A study in the Journal of the American Geriatrics Society suggests older Americans living at home with advancing dementia may endure more pain and more unmet medical requirements than those in nursing communities, reports Considerable . People at home lived with more chronic conditions, experienced more pain, and had more falls compared with nursing community residents. Persons based at home also were more likely to be anxious and in poorer health. "People with dementia benefit from consistent and predictable environments and caregivers," said University of California, San Francisco Professor Krista Harrison. However, she also noted "rates of nursing (community) use are declining because they are expensive and people generally prefer the familiarity of home."

A study at Albert Einstein College of Medicine is exploring whether group dancing might help ward off dementia, reports the Wall Street Journal . Previous research demonstrated that exercise in general results in cognitive enhancements and can even create structural changes in the brain. There is some evidence that dance may especially improve cognitive health. "Our hypothesis is that social ballroom dancing, in particular, will be more efficient than treadmill exercise," says Einstein Professor Helena Blumen. "It involves not only physical activity, but also social and cognitive activity." The Einstein study involves seniors 65 and older meeting twice a week for six months for 90-minute-long instructed dance classes, and a separate group coming in for twice-weekly, 90-minute-long treadmill walking sessions. Researchers have pre-identified participants at risk of developing dementia, with their "executive function" gauged before, during, and after the study. University of Pennsylvania Professor Jason Karlawish concurs with Blumen in that he sees dancing as more advantageous compared to exercise, because "it combines three things that have been shown in multiple studies to reduce the risk of developing dementia: social engagement, cognitive engagement, and physical activity."

A new study published in the Annals of Internal Medicine suggests seniors may be more likely than younger adults to choke on vitamins and dietary supplements, or to have other difficulties swallowing them, reports Physician's Weekly . The researchers reviewed 10 years' worth of adverse event reports, and learned that 76.8 percent of cases involving swallowing problems were in adults 65 and older. "Multivitamins are used by up to 35 percent and calcium supplements by up to 24 percent of older adults, who have higher rates of swallowing issues than younger persons," the team wrote. U.S. Food and Drug Administration (FDA) spokesperson Lindsay Haake recommends seniors taking supplements should be mindful of the choking hazard. "They should avoid taking several pills at once, avoid extra-large pills or capsules, and swallow supplements with plenty of water or other fluid," she says. For larger-sized supplements, the FDA advises consultation with doctors. "Tell your physician you are having difficulty swallowing pills and ask him/her or your pharmacist for other options or if you can cut the supplement in half," Haake notes. "The FDA advises all consumers to talk to their doctor, pharmacist, or other healthcare professional before deciding to purchase or use a dietary supplement."

Research in JAMA Internal Medicine found raising the dosage of blood pressure medication for seniors hospitalized for non-cardiac conditions can be hazardous, according to U.S. News & World Report . "During hospitalization . . . blood pressure can be temporarily elevated in response to illness and stress," said the University of California, San Francisco's Timothy Anderson. He continued that "our findings suggest that making medication changes during this period is not beneficial." Anderson added that a much safer likely course of action is to "defer medication adjustments . . . until after subjects are recovered from their acute illness." The study focused on more than 4,000 individuals 65 and older with high blood pressure, who were hospitalized for non-cardiac conditions that usually do not require an increase in blood pressure drugs. Fifty percent of subjects had their blood pressure meds increased when they left the hospital. A year after they were released, those who received higher blood pressure medications did not exhibit improved blood pressure control or a reduced risk of heart problems, compared to those who did not have their meds upped. Yet within 30 days after release, those who received increased blood pressure meds were more likely to have been rehospitalized for serious drug-related complications like falling, fainting, and kidney injury.

Maine households face increasing strain from the state's burgeoning senior population and a nationwide worker shortage, and experts warn this heralds a national crisis, reports the Washington Post . States with fewer immigrants are expected to be profoundly affected, since immigrants make up the bulk of senior-service employees. "We have added an entire generation since we first put the safety net in place, but with no plan whatsoever for how to support them," says Caring Across Generations co-director Ai-jen Po. "As the oldest state, Maine is the tip of the spear — but it foreshadows what is to come for the entire country." Maine has been struck by record numbers of nursing community closures, and the AARP reports care workers in the state receive a minimum hourly wage of $11. About 33 percent of physicians in Maine are older than 60, while nearly half of the registered nurses in several rural counties are 55 or older and are expected to retire or work fewer hours within 10 years. With AARP projecting that Americans 85 and older will grow more than 200 percent from 2015 to 2050 — with those younger than 65 increasing by about 12 percent — federal programs like Medicare are lagging. SCAN Foundation President Bruce Chernof warns of a "catastrophic" outcome if these problems go unresolved.

Researchers at Keio University in Japan have developed and are now testing a robotic tail to help unstable seniors maintain their balance to prevent accidents like stumbling or falling, reports Medical Daily . The one-meter-long Arque device uses four synthetic muscles and compressed air to move in eight directions. The device emulates tails that animals use to keep their balance while running and climbing. The tail is attached to the user's waist, and it "keeps balance like a pendulum," said Keio's Junichi Nabeshima. "When a human tilts their body one way, the tail moves in the opposite direction." Arque is envisioned as a solution for preventing certain kinds of accidents common to seniors in Japan and possibly elsewhere, like slipping and falling down.

A study by University of California, Irvine (UCI) scientists published in Neuron details a technique to induce the growth of human brain immune cells in mice, reports the Daily Pilot . "The functions of our cells are influenced by which genes are turned on or off," said UCI Professor Mathew Blurton-Jones. "Recent research has identified over 40 different genes with links to Alzheimer's, and the majority of these are switched on in microglia. However, so far we've only been able to study human microglia at the end stage of Alzheimer's in post-mortem tissues or in petri dishes." The team generated a "chimeric" mouse model, using induced pluripotent stem cells donated by human adults and engineered to transform into young microglia, implanting them into young genetically modified rodents. "In addition to yielding vital information about Alzheimer's, this new chimeric rodent model can show us the role of these important immune cells in brain development and a wide range of neurological disorders," said UCI's Morgan Cogburn.

Seniors' anxiety about using ride-hailing apps is preventing them from taking better advantage of such transportation options, reports the New York Times . According to Donna Nettleton at the Oasis Institute in Illinois, older adults are intimidated by such apps partly because of constant warnings about scams and identity theft making them vulnerable to financial abuse. The Pew Research Center says more than half of adults older than 65 own smartphones, but only about 25 percent of adults over 50 used ride-hailing services last year. Moreover, a 2018 AARP survey calculated that only 29 percent of those over 50 had used ride-hailing apps, with 66 percent saying they were unlikely to do so in the coming year due to safety and privacy fears. However, transportation experts envision ride-hailing as a way to improve mobility for older adults who can't or should no longer drive. There is evidence suggesting personalized instruction could enable seniors to better master mobile apps and take "networked transportation" to various appointments and events. To bypass the anxiety problem of using apps and smartphones, Lyft, Uber, and other ride-hailing players are contracting with third parties like healthcare systems to provide better instruction.

Taking care of the growing senior population is a crisis in the making, declares Axios , and many families, most government programs, and the health care workforce are not adequately prepared for it. The problem is bigger than Medicare's finances being strained by an aging Baby Boomer population. Long-term care largely "falls through the cracks" of both public and private health insurance, saddling many seniors and their families with financial burdens they often have not prepared for. Studies differ on the specifics, but they generally concur that somewhere between 50 percent and 66 percent of seniors will need at least some form of long-term care. While Medicare does not cover most long-term care services, the market for private long-term care insurance remains small and fraught with failure. Consequently, that leaves three options: one, be wealthy enough to pay out of pocket; two, be poor enough to qualify for Medicaid; or, three, depend on family and volunteer caregivers. In many cases, seniors end up doing all three. They start paying out of pocket, then quickly deplete their resources, making them Medicaid-eligible. They then come to rely on family members for at least some additional assistance. There is also the problem of high turnover among nurses and caregivers. And because a large percentage of home care workers are immigrants, the issue is getting increasingly tied up with yet another politically charged debate.

The Hearing Industries Association (HIA) claimed that the U.S. Food and Drug Administration's (FDA) marketing authorization of Bose's self-fitting hearing aid is founded on a flawed clinical study design, reports MedTech Dive . The group warned the FDA's decision depends on standards that could "adversely impact safety and effectiveness and would jeopardize the hearing health of consumers." The study aimed to determine whether the results of self-fitting the Bose device were comparable to professional fitting. HIA said in a letter to FDA official Srinivas Nandkumar that the Phase II clinical study "does not provide enough evidence of effectiveness of the self-fitting method given the study's initial reliance on professionals for fitting." FDA's decision summary stated the study of 75 individuals involved three clinic visits alongside several weeks of real-world use, with subjects fit professionally by audiologists in the first two visits, before being assigned to a one-month field trial in a professional fit group or self-fit group. The third visit had participants accessed using speech-in-noise tests and questionnaires about the benefit of the devices. HIA said the study "does not reflect the actual real-world experience," raising issues that "the data the study relies upon may not accurately reflect the ability of treatment-naive hearing subjects to adequately 'self-fit' without the assistance of a licensed hearing professional."