The Regenstrief Institute's Daniel Bateman has received a career development award from the U.S. National Institute on Aging to test the feasibility and utility of Brain CareNotes, a mobile app for improving care for people with Alzheimer's, reports Medical Xpress . Brain CareNotes is designed to assess and manage the behavioral and psychological symptoms of dementia, which can include depression, anxiety, hallucinations, agitation, and apathy. The study Bateman will conduct involves caregivers paired with people with Alzheimer's randomly placed in two cohorts. One will receive usual care at the Healthy Aging Brain Center at Eskenazi Health, while the other group will receive usual care plus the Brain CareNotes app. Caregivers in the first cohort will receive prompts on their phone to fill out a symptom questionnaire — and if the answers reach a designated threshold of concern, the caregivers will be alerted and follow up via a phone call, a message, or other form of communication. "Healthcare is moving mobile," Bateman says. "There are never going to be enough providers to manage the number of people with Alzheimer's disease and dementia, which is only going to increase. We hope the Brain CareNotes app will maximize each geriatrics care worker's ability to make an impact and improve care."

Baby boomers are reaching retirement at a faster rate than millennials can replace them in the workforce, and researchers argue companies should entice older people back to work and give them meaningful, important jobs, reports the Harvard Business Review . Many people, especially those who have had long and meaningful careers, like working, and studies show older, more tenured people are more successful at being entrepreneurs. The solution is to overhaul career systems, pay systems, and recruitment and assessment systems to avoid age discrimination. Research indicates that although raw mental horsepower slips after 30, knowledge and expertise continue to gain even past 80. Evidence also suggests traits like drive and curiosity are triggers for new skill acquisition, even in late adulthood. Cognitive diversity is another competitive advantage that older workers can bring to companies.

Large companies continue to favor a more agile feedback approach to employee performance appraisal via Continuous Performance Management (CPM), reports HR Technologist . The switch should be looked on as a transition program with attendant buy-in, communications, plan, and support. Factors to consider include the value to employees, who should be included in discussions about CPM's ability to support more agile ways of working, build a coaching culture, improve career development, enhance performance, or boost engagement. Another consideration is strategic alignment, with employers guaranteeing that this is clearly written into their People Plan, with appropriate resourcing and budgeting. A formalized action plan based on feedback and quarterly reviews demonstrates commitment to participants, and ensures the feedback is revisited and discussed often, helping bake it into the organization's culture. The program should begin at a modest scale, via pilots in key business areas to learn what works within the organization and what support is needed for successful transition. Employers also should identify key stakeholders to be "Champions" to promote CPM as a management tool, embed feedback as an everyday element, nurture an open feedback culture, and train managers properly. Technology can expedite the transition by adding robustness and safe channels for honest feedback, accurate information in real time, and solutions tailored to business needs.

Best Buy announced that it hopes to provide 5 million seniors with health monitoring services within five years, up from 1 million currently, reports ABC News . This effort aligns with the retailer's goal of collecting $50 billion in annual revenue by 2025. Best Buy has been making acquisitions to own a bigger slice of the healthcare business, procuring Critical Signal Technologies in May and adding personal emergency response systems and telehealth monitoring services for at-home seniors to its repertoire. Two months later Best Buy bought the BioSensics predictive healthcare technology business, while in 2018 it purchased GreatCall, a provider of emergency response devices for older adults. Best Buy Health Director Asheesh Saksena said pendants using certain algorithms can monitor how a senior is walking and forecast the risk of falling. Meanwhile, sensors on refrigerators detect how often the appliance is being used, and prompt a call by GreatCall agent to see whether that senior has been eating.

A study by Rice University researchers in the Journal of the American Chemical Society described a technique to monitor the formation of soluble amyloid beta peptide aggregates that are believed to play a role in the onset of Alzheimer's, reports Phys.org . The team developed a ruthenium-based fluorescent complex that binds to these peptides, and labels the resulting oligomers. This will enable scientists to easily track the progress and movements of aggregates as they expand. "There's a view in the field that soluble oligomers are the main cause of neuronal degeneration, because these oligomers are toxic to neurons," said Rice Professor Angel Martí. "These oligomers are definitely associated with Alzheimer's pathology, so there's been a need for tools to help us study them." The ruthenium complexes exploit fluorescence anisotropy, in which the fluorescent response is polarized, glowing brighter in some directions than others. "When the . . . probe binds to a big macromolecule, it rotates more slowly," Martí explained. "That's how we know we have oligomers, and then we can track their growth and propagation."

A study in Hypertension found fluctuating blood pressure may be linked to compounded dementia in people with Alzheimer's, reports Medical Xpress . The researchers examined data from a randomized trial of 460 people who were 72 on average and had "mild-to-moderate" Alzheimer's. After 18 months, people who scored the highest in blood pressure variability had declined more cognitively than those with the least amount of variability. In 46 individuals for whom data on day-to-day blood pressure fluctuations was available, there were "significant associations" between variable blood pressure and dementia after 12 months, but not after 18. "This tells us it's still important to regulate blood pressure when you already have dementia," said the Radboud University Medical Center's Jurgen Claassen. "More fluctuations might affect whether cognitive function declines more slowly or rapidly."

McDonald's will starting this week allow job seekers to apply via voice command with Amazon's Alexa or Google's Assistant, reports the Associated Press . If users make such a request, Alexa will ask which country they want to work in. Afterwards, users can share their phone number and get a link to continue the application process. Alexa also shares certain information about working for the company, such as how it can lead to jobs in other fields. The service is available in the United States, the U.K., Canada, Australia, France, Germany, Ireland, Italy, and Spain. Google and Amazon say McDonald's is the first direct employer to use its platform is this way, using the fast food giant's in-house Apply Thru technology.

A study from the Kaiser Family Foundation found insurance premiums and deductibles are making employer-based coverage increasingly unaffordable, reports the New York Times . The average premium paid by employer and employee for a family plan now exceeds $20,000 annually, with the worker contributing about $6,000. More than 25 percent of all covered workers and nearly half of those working for small businesses have a yearly deductible of $2,000 or more. "For some reason, we like to focus on coverage when the issue for workers, people, and the public generally is cost," said Kaiser Family Foundation CEO Drew Altman. A Wall Street Journal /NBC News survey found 56 percent of registered U.S. voters oppose the idea of a government-run system like Medicare-for-all as a replacement for private insurance. However, investment advisory firm founder Shalin Madan said the current system creates a gap between those with good employer coverage and those who lack it. Altman said Americans who earn $25,000 or less — about 36 million — are the most likely to be priced out of insurance coverage. The Harvard T.H. Chan School of Public Health's Benjamin Sommer added that some low-wage workers may be eligible for Medicaid in states that expanded the program under the Affordable Care Act, but private insurance enrollees who do not qualify for government help face more difficulty paying for care.

Harvard Medical School Neurology Professor Rudolph Tanzi informed the U.S. Senate Aging Committee that healthy lifestyles could delay Alzheimer's by years or decades in more than 95 percent of people at genetic risk for the disease, reports Forbes . His prescribed lifestyle includes sleeping seven to eight hours daily, de-stressing via meditation or some similar practice, interacting with friends, exercising to strengthen brain regions affected by the disorder, learning new things to boost synaptic activity, and proper dieting — specifically the Mediterranean diet. Tanzi and Sen. Susan Collins (R-Maine) also agreed that staying physically, socially, and cognitively engaged can add to financial strength by allowing seniors to work longer and trim medical bills. "The cost of this disease to our country is approaching $300 billion per year," Tanzi warned. "With the American lifespan up to nearly 80 years, this disease is a burgeoning epidemic that could someday single-handedly collapse our healthcare system."

The U.S. Centers for Medicare and Medicaid Services (CMS) forecast that average monthly Medicare Advantage premiums will hit their lowest point in 13 years in 2020, reports Modern Healthcare . The agency also projected that enrollment in Advantage plans would continue to appreciate as more seniors opt for Advantage over traditional Medicare. Average monthly premiums should fall 14.4 percent from $26.87 in 2019 to $23 next year, marking the lowest premium since 2007. Seniors enrolling in Advantage plans will have more options, with the average number of plans per county rising to 39 plans next year from 33 plans this year. Meanwhile, Advantage plan enrollment should reach hit 24.4 million in 2020, a 9.9 percent gain from 22.2 million now. Advantage enrollment has increased steadily as baby boomers age into Medicare and favor Advantage plans over traditional options. Advantage plans typically offer more benefits such as dental care, eyeglasses, and gym memberships — although beneficiaries must see doctors within the plan's network. CMS estimated that about 250 plans will offer access to non-medical supplemental benefits in 2020, reaching about 1.2 million beneficiaries.