New Study: Proton Pump Inhibitors Do Not Contribute to Dementia or Alzheimer’s Disease

JAGS graphicJournal of the American Geriatrics Society Research Summary

Proton pump inhibitors (PPIs) are medications used to treat digestive problems such as ulcers and reflux disease by reducing the body’s production of the acid that helps us digest food. Ulcers are sores that develop on the lining of our digestive system; when they develop in the upper part of the small intestine they are called “duodenal ulcers.” Reflux disease is a condition in which stomach acid or other fluids in the digestive system irritate our food pipe, also known as the esophagus.

Recently, safety questions about these medications have been raised in several studies. These studies suggested that PPIs increased the risk for dementia and Alzheimer’s disease in people 75-years-old or older. Noting that the prescription of PPIs is on the rise among middle-aged and older adults, a team of researchers designed a new study to examine PPIs and the risk of dementia, mild cognitive impairment, and Alzheimer’s disease. They published their study in the Journal of the American Geriatrics Society. The researchers also examined whether people with mild cognitive impairment who took PPIs were at higher risk for developing dementia or Alzheimer’s disease. Continue reading

Difficulties Diagnosing Delirium in Older Adults After Surgery

JAGS graphicJournal of the American Geriatrics Society Research Summary

Delirium is a medical term for “sudden confusion.” It is an abrupt, rapid change in mental function and can cause a wide variety of shifts in behavior ranging from aggression or agitation to feeling sleepy and inactive (or even a combination of several behaviors). When delirium occurs after an older person has had surgery, it’s called “post-operative delirium.”

Experts still don’t always agree on delirium symptoms or diagnoses, even when they are assessing the same symptoms in the same people. A team of researchers from the Netherlands designed a study to look at the accuracy of delirium diagnoses in older adults after surgeries. Their study was published in the Journal of the American Geriatrics Society.

In the study, researchers examined 167 older adults from one to three days after surgery. The researchers used a standard delirium rating scale and recorded the tests on video. Afterwards, the videos were shown to two independent delirium experts. If the experts didn’t agree on a diagnosis, the researchers asked a third expert to review the video. A third expert was called in for 21 percent of the evaluations. Continue reading

Study Examines Caregiving by Family Members, Other Unpaid Individuals

JAGS graphicJournal of the American Geriatrics Society Research Summary

It’s estimated that nearly 30 percent of the 38.2 million people aged 65 or older in this country receive some form of caregiving, either for health reasons or to help manage daily activities. More than 65 percent of these older individuals rely on family members, friends, and even neighbors for assistance with things like preparing meals, bathing, taking medications, and getting transportation.

Caregiving is a significant public health topic because it affects the health and well-being of both the older adult and his or her caregivers. Recently, a team of researchers examined the various characteristics of people who serve as unpaid caregivers. They also estimated how many people serve in this capacity. The researchers took note of the health-related tasks the caregivers provided, as well as how caregiving affected care providers. The researchers published their findings in the Journal of the American Geriatrics Society. Continue reading

Older Married Couples and Advance Directives

JAGS graphicJournal of the American Geriatrics Society Research Summary

Advance directives (ADs) are legal documents you can use to state in advance what medical treatments you do or do not wish to have under certain circumstances. You also can use an AD to name one or more people to act on your behalf if you are ever unable or uncomfortable making your own healthcare decisions.

Studies have shown that, at the end of life, people who have ADs receive less aggressive life-sustaining treatment and are less likely to be admitted to intensive care units, sometimes because those may not be options an older person wants to pursue. They are also more likely to die at home instead of in a hospital, and they receive hospice care earlier and for longer periods of time.

About 50 percent of people 65 and older in the United States have completed ADs. However, little is known about why some people have them while others do not. Most research treats the decision to complete an AD as an individual choice, but we know little about the roles that spouses and other family members may play in a person’s decision to engage in end-of-life planning.

A new study examined the effects spouses had on the decision of older adults to have ADs. The study was published in the Journal of the American Geriatrics Society. Continue reading

Should Your Primary Care Physician be a Generalist or a Specialist? New Study Sheds Light on Benefits vs Costs

JAGS graphicJournal of the American Geriatrics Society Research Summary

Your primary care provider (PCP) is usually your first medical contact when you’re ill. Beyond taking care of you when you’re sick, PCPs help coordinate your health care and make sure you’re up-to-date with your check-ups, tests, and immunizations.

Typically, PCPs are family medicine practitioners, general internists, pediatricians (for children) and geriatricians (for older adults). Some health plans, such as health maintenance organizations (HMOs), require you to choose a PCP whom you must see first before being referred to specialists when necessary. These PCPs play a special role in coordinating your care.

However, other plans—including traditional Medicare and most preferred provider organizations (or PPOs), don’t require you to see a PCP before seeking more specialized care. As a result, many people may see a specialist as their main doctor rather than a PCP who would act as “gatekeeper.” Continue reading