A study presented at the Alzheimer's Association International Conference 2018 warns the painkiller buprenorphine, which is often used by people with dementia, has exacerbating side effects including sedation and confusion, reports The Guardian . "We know that many people with dementia use drugs that act on the nervous system, often several in combination, for long periods of time with inadequate assessment of ... whether the person still has a beneficial effect from treatment," says the University of Bergen's Ane Erdal. The researchers randomly assigned 44 nursing community residents with advanced dementia in Norway to receive a patch with buprenorphine, while another 45 got a placebo. In comparison with those administered the placebo, those using the buprenorphine patch were 24 times more likely to drop out of the 13-week trial, after accounting for factors such as age, sex, pain, and depression. Meanwhile, 23 of those using the buprenorphine patch exited the trial, versus six using the placebo. Erdal notes people taking antidepressants as well as buprenorphine were at the highest risk of adverse events. Furthermore, those who used the buprenorphine patch experienced a decline in daily activity on the second day of the trial that was not observed in the placebo cohort. "These results suggest that due to side effects like sedation, personality changes, and confusion, very careful consideration should be taken when prescribing opioid pain relief to people with dementia," says the Alzheimer's Society's Sally Copely.

The Centers for Medicare and Medicaid Services (CMS) is refusing to process claims for physical, speech, and occupational therapy, which will prevent seniors from being forced to pay out of pocket if they reach Medicare's annual ceiling of $2,010 for the services, reports Politico Pro . Limits on therapy care are among the set of "Medicare extenders" that expired at the end of 2017 and have not been renewed by Congress. With some seniors expected to hit Medicare's cap beginning in January, the American Physical Therapy Association's Justin Elliott says his organization and others are asking CMS for clarification. CMS says it cannot process claims sooner than 14 days but usually pays them within 30 days. "If legislation regarding the therapy caps is not enacted in this short period of time, then CMS will release and process the therapy claims accordingly," the agency notes on its website. Medicare's limit on how much therapy it would pay for was effected in 1997 but has been overridden by Congress ever since. CMS says it is not holding claims for other Medicare extenders.

Google's Nest division is eyeing seniors who wish to age at home as a major potential market for its smart home technology products, reports CNBC . Sources say the company has been soliciting senior living communities and experts in aging with a pitch about incorporating Nest devices, such as motion sensors to help people get to the bathroom late at night by automatically turning on lights, or alerting those who move around a lot in excessive heat that they might be at risk for dehydration. Also of interest is predicting potentially fatal falls. Nest products can already be useful in senior care, such as by allowing family members to check in on loved ones via camera products or letting only specific persons, such as caregivers, into the home through its smart locks. Experts generally see a lot of opportunity for tech companies in the aging space. "We have more and more older adults and proportionally fewer family members to take care of them," notes Honor CEO Seth Sternberg. "In-home devices like Fitbit or nest really should come together with in-house services to dramatically reduce the cost of care to seniors and the family-members who support them."

CNNMoney reports that Nike has decided to give approximately 7,000 employees, or 10 percent of its global workforce, pay raises. Nike spokeswoman Sandra Carreon-John said the company wants to "support a culture in which employees feel included and empowered," adding that the raises are a way for Nike to ensure its wages remain competitive. Carreon-John noted that Nike reviews pay every year, but that it conducted a "deeper analysis" this year. Nike also changed its bonus structure. Bonus determinations used to be based on a combination of company, team, and individual performances. Now, they will be based solely on company-wide performance. Stock-eligible employees will now have a choice as to how they would prefer to receive annual stock awards: as stock options, restricted stock uses, or a mixture of both.

Companies are incorporating green spaces as their environmental focus matures from simple recycling to more holistic sustainability, and these changes benefit both employees and companies, reports HR Dive . Green spaces in the workplace can enhance employee performance, with academic research suggesting they can relieve mental fatigue, thus improving performance, satisfaction, learning, inquisitiveness, and alertness. A study from the Harvard Center for Health and the Global Environment showed subjects in a green environment scored much higher for crisis response, information usage, and strategy compared to a conventional environment. Green spaces, in addition to recycling, composting, reducing paper products, and offering public transportation incentives for workers, form an overall vision of sustainability, and as enterprises start improving sustainability practices, they may be in for a larger cultural shift. Experts say companies can make progress in enhancing energy efficiency with upgraded lighting and renewable energy. Waste reduction, including recycling and composting, is another popular jumping-off point. As employers make progress in one area, they may discover that they are only at the start of their sustainability cycle.

A study published in JAMA Neurology found an eye test conducted by opticians might help predict dementia risk, reports BBC News . The test involves examining tissue in the retina, usually for signs of eye disease, and the researchers suggest the retina's thinness can be correlated with a person's likelihood of developing memory and reasoning problems. The team measured parts of the retina of 32,000 people, particularly the retinal nerve fiber layer (RNFL), using optical coherence tomography (OCT). Participants, who were between 40 and 69 years old, also were assessed on their memory, reaction time, and reasoning. Those with the thinnest RNFLs were more likely to fail one or more of the evaluations, and twice as likely to score poorer in follow-up assessments over the next three years. University College London Professor Paul Foster suggests OCT tests could help identify people at high risk of developing dementia. "It is likely that treatments will be more effective in slowing or stopping dementia at earlier stages of the disease," he notes. "Also, by targeting people in the earlier stages, it should be possible to design better clinical trials for treatments that make a real difference and improve people's lives."

A new study presented at the Alzheimer's Association's annual meeting suggests illumination that imitates natural night-day patterns could improve sleep and mood problems for nursing community residents with Alzheimer's, reports HealthDay News . The researchers found this lighting intervention encouraged less sleep disturbance, depression, and agitation. The interventions were performed on 43 nursing community residents in three states for four weeks, and 37 residents for six months. The personalized lighting was either a custom-designed LED light table or individual room lighting, based on where subjects spent most of their time during the day. Personal light meters monitored their exposures. The intervention was designed to activate circadian rhythm, which releases melatonin in the brain that regulates normal sleep-wake cycles. Because nursing community residents are often exposed to inconsistent levels of artificial light, these rhythms can be disrupted. After four weeks, sleep disturbance and depression scores in subjects exposed to the tailored intervention declined significantly. After six months, sleep disturbance scores had fallen by about half, while average depression scores among the light-exposed were less than half of baseline levels.

A virtual reality (VR) learning program designed to impart to students the experiences of people living with dementia was detailed at the Alzheimer's Association International Conference 2018 in Chicago, according to EurekAlert . The simulation was incorporated into a training program for high school students at Chicago's Northside College Preparatory School as part of the Bringing Art to Life program. The VR program seeks to better prepare the students to interact with older adults with Alzheimer's and other dementias at long-term care communities and adult day care centers. The simulation modules of people with dementia will next find use with undergraduates volunteering in the Bringing Art to Life program at the University of Alabama next spring. One module is a live-action film, depicting the world as experienced by a 74-year-old man with mild cognitive impairment, macular degeneration, and high frequency hearing loss. Another module features five-minute stories of a middle-aged Latina as she undergoes the early, middle, and later aspects of Alzheimer's dementia. The virtual narratives take participants through a digital version of actual experiences under dementia conditions. "The creators of the modules also highlight other issues that some people experience as they age, including communicating inappropriately with others because they may not be able to see or hear well, in addition to the memory problems that are common for persons with Alzheimer's," says the Alzheimer's Association's Beth Kallmyer.

The Senate on Monday confirmed President Trump's second Department of Veterans Affairs (VA) secretary, Robert Wilkie, to assume the role of VA chief, reports National Public Radio . Wilkie is viewed as a safe pick, but Sen. Bernie Sanders (I-Vt.) voiced his opposition to the appointment in a stand against what he says are the Trump administration's moves to turn VA healthcare over to the private sector. The Senate Veterans Affairs Committee gave Wilkie a fairly frictionless hearing, although several Democratic senators solicited from him a vow to oppose efforts to privatize VA healthcare. The VA has been unsettled in the wake of Trump's firing of his first VA secretary, David Shulkin, while VA Acting Secretary Peter O'Rourke testified at a recent House hearing that many VA officials were exiting because they were not in line with the Trump administration's "historic, transformative changes" that "are going to change the status quo." Wilkie will be overseeing a department facing ambitious changes that include a major overhaul in private care coverage, a realignment of the VA's infrastructure, and an expansion of a caregiver program for disabled vets, as part of the recently passed VA Mission act. Furthermore, the VA is adopting a new electronic medical record while confronted with a staffing shortage and unprecedented demand from aging Vietnam vets and recent veterans of the wars in Iraq and Afghanistan.

A 2018 survey of female healthcare professionals found pessimism is rife, reports RockHealth . Approximately 55 percent of respondents think it will take more than 25 years to achieve gender parity in the workplace versus 45 percent in 2017. Five percent predict this to happen in the next five years, down from 8 percent in 2017. The percentage of women on Fortune 500 healthcare executive teams and boards has been almost flat since 2015, at about 22 percent. The proportion of executives at hospitals has held steady at about 33 percent female, while the portion of women CEOs of funded digital health startups, and women venture capital partners, is about 10 percent to 12 percent. Women in smaller companies are more likely than those at larger firms to concur that their employer nurtures a supportive environment for women leaders, and they also say their employer better supports career development overall. Moreover, the poll positively correlated company ratings and the percentage of women in leadership positions at Fortune 500 healthcare companies. Meanwhile, 86 percent of African-American women surveyed cited race as "very much" an obstacle to career advancement, compared to 9 percent of white women.