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Senior Care News

January 18, 2017      

By Mendy Hecht, Hamaspik Gazette

Study confirms high benefit of pacemakers for seniors

Seniors benefiting from pacemakers may be old news.


But a review of data on over 12,000 seniors who’d gotten the implantable cardioverter defibrillator (ICD) devices now confirms that ICD patients have high survival rates.


The common device is implanted under the skin and connected to the heart with wires.  When it detects an irregular heartbeat, it delivers an electrical shock to restore normal rhythm.


The study looked at records on over 12,000 Medicare patients, aged 65 and older, who received an ICD after sudden cardiac arrest or a nearly fatal fast heart rhythm. 


Nearly 80 percent of the patients survived two years after receiving the implanted device, according to the study published Jan. 16 in the Journal of the American College of Cardiology.


New clue found in Parkinson’s process

What exactly causes Parkinson’s disease?  Medicine doesn’t quite know.


But new research at the University of Bergen (Norway) has now found what seems to be a key mechanism in the development of the disabling disease, which currently affects over ten million people worldwide.


In healthy cells, mitochondria serve as each cell’s powerhouse.  The mitochondria contain their own DNA.  Cells are constantly damaged by the body’s constant aging, but power from healthy mitochondria allows cells to produce more DNA and thus regenerate.


By comparing healthy brain cells with Parkinson’s patient brain cells, the researchers found that brain cells in Parkinson’s patients had damaged DNA inside their mitochondria—denying brain cells the ability to reproduce their own DNA, thus slowly losing the war against age damage.


The study was recently published in Nature Communications.


Half of public has high blood pressure, doesn’t know it

A Canadian study had researchers invite passersby at shopping malls, workplaces, hospitals and community centers to step up to a mobile clinic and take their blood pressure.

Results from nearly 1,100 random members of the public, of all ages, races and backgrounds, found that half did not know that they had high blood pressure.  Further, two percent of them were also deemed at very high risk for health complications.

High blood pressure, also called hypertension, rarely causes noticeable symptoms.  But left untreated, especially in seniors, it often leads to heart disease and stroke.

The findings were published Jan. 5 in the American Journal of Hypertension.

Healthy blood pressure up for healthy seniors

In related news, two leading U.S. medical organizations are recommending a less aggressive target for the treatment of high blood pressure in adults 60 and older who are otherwise healthy.

Traditionally, the threshold for high blood pressure has been set at 140 mmHg systolic blood pressure (the top number in a reading).  But the new guideline from the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) sets the threshold at 150 mmHg or higher for adults 60 and older.

Health benefits from a 140 threshold compared to 150 are small, the groups explain. 

However, various geriatrics and cardiology experts note that while the new 150 threshold may be better as a general rule for healthy seniors (some studies have found that blood pressure below 140 for seniors can actually be bad)—it depends on the individual patient, especially if he or she has a history of heart disease, in which case the 140 threshold should be considered.

The new guidelines were published Jan. 16 in the Annals of Internal Medicine and the Annals of Family Medicine.

Exercise helps Parkinson’s patients

When it comes to the health benefits of exercise for people with Parkinson’s disease, a study of 100 other studies conducted over the past 30 years on Parkinson’s confirms it: exercise helps!


The review of the previous studies, published recently in the Journal of Parkinson’s Disease, found that regular exercise and other moderate physical activity is good medicine for patients.


According to the new research, exercise improves gait, reduces fall risk and generally generates a long-term positive impact—even though there is no evidence that it prevents disease progression.


Specifically, one theory is that exercise releases natural compounds that contribute to brain cell growth.  Parkinson causes the brain to produce less dopamine, which leads to a loss of movement control.  Physical symptoms include shaking, slowness and stiffness.


About one million Americans live with the disease, which can develop over many years.  Between 50,000 and 60,000 cases are diagnosed annually in the United States.


Medicare starts new care reimbursement systems


A 2015 federal law that changes how doctors are paid for caring for members of Medicare, the taxpayer-funded health insurance plan for seniors, officially kicked in on Jan. 1, 2017.


The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated Medicare’s need to eventually impose drastic cuts to payments made to doctors treating Medicare members.


(That looming need, which was postponed by Congress every year for many years, was known as the Sustainable Growth Rate (SGR) until MACRA came along and removed it.)


Under MACRA, which will fully roll out over 2017 and beyond, doctors will be paid more for health results that they produce, not set fees for the services they provide (fee-for-service).


The MACRA law will eventually use Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS) to pay doctors who treat Medicare patients.


Under MACRA, to get paid, most doctors taking Medicare will eventually have to produce and submit patient results, not just bill Medicare for services regardless of patient results.


For now, the transition period consists of a handful of new Medicare billing systems based on results, not fee-for-service.  These include systems for end-stage renal disease, oncology and primary care.