Category Archives: Aging

New tip sheet highlights frailty

Photo by Mark via Flickr.

Frailty is an emerging global health challenge, but it’s not an inevitable consequence of aging. Whether or not a person is frail can often mean the difference between living independently or having to move to a congregate setting like a nursing home. Many clinical trials often exclude frail elders, making it more challenging for practitioners to accurately assess how drug or interventions might work.

Frailty status is important for journalists to bear in mind as they report on clinical studies, programs or therapies for older people. For example, frailer adults may have more limited cognitive or physical reserve or have greater difficulty understanding information. They may require a modified approach — or even several interviews to complete the story.

Numerous home and community services are designed specifically to assist frail elders, so it’s also important to clarify exactly who these interventions target. As this new tip sheet describes, someone is considered frail if they show at least three of the following:

  • Muscle weakness
  • Unintentional weight loss
  • Low physical activity levels
  • Fatigue
  • Slow walking speed

About 15% of non-nursing home residents are considered frail according to the above criteria. Another 45% are regarded as pre-frail. That’s when they meet one or two of the criteria and have a strong likelihood of progressing to frailty. Pre-frailty can even occur in adults in their 50s and 60s, according to researchers at Columbia University.

Frailty has a huge impact on health care costs, quality of life, and is only expected to worsen as more people live into older age. This tip sheet will help you understand some of the condition’s ramifications and connect you with resources and experts who can help put it in context.

Racial disparities seen in Alzheimer’s disease diagnoses

Photo by Tony Gonzalez via Flickr.

Black participants in Alzheimer’s disease research studies were 35% less likely to be diagnosed with Alzheimer’s and related dementias than white participants, according to a recent analysis, despite evidence indicating that that Black Americans are overall about twice as likely to develop Alzheimer’s and other dementias than whites.

The study also revealed that Black participants with Alzheimer’s and related dementias had more risk factors for the disease, greater cognitive impairment and symptom severity than white participants.

These findings offer an opportunity for journalists to educate their audience(s) about risk, prevalence, warning signs and the need for more provider and consumer education about dementia in underserved populations.

A glance at the research

The analysis was conducted among participants in the National Institute on Aging’s network of Alzheimer’s Disease Research Centers (ADRCs) located at major medical institutions throughout the U.S. The goal of these centers is to translate research advances into improved diagnosis and care for people with Alzheimer’s disease and related dementias.

For the current study, investigators wanted to determine if there were related racial differences in cognition, neuropsychiatric symptoms, and functional abilities in diagnosed study participants. They tracked 15 years of data (2005-2020) on 5,700 Black and 31,225 white participants using the Uniform Data Set of the National Alzheimer’s Coordinating Center (NACC), which aggregates data from ADRCs from across the country.

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New index evaluating aging across states is a valuable resource for journalists

Photo by Carlos Ebert via Flickr.

Where you live will help determine how successfully you age. A retrospective analysis by leading aging experts in the U.S. found wide variation in how well states are adapting to their aging populations. They concluded that without a cohesive federal approach, state policy plays a more pivotal role in this process.

In a new article in the Milbank Quarterly, researchers describe how they developed an empirical index to evaluate how U.S. states adapt to societal aging across five critical domains: productivity and engagement, security, equity, cohesion and wellbeing. They found that the level of adaptation to successful aging varied substantially between states and over time. The index is another tool reporters can use to assess whether state health policy is keeping pace with the needs of its older population.

The highest-ranked states in 2017 were Vermont, Hawaii, Iowa, Colorado and New Hampshire. The lowest-ranked states were Louisiana, Arkansas, Kentucky, West Virginia and Mississippi. The greatest improvement in rankings between 2003 and 2017 was shown by South Carolina, Iowa, Arizona and Delaware. Louisiana saw the greatest decline starting in 2010. The study found no national trends in successful aging, suggesting that policy at the state level a significant determinant in adapting and meeting the needs of aging populations.

Data from multiple sources for all 50 states and the District of Columbia from 2003 to 2017 was used to measure key aging domains, which define successful aging at the population level. This index drills down to more granular markers of successful aging compared with other indexes, which have previously assessed more general societal support of its older population, such as life expectancy or activities of daily living. Supplemental charts and graphs provide a closer look at changes in potential policy drivers by state, such as spending on supplemental nutrition programs, recreation, public transportation or libraries.

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Report: Home care workers deserve more pay, benefits

Two SEIU home care workers at a rally with Labor Secretary Marty
Walsh (Photo courtesy of Wikimedia Commons)

A new report from the Economic Policy Institute (EPI) paints a stark picture of the financial plight of home care workers. Most of these workers — who care for sick, frail, vulnerable older adults and those with serious disabilities, are significantly undervalued and underpaid and deserve a higher wage.

The Biden Build Back Better Act, which recently passed the House and awaits passage by the Senate, would make an unprecedented investment of $150 billion in home and community-based services over 10 years. It will also increase the demand for qualified home care workers. However, finding people willing to do these jobs will likely get more challenging.

Many employers already can’t find qualified workers at current rates. If workers quit due to job dissatisfaction or burnout or because they can make more money at a big box store, what happens to those who need their help? Journalists can use the data in this report to delve into pay rates, workforce composition and investigate potential worker shortages and solutions in their communities. 

EPI report key findings 

The EPI report revealed that home care workers earn a mean of $13.81/hour, about half of what the average U.S. worker is paid ($27.31). Home care workers are primarily women (88.6%) and disproportionately Black (23.9%) and Hispanic (21.8%). Roughly three in 10 home care workers were born outside the U.S., according to the report.

The authors call for boosting the hourly wage at minimum, to between $21.11 and $25.95, depending on the benchmark applied, to help recruit and retain high-quality, skilled home care workers. Contrary to what some may believe, traditional Medicare typically does not pay for home care unless skilled nursing is also needed. Some Medicare Advantage (MA) plans now cover some in-home help annually, but it’s often far less than what’s needed to help an older person remain independent at home.

Medicaid, on the other hand, does pay for needed home care for people who qualify, but states must apply for waivers to implement home and community-based programs. Currently, there are over 800,000 people across the U.S. who are on waiting lists for home care programs like PACE, a Medicaid-funded state-run initiative that provides comprehensive medical care and assistance with activities like bathing, eating and dressing. (What is the waiting list like in your state for these highly in-demand home and community-based programs?)

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New research highlights vaccine effectiveness vs. natural immunity in older adults

Photo by National Guard via Flickr.

New research published in the CDC Morbidity and Mortality Weekly Report (MMWR) revealed how much more effective COVID-19 vaccines are compared with natural immunity at preventing hospitalizations in people over 65. Data analysis from nine states show that the odds of COVID infection in hospitalized people were nearly 20 times greater among unvaccinated seniors than  fully vaccinated recipients with no previous documented infection. Additionally, the study found hospitalized people under 65 who were unvaccinated were at 5 times greater risk of COVID infection compared with those who received both doses of an mRNA shot.

The study further confirms that vaccine-induced immunity was more protective than infection-induced immunity against laboratory-confirmed COVID-19. Study researchers issued several strong calls for everyone eligible to get vaccinated against COVID-19 as soon as possible, even if they have previously been infected with SARS-CoV-2.  It’s especially important for the older population who are not yet fully vaccinated to do so, said the experts. Although those 65 and older make up about 16% of the total U.S. population, they account for some 75% of COVID deaths.

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