San Diego-based Acadia Pharmaceuticals has brought testing of its drug Nuplazid for treating psychosis in people with dementia to an early halt thanks to positive results, reports the San Diego Union Tribune . The drugmaker said it will consult with the U.S. Food and Drug Administration (FDA) next year about approving the drug. The Phase 3 placebo-controlled, double-blind trial assessed whether Nuplazid significantly delayed a relapse to psychosis. "The primary endpoint chosen was not simply a movement on a scale, but an important clinical outcome that physicians and their customers can clearly understand and easily relate to," explained Acadia President Serge Stankovic. The Alzheimer's Association's Maria C. Carrillo said her organization is eager to see the study results. "The need is high because there currently is no FDA-approved treatment for dementia-related psychosis," she noted. "It is especially good to see attention paid to treating the non-cognitive symptoms of Alzheimer's and other dementias."

Los Angeles County's LA Found program recently celebrated its first anniversary, reports CBS Los Angeles . The program helps locate people with Alzheimer's disease and dementia who wander off by equipping them with small monitoring bracelets. Every bracelet corresponds with a unique radio frequency. When a person wearing the bracelet goes missing, the L.A. County Sheriff's Department Mental Evaluation Team employs a handheld or helicopter-mounted receiver to track their location. Since the program's inception, 12 people with bracelets went missing and all were retrieved safely.

Cortexyme, a U.S.-based firm, has developed an experimental treatment that shows promising signs for the future care of Alzheimer's disease, reports New Scientist . The treatment presupposes that Alzheimer's may be caused by bacteria that creates gum disease migrating into the brain and causing inflammation — a stark departure from the traditional theory that Alzheimer's is caused by a build-up of toxic amyloid plaques in the brain. Trial participants in Cortexyme's experimental treatment took an oral drug called COR388 that is designed to block the toxins released by the bacteria. After four weeks, the participants had lower levels of an inflammation called RANTES in their blood as well as lower levels of their protein ApoE in the spinal fluid. Cortexyme is launching an expanded program to test more than 500 people with Alzheimer's. Until that study concludes in two years, the results are not "enough to get excited about, but they are enough to say that this hypothesis is interesting," said Carol Routledge, Director of Research at Alzheimer's Research UK.

The Association of American Medical Colleges forecasts a shortage of 46,900 to 121,900 physicians by 2032 in primary and specialty care in the United States, as the aging American population outgrows the supply of physicians, reports CNBC . "We know older people use two-to-three times as many medical services as younger persons, and the number of people over age 65 will increase by almost 50 percent just in the next 10 to 15 years alone," noted the association's Atul Grover. "We need positions across the board in just about every specialty and location . . . but about half of those physicians needed will be in primary care." Certain states and localities, like Arizona and particularly rural regions, face a greater need for doctors. "What we know . . . is that about 50 percent of trainees tend to remain in the place where they train," said Akil Loli with Arizona-based Abrazo Health. Arizona aims to mitigate the shortage through licensing law revisions, with Gov. Doug Ducey signing a Universal Licensing Recognition statute so doctors licensed in other states can relocate to Arizona and secure similar accreditation with less difficulty. Meanwhile, the Association of American Medical Colleges is adamant that the number of residency programs must expand.

A study published in the Journal of the American Geriatrics Society found roughly 36 percent of prescribed proton pump inhibitor drugs for older adults are potentially unnecessary, mainly because people take them far longer than eight weeks as recommended, reports Medical Xpress . The researchers identified 69,000 people 65 and older who were receiving primary care at a large health system in 2018, of whom 8,700 were prescribed the inhibitors. A random sample of charts for 399 individuals prescribed the inhibitors was reviewed to ascertain which individuals did or did not have conditions calling for their use. "Most proton pump inhibitor prescriptions began appropriately but became unnecessary because they were prescribed far longer than needed, suggesting that electronic health records can automatically default low-value prescriptions to remain short term," noted University of California, Los Angeles Professor John Mafi. He recommended consultations with doctors about whether the prescription is medically necessary, and suggested other health systems act to measure and eliminate harmful, low-value care on a wider basis.

The U.S. retirement crisis is not likely be solved by having employees work longer, according to New School Professor Teresa Ghilarducci in Forbes . This is due to endemic age discrimination, unanticipated life disruptions, and involuntary retirement. "Our data show that 52 percent of retirees retire involuntarily," Ghilarducci writes. "The advice to work longer rings hollow when employment is so insecure for older workers." People who want to work after losing their job involuntarily also can be hindered by age discrimination and bias against jobless persons. "There may be some potential benefits to working longer, such as healthy social interaction and a feeling of purpose," Ghilarducci acknowledges. "But typically it's those who are already better off who get to enjoy these benefits — think doctors, lawyers, and university professors." Ghilarducci concludes that "the work-longer debate thus creates an intractable dilemma for older workers who face difficulties in the labor market. Some are involuntarily retired, and leave the labor force 'too early.' Others who face mid- or late-career shocks . . . wonder if they can ever retire at all. "

The U.K. Chief Medical Officers' Physical Activity Guidelines recommend twice weekly weight-lifting sessions for adults to improve muscle mass and bone density, reports Sky News . Heavy gardening, carrying in one's groceries, or lifting young children also can be counted toward weekly exercise goals. Exercises should be repeated until the muscles feel temporarily fatigued and unable to repeat until rested. Bone density and muscle mass declines naturally after age 50, and the guidelines suggest those 65 and older should follow activities to help improve or maintain muscle strength and balance, such as tai chi, bowling, or dancing. "In older adults with frailty, moderate-to-severe dementia, or a history of vertebral fractures or regular falls, it might be more appropriate for any new exercises to be initially supervised by a trained professional, to ensure efficacy and safe techniques to avoid injury," the guidelines state. Sedentary periods also need to be minimized or broken up at all ages.

A study published in the Journal of Neuroscience demonstrates that in hereditary forms of Alzheimer's disease, the creation of new brain cells can be disrupted by the brain's own immune cells, reports ScienceDaily . Some varieties of early-onset genetic Alzheimer's are triggered by mutations in the presenilin 1 (PS1) and presenilin 2 (PS2) genes. Previous research showed that when healthy mice are placed into an "enriched" environment where they can exercise, play, and interact, many more new neurons are created in the hippocampus — while mice carrying mutations to PS1 and PS2 do not exhibit the same uptake, and show signs of anxiety. When the mice were administered a drug that causes microglia to die, neurogenesis reverted to normal, and specimens with presenilin mutations placed into an enriched environment exhibited no memory deficits or anxiety, and generated a nominal number of new neurons. The implication is that microglia could be overplaying their immune system role in this instance. Alzheimer's typically causes inflammation in the microglia, so when they encounter newly-formed neurons with presenilin mutations, they may overreact and prematurely kill them off.

A study published in Science Translational Medicine determined people who have suffered a single head injury exhibit protein "tangles" associated with dementia in their brains, reports Medical Xpress . Twenty-one subjects who had suffered a moderate to severe head injury at least 18 years earlier, along with 11 healthy individuals who had not had a head injury, were analyzed via positron emission tomography, in conjunction with a material that binds to tau protein. Certain subjects had clumps of tau tangles in their brain. Tau tangles are found in Alzheimer's and other kinds of dementia, and are linked to progressive nerve damage. This is the first study to spot tau tangles in the brains of living people. Subjects with higher levels of tau tangles did not necessarily have lessened brain function, compared to individuals with fewer tangles. However, the researchers note tangles can form years before symptoms manifest themselves. The team suggests these findings could help accelerate the development of treatments that break down tau tangles, by allowing medics to monitor the amount of tau.

A study in the Journal of the American Geriatrics Society found older adults with hearing aids have a lower probability of anxiety, depression, and dementia compared to those who lack hearing aids, reports United Press International . Yet only about 12 percent of seniors get hearing aids after being diagnosed with hearing loss. "Though hearing aids can't be said to prevent these conditions, a delay in the onset of dementia, depression, and anxiety, and the risk of serious falls, could be significant both for the individual and for the costs to the Medicare system," said the University of Michigan's Elham Mahmoudi. The researchers analyzed Medicare health maintenance organization data from 2008 to 2016 for roughly 115,000 people older than 66 who have had hearing loss. Older adults with hearing aids were found to have an 18 percent reduced risk of dementia, an 11 percent lower risk of depression or anxiety, and a 13 percent lower risk of falling-related injuries within three years of a diagnosis. "We hope our research will help clinicians and people with hearing loss understand the potential association between getting a hearing aid and other aspects of their health," Mahmoudi concluded.