Can Home-Based Physical Therapy Benefit Older Adults with Dementia?

Journal of the American Geriatrics Society Research Summary

Dementia is the leading cause of disability for more than 5 million people aged 65 and older in this country. By 2050, that number is predicted to quadruple. Dementia can cause memory, language and decision-making problems, mood changes, increased irritability, depression, and anxiety.

Dementia also can cause poor coordination as well as balance problems and falls. These difficulties can affect quality of life, reduce caregiver well-being, and increase healthcare costs.

Researchers designed a study to learn more about whether physical therapy (PT) rehabilitation services could improve dementia-associated declines. They published their findings in the Journal of the American Geriatrics Society.

The researchers noted that we understand that physical activity and exercise programs provided by physical therapists can improve balance and reduce fall risk. However, we don’t know whether providing PT in the home could benefit people with dementia. The researchers wanted to learn whether home health PT could help older adults with dementia improve their ability to perform daily functions. These functions include activities like grooming, dressing, bathing, being able to get to and from the toilet (and being able to clean yourself properly after using the bathroom), getting from bed to a chair, walking, eating, being able to plan and prepare light meals, and being able to use the telephone. The researchers also wanted to learn what amount of home-based PT services resulted in the most improvement with these essential tasks. Continue reading

How Do Older Adults Fare After Hip Fracture?

Journal of the American Geriatrics Society Research Summary

Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home.

As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called “activities of daily living,” or ADLs). They may not be able to get around for months to even years after their fracture. This physical decline can lessen their quality of life, and some 20 percent of older adults go on to long-term care facilities after having a hip fracture.

Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs.

What’s more, hip fractures affect not only the quality of life and health of the older adult, but also that of their caregivers—and can cause financial burdens when the individual requires more care.

Despite all this, the number of daily hours of care people need after a hip fracture has not been well studied. To learn more, researchers designed a study to better understand how older adults fare after suffering hip fractures. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Older Adults with Blood Cancers: How They Fare

Journal of the American Geriatrics Society Research Summary

Although the majority of patients who have blood cancers are older adults, they make up only a small percentage of participants in the clinical trials that lead to new therapies. That’s because the standard research methods used in oncology (cancer medicine) are not ideal for identifying certain vulnerabilities linked to aging, such as having multiple chronic diseases and being frail.

To help remedy that situation, the American Society of Clinical Oncology (ASCO) issued a guideline recommending that older adults who have cancer receive a geriatric assessment to see if they are at increased risk for experiencing side effects from medication and other complications from cancer and its treatment. Recently, a team of researchers examined older adults who have cancer to see whether their ability to manage daily activities as measured by these assessments was linked to staying alive longer. The team published their study in the Journal of the American Geriatrics Society. Continue reading

For Older Adults with Heart Failure: Can Taking Too Many Medications Reduce the Ability to Perform Daily Activities?

Journal of the American Geriatrics Society Research Summary

As we age, we tend to develop a number of chronic health conditions and concerns. Often, managing health problems can mean that older adults may take many different medications. When older adults take five or more medicines (a scenario health experts call “polypharmacy”), it can increase the risk of harmful side effects.

Polypharmacy can contribute to serious problems including falls, disability, and hospitalizations. Taking more than five medications is especially common among older adults with heart failure, which is the leading cause of hospitalization for people age 65 and older. Doctors often prescribe several different drugs to improve heart failure, but this can increase your risk of harmful side effects and interactions between your medications. Older adults who have trouble performing routine daily activities are at a particularly high risk for the negative effects of taking a large number of medications.

In a new study, researchers examined whether limitations in older adults’ abilities to perform their routine daily activities were linked to taking multiple medications for heart failure. They published their study in the Journal of the American Geriatrics Society. Continue reading

Can a Neighborhood Affect an Older Adult’s Health?

Journal of the American Geriatrics Society Research Summary

According to a new study published in the Journal of the American Geriatrics Society, living in socially and economically disadvantaged neighborhoods can have a negative influence on older adults’ health and well-being.

Older adults who live in disadvantaged neighborhoods report having poorer health and have more difficulty getting around and performing daily tasks. What’s more, older adults living in disadvantaged neighborhoods tend to have more chronic illnesses and higher rates of death than do older adults who live in less disadvantaged neighborhoods.

Many issues affect the relationship between neighborhoods and health. One may be that disadvantaged neighborhoods have lower levels of social support for older adults and their caregivers. These neighborhoods also tend to have fewer physical resources, such as access to health care, retail stores, and recreational facilities.

Social and other resources are important for older adults. Therefore, older adults living in disadvantaged neighborhoods may find it harder to maintain well-being while aging. This can make it challenging for our society as a whole to benefit from our increased longevity.

The research team who conducted the study used the 2013 Medicare Health Outcome Survey (HOS) survey. This is a telephone and mail survey that was given to older adults enrolled in Medicare Advantage (MA) health plans (MA plans are insurance plans offered by private companies approved by Medicare). Around 17.6 million people are enrolled in MA plans. This is 31 percent of the population eligible for Medicare (the government program that provides health insurance to people 65-years-old and older). Information about 187,434 older adults was included in the study.

The researchers concluded that disadvantaged neighborhoods are an important predictor of mobility and other limitations among MA beneficiaries, particularly for those with multiple chronic conditions. Compared to those living in less disadvantaged neighborhoods, MA beneficiaries who have multiple chronic conditions and who live in the most disadvantaged neighborhoods are 12 percent more likely to report difficulty performing at least one daily task, such as bathing, dressing, or keeping house.

The researchers suggested that increasing resources in disadvantaged neighborhoods to support health programs for older adults could improve their health outcomes.

This summary is from “Linking Neighborhood Context and Health in Community-Dwelling Older Adults in the Medicare Advantage Program.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Daniel Jung, BS; Amy Kind, MD, PhD; Stephanie Robert, MSW, PhD; William Buckingham, PhD; and Eva DuGoff, PhD, MPP.