If Health and Human Services (HHS) Secretary Alex Azar has his way, Medicare Advantage plans could get even more flexibility to address social determinants of health for beneficiaries, reports Home Health Care News . In turn, that could result in even greater opportunities for home care providers to offer and be reimbursed for such services as companion care, bathing, and transportation. Azar said earlier this week during the Medicare Advantage (MA) Summit in Washington, D.C., "Our system can often be penny-wise and pound-foolish, spending generously on health care without considering how health could be improved by addressing non-health needs." As of late, the federal government has made efforts to change that by permitting Medicare Advantage plans to cover an array of non-medical needs. To be sure, the cohort of patients who can receive such services remains somewhat limited. But that could change. Azar told summit attendees: "You've already seen one effort to address social determinants through new supplemental benefits in Medicare Advantage, like home-delivered meals, transportation, and home modifications. We want to go further."

According to new research, older adults with a big waist and high BMI may be more likely to display signs of brain aging that have been linked to dementia, reports Newsweek . The research team studied almost 1,300 adults, measuring waist circumference and BMI before following up six years later, repeating the measurements and issuing brain scans. The team found that a higher BMI tended to correlate with a thinner cortex, a common sign of Alzheimer's. Each unit increase in BMI was found to accompany a 0.098 millimeter thinner cortex, though that number jumped to 0.207 millimeters for obese participants. "These associations were especially strong in those who were younger than 65, which adds weight to the theory that having poor health indicators in mid-life may increase the risk for brain aging and problems with memory and thinking skills in later life," said study co-author Dr. Tatjiana Rundek. She also said that the study reveals obesity may speed up brain aging by a decade or more, but affirmed that, equally, losing weight can contribute to a healthier brain for older adults.

A recent study from the University of South Australia found that eating spicy food may hasten cognitive decline, reports the Atlanta Journal-Constitution . The researchers spent 15 years studying more than 4,500 Chinese adults aged at least 55, discovering that participants who ate more than 50 grams of chili per day experienced faster cognitive decline than their peers who did not. Older adults who ate spicier food had double the risk of developing memory decline and were more likely to have worsening cognitive functions. While chili is very common in Asian cuisine, it is uncommon to consistently eat more than 50 grams per day in the United States. The research team also found that older adults who eat chili and are underweight or at standard weight are at higher risk for cognitive decline.

The Senate Finance Committee has announced a bipartisan drug-pricing proposal designed to limit price increases in Medicare and put a cap on older adults' out-of-pocket costs, reports the Washington Post . Committee Chairman Chuck Grassley (R-Iowa) and the ranking Democrat, Ron Wyden (Ore.), spent half a year developing and adapting the plan, which has the support of the White House and which should save the federal government roughly $100 million over the next decade. During that same time period, older adults will save $27 billion in out-of-pocket costs and $5 billion in lowered premiums. The bill would cap out-of-pocket payments for Medicare Part D at $3,100 per year starting in 2022. It would also limit drug price increases to the rate of inflation and limit drug prices specifically in Medicare Part B. A health aide for House Speaker Nancy Pelosi (D-Calif.) said that the House will introduce its own drug pricing proposal later this fall, though that proposal is expected to be more liberal than the Senate's plan. Drugmakers have already expressed opposition to the Grassley-Wyden bill.

The Mighty reports that depression is often underdiagnosed and undertreated in men and women age 65 or older. Some risk factors for depression in seniors include: history of depression, being a widow/having someone you love die, lack of a supportive social network, reduced independence, damage to body image, fear of death, and side effects of prescription medications. So, why is depression underdiagnosed in this demographic? One reason is because baby boomers are less likely to believe they need mental health care and so they are less likely to bring it up. "Older people grew up in an era when talking about a psychiatric issue was certainly frowned upon, so there may be a generational issue," remarks Dr. Philip R. Muskin, psychiatry professor at Columbia University Medical Center. A second reason why depression is underdiagnosed in older adults is because the signs of depression may be misinterpreted. Difficulty sleeping, loss of appetite, lack of concentration, and forgetfulness are four common signs of depression. But all four individually or together could be mistaken for other health conditions.

A new report released by Bankrate has put Hawaii in the top ten states for retirement, according to Pacific Business News . Bankrate compiled its list based on criteria important to older adults and retirees, including affordability, safety and crime, culture, weather, and wellness. Hawaii had a poor affordability rating, but it was ranked first in the nation for weather and held top spots in wellness and culture. When put together, the rankings propelled the Aloha State to the No. 10 position. Many older adults are primarily concerned about access to quality, affordable healthcare, and Hawaii was recently found to have the No. 3 most expensive nursing communities in the country. The Bankrate study found that the best state to retire is Nebraska, primarily because of its high wellness and affordability scores. Maryland, meanwhile, was ranked the worst place to retire in the nation.

University of California San Diego School of Medicine researchers have used the transcriptome — the sum of all messenger RNA (mRNA) molecules expressed from genes — to map protein-gene interactions involved in Alzheimer's disease, reports ScienceDaily . In a new study , published July 23, 2019 in Cell Reports , the research team used the transcriptome to compare more than 400 study participants with clinically diagnosed and neuropathologically confirmed AD with an age-matched, non-demented control group from a community-based neuropathological study. Their results suggest that integrating gene perturbations with protein interactions can generate a comprehensive framework for characterizing alterations in the molecular network related to Alzheimer's. Senior author Dr. Robert Rissman, professor of neurosciences at UC San Diego School of Medicine and director of the Biomarker Core for the Alzheimer's Disease Cooperative Study (ADCS), remarked, "One of the big problems in AD research is identifying patients at risk at the right time. Understanding the gene networks that may change in specific patient groups can help streamline clinical trials recruitment efforts and reduce costs and time to enroll trials."

New research reaffirms the idea that social interactions help keep older adults' minds sharp, reports United Press International . A new Boston-based study followed 217 older adults, some with high levels of a protein linked to Alzheimer's, and found that mental decline slowed in those participants who regularly socialized with others. This suggests that "social engagement may be an important marker of resilience" in older adults who may develop dementia or Alzheimer's disease, states senior author Dr. Nancy Donovan. The study followed the seniors for three years and found that participants with high Alzheimers's-linked protein levels and low social engagement tended to experience a quicker mental decline than their peers who socialized frequently. Meanwhile, older adults without the Alzheimer's protein who did not regularly socialize didn't report similar levels of cognitive decline. Donovan and her colleagues believe further study on the topic could prove invaluable to the medical community's understanding of Alzheimer's.

Older adults have long been a valuable bloc of the electorate, and recent trends suggest they may be moving to the left of the political spectrum, Vox reports. In the 2016 presidential election, 53 percent of adults at least 65 years old voted for President Trump, but subsequent attempts to repeal the Affordable Care Act and a proposed cut to Social Security funding may have alienated some seniors ahead of the 2018 midterms. In those midterms, among voters who reported that they cared about issues traditionally prioritized by older adults, 52 percent voted for Democratic candidates. Also in 2018, a Public Policy Polling survey found that 72 percent of voters aged at least 65 said they were more likely to support a political candidate who would expand Social Security, while 68 percent said the same thing about Medicare. The Democrats vying for the 2020 party nomination for the presidency have prioritized outreach to older Americans, developing plans on everything from drug pricing to affordable housing

Recent research suggests that adults over the age of 55 comprise one of the largest pools of workers, but have the most difficulty getting job interviews and being offered full-time positions, reports WGAL-TV . According to the NBC affiliate in Harrisburg, Pa., experts say the problem has less to do with a skills deficit than ageism. Older adults now are working at ever-increasing rates because of financial constraints and increased life spans, but those adults in the market for a new position struggle to get an interview compared to younger applicants with less experience. That means that at least three million older Americans are struggling to find a well-paying job. Maureen Leader, who works at a retirement community in Pennsylvania, urges companies to incorporate more age-blind policies into their hiring procedures. "Anyone who dismisses someone who's over 55 and doesn't choose to hire them because they're over 55 is missing out on a lot of experience that would help their organization," she said.