Health In Aging Blog


Have Sleep Apnea? Using Your CPAP Device Consistently May Slow Memory Loss

Journal of the American Geriatrics Society Research Summary

Mild cognitive impairment (MCI) refers to having problems with your memory and decision-making abilities. Usually, people with MCI experience few if any problems with performing their daily activities. Experts say that MCI could be a stage between normal aging and Alzheimer’s disease.

A growing number of studies suggest that obstructive sleep apnea (OSA), or “sleep-disordered breathing,” is associated with a higher risk for memory problems and for problems with thinking and making decisions. OSA is a common condition in older adults who have MCI. Symptoms include disturbed sleep due to reduced or momentarily stopped breathing at night.

If your healthcare practitioner diagnoses you with OSA, she may recommend treatment with continuous positive airway pressure (CPAP), a pressurized mask worn during sleep. CPAP treatment eliminates obstructive sleep apnea. However, to be effective, people must use the CPAP machine regularly for at least four hours per night. Only 30 to 60 percent of people who are prescribed CPAP therapy use the machine regularly as prescribed. Additionally, few studies have confirmed whether or not CPAP treatment delays cognitive decline. Now researchers in a new study examined whether using CPAP treatment had an effect on slowing cognitive decline. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Periodontitis May Raise the Risk for Developing Dementia

Journal of the American Geriatrics Society Research Summary

Gum disease (gingivitis) that goes untreated can become periodontitis. When this happens, the infection that affected your gums causes loss in the bone that supports your teeth. Periodontitis is the main cause of tooth loss in adults.Interestingly, periodontitis is also a risk factor for developing dementia, one of the leading causes for disability in older adults. A United Nations forecast estimates that 1 in 85 individuals will be diagnosed with Alzheimer’s disease, a form of dementia, by the year 2050. Reducing the risk factors that lead to dementia and Alzheimer’s disease could potentially lower older adults’ chances of developing those conditions.

Recently, researchers in South Korea studied the connection between chronic periodontitis and dementia. They published their findings in the Journal of the American Geriatrics Society.

The research team examined information from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS). In South Korea, the NHIS provides mandatory health insurance covering nearly all forms of health care for all Korean citizens. The agency also provides health screening examinations twice a year for all enrollees aged 40 years or older and maintains detailed health records for all enrollees.

The researchers looked at health information from 262,349 people aged 50 or older. All of the participants were grouped either as being healthy (meaning they had no chronic periodontitis) or as having been diagnosed with chronic periodontitis. The researchers followed the participants from January 1, 2005 until they were diagnosed with dementia, died, or until the end of December 2015, whichever came first.

The researchers learned that people with chronic periodontitis had a 6 percent higher risk for dementia than did people without periodontitis. This connection was true despite behaviors such as smoking, consuming alcohol, and remaining physically active. The researchers said that to their knowledge, this is the first study to demonstrate that chronic periodontitis could be linked to a higher risk for dementia even after taking lifestyle behaviors into account.

The researchers suggested that future studies be conducted to investigate whether preventing and treating chronic periodontitis could lead to a reduced risk of dementia.

This summary is from “Association of Chronic Periodontitis on Alzheimer’s Disease or Vascular Dementia.” It appears online ahead of print in the February 2019 issue of the Journal of the American Geriatrics Society. The study authors are Seulggie Choi, MD; Kyuwoong Kim, BSc; Jooyoung Chang, MD; Sung Min Kim, BSc; Seon Jip Kim, RDH; Hyun-Jae Cho, DDS, PhD; and Sang Min Park, MD, PhD, MPH.

AGS Releases New Action Steps to Guide Care for Older Adults with Multiple Chronic Illnesses

Journal of the American Geriatrics Society Research Summary

Caring for older adults with multiple chronic conditions can create challenging situations. For example, some treatments may be harmful to older adults who live with and manage several chronic conditions. In some cases, several treatments might be available but healthcare providers may not know which are best for a particular individual. In other cases, older adults and caregivers could even receive different treatment recommendations depending on the healthcare providers who offer guidance. Most important of all, managing care for multiple chronic conditions can make it difficult to focus on what matters most to us as individuals—a key priority when we think about the high-quality, person-centered care we all want and need as we age.

In 2010, the American Geriatrics Society (AGS) convened a panel of medical experts to address how to provide the best care for older adults living with multiple chronic conditions. The panel reviewed a host of clinical studies and developed the AGS Guiding Principles for the Care of Older Adults with Multimorbidity as a result.

The expert panel identified five “key principles” that healthcare providers should follow to support the best care for older adults with multiple chronic conditions:

  1. Include personal preferences in care decision-making. Older adults who have multiple chronic health conditions should be asked how they wish to make medical decisions affecting their care. Whenever appropriate, caregivers and family members should also be involved in these discussions.
  2. Understand the limits of evidence on treatment options. Clinicians must understand that specific, evidence-backed answers to questions about the best medical choices for individual older adults may not exist. That’s because every older adult and every health situation is unique.
  3. Weigh benefits versus harms. When addressing multiple chronic conditions for an older individual, clinicians must consider how a person might be burdened by one medical plan or treatment versus others. They also must weigh the benefits of treatment options, as well as information on the person’s functional status (their ability to perform daily activities such as bathing and eating), life expectancy (how long they are likely to live), and quality of life.
  4. Consider if treatment is manageable. When sharing recommendations, clinicians must account for the complexity of a treatment and whether it suits an older adult’s particular situation.
  5. Make the best informed choice possible. Ultimately, healthcare professionals also must try to choose therapies that have the most benefit, pose the least harm, and will work to enhance an older person’s quality of life.

Now, an expert group of geriatricians, cardiologists, and general physicians have identified a set of action steps based on those guiding principles to help healthcare providers work with older adults and caregivers to make the best treatment choices possible when addressing multiple chronic conditions.

These steps include: Continue reading

Depression Increases Risk of Death in Older Adults

Journal of the American Geriatrics Society Research Summary

As we age, we become more likely to experience symptoms of depression. Research shows that depression’s symptoms can be linked to a higher risk for death. Yet often, older adults’ symptoms of depression may be missed by healthcare professionals.

What’s more, symptoms of depression have been linked to heart disease and stroke in middle-aged and older adults. Researchers suggest that the depression-heart disease link could play a role in the increased risk of death among older adults who have symptoms of depression. There’s also a known link between depression and deaths from cancer and falls in older adults. These connections might contribute to an increased risk of death for older adults, researchers suggest.

Since depression symptoms change over time, it’s possible that studying those symptoms during an older adult’s doctor visits could provide more information. To learn more, a research team designed a study to investigate the role depression symptoms play in an increased risk of death over time. The team also examined the role heart disease and stroke play in the link between depression symptoms and increased risk of death. Their study was published in the Journal of the American Geriatrics Society. Continue reading

New Wisdom about High Cholesterol Treatment for Adults Aged 80 and Older

Journal of the American Geriatrics Society Research Summary

Experts know that in adults younger than 65, having high cholesterol levels in your blood can raise your risk for heart attacks and strokes. However, in adults 80 years old and older, researchers have not—until now—thoroughly studied high cholesterol’s impact on heart disease, your ability to function well, or your risk for death.

In fact, some research shows that a higher level of total cholesterol and a lower level of so-called “bad” cholesterol (also known as “low-density lipoprotein” or LDL cholesterol) might be helpful in protecting your ability to perform daily activities and preserving your life for longer.

What’s more, it appears that having low cholesterol is linked to a higher risk of death from cancer, respiratory disease, and accidents in adults aged 80 and older. It also appears that the benefits of taking medications known as statins, which lower cholesterol, may lessen as people age. Researchers even have a phrase for this phenomenon. They call it the “risk factor paradox.” This describes the fact that for adults aged 80 and older, having some conditions that are considered health risks in younger adults predicts better survival. These conditions include having higher total cholesterol, higher blood pressure, and higher body mass index (BMI, a ratio of body weight to height that helps determine whether you are overweight or obese). Continue reading