Number of Kidney Transplants Double Among Elderly

Elderly kidney failure patients in the United States are twice as likely to get a kidney transplant as they were in the mid-1990s.

While a new study just released reports that the likelihood is still low, the researchers noted that elderly kidney failure patients now have greater access to kidneys from living donors and older deceased donors, and are less likely to die while waiting for a transplant.

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About half a million people in the United States have kidney failure according to data gathered by the American Association for Long-Term Care Insurance which tracks medical and health conditions impacting the longevity of Americans.  The data notes that  48 percent of them are 60 or older.

The study which will be published shortly in the Clinical Journal of the American Society of Nephrology, included kidney failure patients, aged 60 to 75, listed in the national Renal Data System between 1995 and 2006.

In 2006, these elderly patients had a 7.3 percent chance of getting a kidney transplant within three years of their first treatment for kidney failure. That rate was two times higher than in 1995.

Elderly kidney failure patients should consider transplantation over other types of treatment, suggested the study authors.

Hospitalized Patients With Sepsis Seniors More Likely To Get Alzheimer's

Older patients hospitalized for severe sepsis are at higher risk for long-term cognitive impairment and physical limitations than those hospitalized for other reasons.

The conclusion was reported following a study by ached by the Department of Preventive Medicine at Stony Brook University Medical Center and reported in the Journal of the American Medical Association.

Sepsis is a condition in which the immune system goes into overdrive releasing chemicals into the blood to combat infection. Sepsis occurs in 1 percent to 2 percent of all hospitalizations in the United States. Sepsis often results after common problems such as pneumonia and urinary tract infections.

Approximately 40 percent of those with severe sepsis die from the condition.  Among surviving patients the researchers found that the odds of acquiring moderate to severe cognitive impairment were 3.3 times higher following an episode of sepsis than for other hospitalizations.

Overall, the study also showed that 60 percent of hospitalizations for severe sepsis were associated with worsened cognitive and physical function among surviving older adults. Severe sepsis also was associated with greater risk for the development of new functional limitations following hospitalization.

Among patients who had no limitations before sepsis, more than 40 percent developed trouble with walking. Nearly 1 in 5 developed new problems with shopping or preparing a meal. Patients often developed new problems with such basic things as bathing and toileting themselves both conditions that result in the need for long-term health care services according to the American Association for Best Long-Term Care Insurance Information (AALTCI) a national trade group.   

Patients in the study had a mean age of nearly 76.9 years. The cohort involved 1,194 individuals with 1,520 hospitalizations for severe sepsis drawn from the Health and Retirement Study, a nationally representative survey of U.S. residents from 1998 to 2006, which collects information on the health, economic, and social factors influencing the health and well-being of Americans over age 50. 

Medicaid's Growth Will Strain States

While the federal government will pay much of the costs related to the Patient Protection and Affordable Care Act (PPACA), states will still find their share unaffordable. 

That's the analysis reported by Devon Herrick, a senior fellow with the National Center for Policy Analysis.

The Patient Protection and Affordable Care Act (PPACA) is expected to add up to 16 million more Medicaid enrollees and will significantly expand eligibility for families with incomes up to 133 percent of the federal poverty level. The PPACA requires states to streamline their enrollment process - making it easier for eligible populations to enroll and retain Medicaid coverage.

Initially, the federal government will pay 100 percent of the cost of the newly eligible, newly enrolled populations and 95 percent of costs through 2019. However, there are hidden costs that will strain state budgets.

According to various estimates, there are 10 million to 13 million uninsured people who are already eligible for Medicaid - but not enrolled. When the individual mandate to obtain health coverage takes effect in 2014, many of the uninsured are likely to be swept up in outreach efforts, Herrick reports.

Although the cost of enrolling newly eligible individuals will be paid by the federal government, the cost of covering those previously eligible for Medicaid must be paid for under the current federal matching formula. Many states will find the cost of their Medicaid programs higher as a result. 

For example, a decade after the PPACA's implementation, Texas Medicaid rolls are predicted by the Texas Department of Health and Human Services to rise by 2.4 million people.  Of these, only 1.5 million enrollees will be newly eligible. About 824,000 individuals will be those previously eligible but not enrolled. The federal government will contribute a much smaller share of the cost of these previously eligible enrollees compared to newly eligible enrollees.

On the average, reimbursements for Medicaid providers are only about 59 percent of what a private insurer would pay for the same service, but it varies from state-to-state.   The reports notes that New York pays primary care physicians only about 29 percent of what private insurers pay for primary care.

Many of the newly insured under Medicaid will likely be those who previously had private coverage. Research dating back to the 1990s consistently confirms that when Medicaid eligibility is expanded, 50 percent to 75 percent of the newly enrolled are those who have dropped private coverage. In addition, a 2007 analysis by MIT economist Jonathan Gruber, found, on average, about 60 percent of newly enrolled children in State Children's Health Insurance Program were previously covered privately. Thus, it is reasonable to conclude that much of the increase in Medicaid rolls will be individuals who were previously privately insured, meaning the number of uninsured will not fall as expected.

"Everyone wants something for nothing forgetting that someone ultimately has to pay the cost," explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance.  "In two decades we will have two classes of citizens.  Those with the means to pay will have choice and control of their care.  Everyone else will depend on whatever taxpayer-paid government programs exist."

Women Heavily Burdened by Alzheimer's Disease

Alzheimer's disease will place an increasing burden on women according to new reports.

November is Long-Term Care Awareness Month and even the U.S. Congress has urged "the people of the United States to recognize (this) as an opportunity to learn more about the potential risks and costs … and the options available."   Alzheimer's is a leading cause of need for long-term care.

Over 10 million American females either have Alzheimer's disease (AD) or look after a patient with the disease, according to the American Association for Long-Term Care Insurance. 

Two thirds (65%) of all Alzheimer's patients are female (3 million in America) and 6.7 million women care for somebody with the disease, says The Shriver Report, a collaboration between California's First Lady Mary Shriver and The Alzheimer's Association.

By the year 2050 approximately 8 million women will have AD in the US.

Here are some of the highlights of the report:

·         Over 10 million American females either have AD or look after a patient with the disease

·         65% of Alzheimer's patients are female

·         60% of caregivers of Alzheimer's patients are female

·         40% of caregivers who are female say they have no choice

·         One third of all female caregivers are caring for somebody with AD around the clock, seven days a week

·         The impact of AD on business, families and government is estimated to be $300 billion annually

·         Nearly two-thirds of caregivers who also have a job say they have no choice but to get to work late, clock off early and sometimes take time off to care for somebody with AD.

Despite hundreds of clinical trials and millions spent on research, Alzheimer's disease is still incurable. Researchers and experts continue to hope, and say we are making progress. Even so, there is a feeling among most Americans that scientific progress is too slow. When compared to innovative breakthroughs that have occurred in diabetes, stroke, cancer and heart disease, Americans rank Alzheimer's at the bottom of the list.

Carrots And Celery Reduce Memory Decline

Diets rich in the plant compound luteolin reduces age-related inflammation in the brain and related memory deficits.   

Luteolin is found in many plants, including carrots, peppers, celery, olive oil, peppermint, rosemary and chamomile.  The compound inhibits the release of inflammatory molecules in the brain.

According to researchers who examined the effects of dietary luteolin in a mouse model of aging and reported their findings in the Journal of Nutrition.

The researchers focused on specialized immune cells that reside in the brain and spinal cord.   Inflammation in the brain also appears to be a key contributor to age-related memory problems, said the University of Illinois animal sciences professor who led the new study.

Scientists found previously that during normal aging, microglial cells become dysregulated and begin producing excessive levels of inflammatory cytokines.  The researcher has spent nearly a decade studying the anti-inflammatory properties of nutrients and various bioactive plant compounds, including luteolin.

According to the American Association for Long-Term Care Insurance which tracks aging research and issues, this is the first study to suggest, however, that luteolin improves cognitive health by acting directly on the microglial cells to reduce their production of inflammatory cytokines in the brain.

The researchers showed that microglial cells that were exposed to a bacterial toxin produced inflammatory cytokines that could kill neurons. When the microglia were exposed to luteolin before they encountered the toxin, however, the neurons lived.

The researchers next turned their attention to the effects of luteolin on the brains and behavior of adult (3- to 6-month-old) and aged (2-year-old) mice. The mice were fed a control diet or a luteolin-supplemented diet for four weeks. The researchers assessed their spatial memory and measured levels of inflammatory markers in the hippocampus, a brain region that is important to memory and spatial awareness.

Normally, aged mice have higher levels of inflammatory molecules in the hippocampus and are more impaired on memory tests than younger adult mice. Aged mice on the luteolin-supplemented diet, however, did better on the learning and memory task than their peers, and the levels of inflammatory cytokines in their brains were more like those of the younger adult mice.

The data suggests that consuming a healthy diet has the potential to reduce age-associated inflammation in the brain, which can result in better cognitive health.

Record Poor Will Impact Long Term Care Services

A record number of Americans signed up for Medicaid last year and experts warn it will impact those needing long term care.

According to a report released by the Kaiser Family Foundation enrollment in Medicaid, medical insurance program for the poor, increased to more than 48 million - a record 15.7 percent share of the U.S. population.  

"There will be two classes of Americans, those who will have to accept whatever care the government programs can afford, and those who have assets or insurance to pay," explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance.  "People in their 50s today are in for a real shock unless they expect things to get much better."

With the economy barely improving, states are forecasting a 6 percent increase in the rolls next year, meaning another strain on their cash-depleted budgets. The Medicaid numbers are the latest piece to emerge in a grim statistical picture of the recession's toll.

The ranks of the working-age poor climbed to the highest level since the 1960s last year, according to a recent Census report. Nearly 12 million households received food stamps, a record.

The $814 billion federal economic stimulus plan passed last year provided extra funding for states for Medicaid, in the hope of covering the costs of the increased number of enrollees and of freeing up state budgets for spending in other areas.

The plan helped states drop their spending on Medicaid, which can take up a third of their budgets, by 7.1 percent in fiscal 2010 and by 10.9 percent in fiscal 2009, Kaiser found. But even with the U.S. government shouldering a greater share of the burden, states were forced to make cuts. In fiscal 2010 48 of the 50 states made cuts to some part of their Medicaid programs, according to the report. In fiscal 2011, 46 states intend to cut back on Medicaid spending.

Altogether, 20 states restricted the types of benefits enrollees could use in fiscal 2010, the largest number since records began in 2001.