM Resident e-Bulletin is one of the ways I keep up with medical information. While it will not be possible for me to reproduce every email that comes from this service, on occasion I will post topics of interest. Copyright remains vested with the NEJM so don’t try and steal this to make money.
R.C. Petersen
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MCI represents an intermediate state of cognitive function between the changes seen in aging and those fulfilling criteria for dementia, often Alzheimer’s disease (AD).
The estimated prevalence of MCI in population-based studies ranges from 10 to 20%. In the Mayo Clinic Study of Aging, a prospective, population-based study of non-demented persons ages 70 to 89 years at enrollment, the prevalence of amnestic MCI was 11.1% and of nonamnestic MCI, 4.9%.
Neuropsychological testing may be necessary to corroborate a history of decline in cognition, usually memory. At times, the “worried well” can give a convincing history for memory loss, but neuropsychological testing reveals normal performance.
Figure 1. Diagnostic Algorithm for Amnestic and Nonamnestic Mild Cognitive Impairment.
A. As compared with the incidence rate for dementia in the general population of 1 to 2% per year, the incidence of dementia in patients with MCI is significantly increased, with an annual rate of 5 to 10% in community-based populations and 10 to 15% in clinic-based populations. The degree of cognitive impairment at presentation is a clinical predictor of progression; those with greater baseline impairment appear more likely to progress more rapidly. The presence of the apolipoprotein E ε4 allele is also predictive of progression rate. Several MRI measures have also been reported to predict a faster rate of progression, including atrophic hippocampi, dilated ventricles, reduced total brain volume, and the presence of white matter hyperintensities.
A. Limited data support the potential benefit of cognitive rehabilitation approaches. Several clinical trials that treated persons with MCI with cholinesterase inhibitors used for AD (donepezil, galantamine, and rivastigmine) at standard AD treatment doses for 2 to 4 years have shown no significant reduction in the rates of progression to dementia.
Medical News: Olive Oil Protects Against Stroke – in Neurology, Strokes from MedPage Today
Observational study on French people.
I wonder if the researchers controlled for red wine consumption.

Why We Don’t Take Care of Ourselves
Negative stereotypes about aging lead to the adoption of less healthy lifestyle choices that turn the negative stereotypes into a self-fulfilling prophecy.
Take Home Message:
Watch for signs of negative belief systems about aging in medical records.
Especially in the older population.

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