Clover Health recently entered into a partnership with researchers at MindMate App, which combines brain games, healthy dieting, regular exercise, and social interaction, reports VentureBeat . MindMate encourages users to make multifaceted, holistic lifestyle changes to help ward off the effects of cognitive decline. Clover Health's Matt Waellert says the partnership allows his organization to monitor participating members' app activity and flag the Clover care team of any significant decline in cognitive performance. This can substantially improve healthcare providers and caregivers' ability to identify Alzheimer's, dementia, stroke, and other neurological disorders early. "If you look at the average health app, it's about 3.5-minute session times," Waellert notes. "They're not very engaging. MindMate is more like a 16-minute session length, much more like a mobile game." Waellert describes most games as "presentation layers on top of very traditional game mechanics. Those mechanics yield interesting data. The app feels very traditionally like a game, but because games stretch our minds, it does provide good cognitive data."

The Trump administration late last week issued a final rule to overhaul and reboot the Medicare Shared Savings Program, reports Politico Pro . In August, the administration introduced a proposed rule on accountable care organizations (ACOs) that drew concerns from the National Association of ACOs (NAACOS) and such other groups as the American Hospital Association and the American Medical Association. NAACOS and the groups were primarily concerned that the plan forced ACOs to assume financial risk too quickly and the amount of shared savings they would receive in the initial years was too low. The administration contended at the time that ACOs taking on financial risk have a greater incentive to save Medicare money and improve the quality of care they provide.

The Apple Watch is the first mass-market product with an electrocardiogram, and some doctors are concerned that such wearables could be detrimental to consumers if it provides erroneous information that leads to needless tests and procedures, reports CNBC . One anxiety among many practitioners is that this can bring health risks and added costs to an already overwhelmed healthcare system. Critics also have reservations about misinformation, especially with a recent array of unconfirmed assertions that the Apple Watch is saving lives. However, many studies have found that consumers are becoming more informed about their health than ever thanks to new technologies. "The Apple Watch could give doctors a new way to communicate with their customers," says Stanford University Professor Oliver Aalami. David Albert, founder of heart health technology company AliveCor, suggests artificial intelligence will eventually filter the information from wearables that doctors use. The challenge is to avoid submitting an "avalanche of inconsequential data," he notes.

A report from the Oregon Department of Human Services, Oregon State University, and Portland State University suggests the state is making progress in relocating residents who need less intensive long-term medical care into more home-like settings, according to the Register-Guard . Oregon State University's Jeff Luck says the state's over-75 population has increased in the past 18 years, while the number of nursing homes has remained the same and the number of beds and the length of time a person stays in a nursing home have declined. Concurrently, Portland State University's Paula Carder adds that the number of assisted-living, residential care, and memory care homes in Oregon grew from 325 in 2000 to 524 in 2017. In 2013, Oregon started a program to cut the amount of money the state was paying via Medicaid for the care nursing homes provide and to move people who did not need such care into more affordable options. About 72 percent of those who leave a nursing facility move to a community care organization such as an assisted-living, memory care, or adult foster care home or just return home.

Most U.S. businesses are overwhelmingly opposed to phased retirements, forcing older workers to either work full-time or not work at all, reports The Motley Fool . Although a growing number of U.S. workers are opting to work longer, they cannot manage the rigorous schedules they once could as they age, thus reducing their productivity and risking their health if they try to sustain physical levels they can no longer uphold. However, older workers offer significant value that younger peers do not have, often because they have the wisdom and experience to provide guidance during periods of prosperity and turbulence. They also are more likely to have entrenched relationships with vendors and partners that can help companies prosper. Phased retirements allow older employees to scale back their hours over time and enable a less bumpy transition on both sides, with older workers continuing to earn money while their employers get ample notice to onboard and train new hires. With phased retirements, firms also can maintain a level of goodwill with long-serving employees, who might agree after retirement to consult on an as-needed basis, adding to employers' sense of security.

Only 3.3 percent of the Saudi Arabian population is older than 65, which means the country has time to plan for the inevitable growth of the segment with dementia, reports Arab News . In the Middle East for the most part, "People don't see it as a disease. They think it is simply part of getting old," says Alzheimer's Disease International (ADI) CEO Paola Barbaroni. "Awareness is low and stigma is high." The Dubai Health Authority's Mohammed El-Noaman conducted research citing "uncertainty" over how to distinguish normal aging from dementia, noting its incurability has bred "prejudice" against spending time or money on diagnosis. Although ADI offers an action plan for countries to record, track, and help those with dementia, Barbaroni says documentation in the Middle East is poor. Saudi Arabia is a particularly poor performer in terms of early detection and diagnosis, with one possible explanation being a lack of a centralized patient databank. Despite this and other serious oversights, ADI's Readiness Index calls Saudi Arabia "exceptional" in government-sponsored care for people with dementia and support for their families. Barbaroni concludes that while the West is lagging the rest of the world in managing dementia, "The Gulf nations . . . are in a position to learn from earlier mistakes, and they have both the luxury of a little time and the financial capability to plan for this and get it right."

A study published in The Lancet: Neurology found the number of people living with dementia worldwide more than doubled between 1990 and 2016 from 20.2 million to 43.8 million, reports Futurity . In addition, 22.3 percent of healthy years lost due to dementia in 2016 were on account of modifiable risk factors, such as being overweight, high blood sugar, consuming sugar-sweetened beverages, and smoking. Analysis of the Global Burden of Disease Study 2016 determined dementia to be more common at older ages, with the prevalence doubling every five years over 50. "Already the importance of these risks in allowing us to prevent or delay dementia is clear," says University of Melbourne Professor Cassandra Szoeke. "The paper noted that changes in risk factor exposure over time as we become healthier might account for several cohort studies documenting a reduction in age-specific incidence rates in their study populations." Dementia develops over at least 20 to 30 years before a diagnosis, and Szoeke says studies should probe cognition over two to three decades to determine when and for how long intervention is necessary to prevent disease. She warns the number of people living with dementia could total about 100 million by 2050. "We need to enhance the quality of life and function of people living with cognitive impairment and focus on preventing further cognitive decline," Szoeke stresses. "This will need a co-developed community-wide approach with well-developed services and an even greater network of trained health professionals."

The Caring Collaborative program brings older women together to help one another when short-term illness or disability strikes, addressing an all-too-often unmet need, reports Kaiser Health News . Loners, like most Caring Collaborative members, frequently worry about finding this kind of aid. Across the United States, 35 percent of women 65 and older fall into this category, while 46 percent of women 75 and older are in the same category. The Caring Collaborative includes an information exchange, which members use to share information about medical conditions and medical providers; a service corps of women volunteers to provide hands-on assistance to other members; and small neighborhood groups that meet monthly to discuss health topics and personal concerns. The program started 10 years ago in New York City and has since spread to Philadelphia and San Francisco. Many members of the program's New York City branch are retired professionals who want to make new friends and explore activities after leaving the workforce; they reach the Caring Collaborative through its parent organization, The Transition Network. Members consent not to reveal confidential information about one another, give medical advice, or perform medical tasks like bandaging a wound or giving someone medication. Fundraising and an annual $100 membership fee for The Transition Network covers costs for the program.

A study published in Neurobiology of Disease found new changes occurring in the human brain in the early stages of Alzheimer's, reports ScienceDaily . The researchers used a multiomic approach to ascertain RNA, protein, and phosphorylation levels, and conducted further neurobioinformatic analyses on them. They used data available in a Finnish biobank of brain tissue samples, where samples were categorized according to the accumulation of phosphorylated tau protein. Genome-wide analysis indicated associations of functional changes in certain brain cell types with Alzheimer's-related accrual of phosphorylated tau protein. The team also demonstrated that machine learning can classify subjects into different stages of disease pathogenesis simply by examining changes in the expression of a selected group of genes. Later studies will explore whether the newly discovered brain changes in the different stages of Alzheimer's also are visible in cerebrospinal fluid and blood samples, and whether these could be used as new predictive biomarkers. Furthermore, the changes will open up new avenues for potential targets of treatment for the disease.

Few older Americans are getting the opportunity to fortify their savings or pay down debt to ease their way into retirement in their last few years of employment, reports the Wall Street Journal . Government data indicates that although the official unemployment rate is 3 percent for older workers, close to 8 million older Americans are unemployed or stuck in low-quality jobs that offer little opportunity to prepare for retirement. Stony Brook University estimates that workers 56 and older earn on average 27 percent less in their new job after they have been unemployed for at least a month, versus an average raise of 7 percent for people younger than 30. According to Stony Brook's David Wiczer, people who go through unemployment "and come out better on the other side are almost exclusively under 35." Being unemployed for only a few months or living on a depressed salary without benefits can hurt a senior's finances as he or she struggles to cover mortgage payments, healthcare, and other regular expenses. Reasons underlying little hiring for older workers range from age discrimination to a lack of skills to their unfamiliarity with new recruiting channels. The Bureau of Labor Statistics calculates that 31 percent of job seekers 55 and older have been looking for work for 27 weeks or longer, compared with just 24 percent of younger job seekers. Older seekers report looking for work, on average, for 34.6 weeks, almost three months longer than the average of 23.4 weeks among jobless 25- to 54-year-olds. Meanwhile, the Boston College Center for Retirement Research says 17 percent of workers 55 to 64 had a pension plan in 2016, down from 33 percent in 1992.