When an Advance Directive is in Place, Dying is More Dignified and Peaceful
A Belgian study suggests that when a nursing home patient has advanced directives in place, dying is more peaceful. Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life. Investigators set out to investigate to what extent (1) advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2) the existence of written advance general practitioner orders were related to the quality of dying of nursing home residents with dementia. Researchers concluded that for nursing home residents with dementia there is a strong association between having a written advance directive and quality of dying. Where wishes are written, relatives report lower levels of emotional distress at the end of life. Read my full post on my about.com site.
COPD Associated With Increased Risk for Mild Cognitive Impairment
A diagnosis of chronic obstructive pulmonary disease (COPD) in older adults was associated with increased risk for mild cognitive impairment (MCI), especially MCI of skills other than memory, and the greatest risk was among patients who had COPD for more than five years according to a study in JAMA. Balwinder Singh, M.D., M.S., of the Mayo Clinic, Rochester, Minn., and colleagues conducted the study. COPD is an irreversible limitation of airflow into the lungs, usually caused by smoking. More than 13.5 million adults 25 years or older in the U.S. have COPD. Previous research has suggested COPD is associated with cognitive impairment. The authors examined the association between COPD and MCI, as well as the duration of MCI, in 1,425 individuals (ages 70 to 89 years) with normal cognition in 2004 from Olmsted County, Minn. At baseline, 171 patients had a COPD diagnosis. Of the 1,425 patients, 697 developed some type of impairment.åÊ A diagnosis of COPD increased the risk 83 percent during a median of 5.1 years of follow-up. Patients who had COPD for more than five years had the greatest risk for MCI. Enough said.
Supplements Have No Benefit in Reducing Risk of Cardiovascular Disease in Elderly with Macular Degeneration
According to a new study in JAMA, supplements have no benefit in reducing risk of cardiovascular disease in the elderly with macular degeneration. Daily dietary supplements of omega-3 polyunsaturated fatty acids (also found in fish) or lutein and zeaxanthin (nutrients found in green leafy vegetables) were not associated with reduced risk for cardiovascular disease . According to researchers, diet studies have suggested that increased intake of fish, a source of omega (ìä)-3 fatty acids, can reduce rates of cardiac death, death from all other causes and heart attack. However, the evidence that taking dietary supplements containing those fatty acids has been inconsistent and has suggested no reduction in CVD events. They wanted to particularly study the impact for those with the eye disease. 4,203 individuals were randomized to take supplements. The supplements were added to vitamins and minerals recommended for macular degeneration and given to the participants, who were primarily white, married and highly educated with a median age of 74 years at baseline. There was no reduction in CVD (heart attack, stroke and cardiovascular death) or secondary CVD outcomes (hospitalized heart failure, revascularization or unstable angina) among patients taking the supplements. Supplements have always been a touchy topic. My wife and I had our metabolism checked several years ago and went on a number of supplements and lost 30 pounds. Off the supplements I have gained a bunch back. Personally I rather be putting fewer unknown substances in my body. Check with your health professional if you are thinking about supplementation.
New Blood Test Can Predict Alzheimer’s Before Symptoms. Do You Want to Know?
Lead researcher Howard Federoff
Hearing Impairment Associated With Depression in Adults, Especially Women
Hearing Impairment (HI) is associated with depression in adults, especially women and individuals younger than 70 years, according to JAMA authors Chuan-Ming Li, M.D., Ph.D., of the National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Md., and colleagues. Depression and HI are associated with personal, societal and economic burdens. However, the relationship between depression and HI has not been reported in a national sample of U.S. adults. The authors used data on adults 18 years or older (n=18,318) from the National Health and Nutrition Examination Survey (NHANES). A questionnaire was used to assess depression, and HI was measured by self-reporting, as well as hearing tests for adults 70 years or older. The prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater HI. Depression rates were higher in women than in men. The prevalence of depression increased as HI became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 or older; however, an association between moderate HI and depression was found in women but not in men. After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. The authors conclude that health care professionals should be aware of an increased risk for depression among adults with hearing loss. I would add that both my mother and my father-in-law have hearing issues and blast their televisions to damaging decibels. It is certainly frustrating to them when they can not hear but conversely neither, for matters of pride, will consider a hearing aide. So I have a question for the researchers. How do we get more of our hearing impaired to consider these devices and how can we make them more affordable?
