A study presented at the Annual European Congress of Rheumatology and published in Annals of the Rheumatic Diseases found seniors with gout have a 17 percent to 20 percent higher-than-normal risk for developing dementia, reports Health Central . The study entailed data on 1.23 million people on Medicare, 65,325 of whom had dementia. Following adjustment for other factors that affect dementia risk, the researchers determined gout to be an independent risk factor for dementia. The connection between the two diseases was greatest in older age groups, women, African Americans, and seniors with other chronic health conditions.

Attorneys general in Florida and Georgia suggest ways to combat senior abuse, with Florida AG Pam Bondi noting more than 3.2 million senior Florida residents are ripe targets for scammers, reports Daily Business Review . "Anyone who would prey on these great citizens in their golden years is lower than dirt, and my Consumer Protection Division will aggressively investigate anyone targeting Florida seniors," she vows. Meanwhile, Georgia AG Chris Carr cites such abuse as "a tragic, evolving issue in our state, and we owe it to our older, at-risk Georgians to do all we can to protect them." He notes that "approximately 90 percent of these offenses are committed by a family member, and ... they are particularly devastating in these situations. As we continue to make it a priority to protect our state's most vulnerable citizens, we are urging the public to be on the lookout for signs of senior abuse in all its forms: physical, emotional, and financial." One particularly pernicious scam Carr calls attention to involves fraudsters calling older people along the lines of: "Hi Grandma, do you know who this is?" When the grandparent guesses the name, "the scammer has established a fake identity without having done a lick of background research," he says. Carr notes Georgia has special laws to shield residents 65 and older, disabled adults 18 and older who are mentally or physically incapacitated or have Alzheimer's or dementia, and residents of long-term care communities.

The New York Academy of Medicine, Global Coalition on Aging, AARP New York, and Bank of America Merrill Lynch have set up a website providing financial advisers and the public with resources and education on why seniors are often exploited by financial scams and ways to fight such abuse, reports Financial Adviser . "There is a complex, multidirectional relationship between financial, physical, and mental health," says Dr. Judith A. Salerno with the New York Academy of Medicine. Global Coalition on Aging CEO Michael W. Hodin notes extended lifetime "brings about new challenges and opportunities that government, non-profits, and businesses alike must address together to ensure that today's seniors — as well as tomorrow's — can live their most productive, fulfilling, and happiest lives possible. Financial wellness is a critical component toward achieving this goal, and it can only be realized by shattering outdated assumptions about retirement and adopting new models for working and saving aligned to the realities of healthy and active aging." The coalition says innovative financial planning tools are required to promote lifelong financial wellness. "Discussions at a recent Financial Wellness symposium underscored how the financial industry plays a leadership role in protecting seniors' net worth, self-worth, and lives," says BeyondBrooke.org founder Philip C. Marshall. He stresses that financial advisers should spearhead the fight against senior financial abuse because they can spot the signs early.

President Trump is testing how far he can assert a law banning government interference in negotiations between drugmakers and insurance companies that provide drug coverage to more than 42 million Medicare beneficiaries, reports the New York Times . With new drug prices often topping $10,000 annually, Trump has proposed a plan to cut prices, with possibly more government authority invoked. The plan would require insurers to reduce retail drug prices to reflect the discounts they get from drugmakers, typically as rebates paid to insurers and pharmacy benefit managers. Trump also has suggested Medicare "restrict or reduce" or perhaps even ban their use. Administration officials argue the rebates could be seen as illicit kickbacks because they profit an insurer for hiking the sales of a drugmaker's products. The plan mandates a fixed price for a medication, rather than rebates, in contracts between drugmakers and the insurers that offer Medicare's prescription drug plans (PDPs). Opponents cite unwanted interference, with Pharmaceutical Care Management Association Vice President Wendy L. Krasner warning Medicare would "dictate the details of pricing arrangements between the parties" — details that, under the Medicare statute, are supposed to be worked out in negotiations between drugmakers and PDPs. She stresses that Medicare officials "may not interfere in those negotiations," noting "this free market approach is generally credited for the overwhelming success" of Medicare Part D. The noninterference clause is core to the approach Republicans adopted when they added drug benefits to Medicare.

Organizations like the National Center for Creative Aging (NCCA) are hosting "creative aging" courses, which the NCCA's Jennie Smith-Peers describes as "any opportunity for an older adult to be engaged in a meaningful opportunity to express themselves through art," reports Art Sy . The classes are designed to teach a skill, and enthusiasm for such projects is rising thanks to research by geriatric psychiatrist Gene D. Cohen. He conducted a study of 150 adults in Washington, D.C., aged 65 or over who met weekly in an "arts group" for much of 2001, comparing them to a control group that did not take part in such a program. After several years, the arts group had better health, fewer doctor visits, used fewer drugs, felt less lonely and depressed, had higher morale, and were more socially engaged. In 2008, the Lifetime Arts organization was founded to offer training and support so many community groups can build up their own independent creative aging programs. Lifetime Arts trains teaching artists to work specifically with older adults. The NCCA also provides training and resources for institutions ready to embrace the benefits of creative aging. "We're seeing it become more and more a part of the culture of community centers, of long-term care communities," says Smith-Peers. "It's no longer an afterthought. The arts are what make these places for older adults a more interesting, meaningful place to engage in and to live in."

A data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics says people 65 years and older more often visit mental health-related physician offices than primary care physicians (PCPs), reports HealthDay News . The researchers used data from the National Ambulatory Medical Care Survey to study adult mental health-related physician office visits by specialty and selected visitor characteristics. They determined the rate of mental health-related physician office visits to psychiatrists was higher than the rate to PCPs overall among adults aged 18 years and older, and for all age groups except those 65 and older. The rate of mental health-related office visits to psychiatrists was higher than visits to PCPs for both men and women. In rural regions, the percentage of mental health-related office visits to psychiatrists was lower than to PCPs, while it was higher in large metropolitan areas. "These results together may indicate that older adults, who are also more likely to use Medicare, are as likely to visit a primary care physician as they are a psychiatrist for mental health-related issues," the investigators note.

A study published in Alzheimer's & Dementia suggests sex and gender differentially affect the risk, clinical presentation, and progression of Alzheimer's disease (AD), and they should be mulled in the planning and analyses of AD studies and development of AD therapeutics, reports Medscape . Among the research priorities in sex and gender differences identified by the researchers are the extent to which findings of sex and gender differences in AD are due to longevity, survival bias, and comorbidities; potential sex-specific risk factors for AD across the lifespan, including oophorectomy, menopause, pregnancy, androgen deprivation therapy, and testosterone loss; the influence of estrogens and hormone therapy on brain function and AD risk, given discrepancies in the clinical literature; potential sex differences in genetic risk factors for AD; sex differences in AD progression and the pathway of change in cognitive function, neuroimaging, cerebrospinal fluid, and blood-based biomarkers of AD; gender differences in caregiving and how the burden of caregiving influences AD risk; and sex and gender disparities in development of AD therapeutics, from preclinical to clinical studies, and in the design of clinical trials. "Having a better understanding of what those differences are and how they are contributing to the disease is important, because ultimately when we have a therapy or when we have a diagnostic tool we need to understand how that is going to work in men and women," says the Alzheimer's Association's Heather Snyder.

A study published in Acta Neuropathologica found the cellular waste-disposal system can spread damaging protein aggregates between neurons in the brain in Alzheimer's disease, reports ScienceDaily . The researchers demonstrated that small membrane-covered droplets called exosomes used by cells to eliminate waste also can transport toxic aggregates of amyloid beta, and in this way spread Alzheimer's to new neurons. "The spread of the disease follows the way in which parts of the brain are anatomically connected," says Linköping University Professor Martin Hallbeck. "It seems reasonable to assume that the disease is spread through the connections in the brain, and there has long been speculation about how this spread takes place at the cellular level." Analysis of cadaveric brain tissue found more amyloid beta in exosomes from brains affected by Alzheimer's than in healthy controls. The team also purified exosomes from the brains from people with Alzheimer's disease, and probed whether they could be absorbed by cells cultured in the lab. "Interestingly, exosomes from people were absorbed by cultured neurons, and subsequently passed on to new cells," Hallbeck says. "The cells that absorbed exosomes that contained amyloid beta became diseased."

A study published in Medical Care found older adults with more financial literacy are less likely to be hospitalized, reports News-Medical . The researchers focused on 388 older adults without dementia, who completed a questionnaire assessing their financial literacy. During an average follow-up of 1.8 years, 30 percent of the participants were hospitalized at least once. Lower financial literacy was linked to a higher risk of hospitalization. Average financial literacy scores were 11 points for seniors who were hospitalized versus 13 points for those who were not. The connection remained significant after adjustment for various factors, including income and indicators of physical and mental health. The final model associated a 4-point increase in financial literacy score with a 35 percent lower risk of hospitalization. The only other independent risk factors were older age and difficulties with daily activities for independent living. The association between financial literacy and hospitalization risk was mainly related to knowledge of financial concepts, and not the ability to perform calculations. This link seemed stronger for elective hospitalizations, instead of for urgent or emergency ones. "These findings build on a growing body of research indicating that financial literacy is associated with better health and well-being in old age," say the researchers.

Medical costs are expected to grow 6 percent in 2019, continuing their relatively flat growth of the past five years, reports Modern Healthcare . Yet higher costs have not translated to similar gains in consumers' health and productivity, according to PricewaterhouseCoopers researchers who studied employer-sponsored healthcare spending. Costly new medical services and drugs and market consolidation are driving higher costs, said Barbara Gniewek, a health services principal at PwC. "It looks like costs are stabilizing, but they are still going up at a rate above inflation," she said, calling this pace "ultimately unsustainable." As health systems consolidate and acquire physician practices, prices tend to increase through facility fees and other fixed costs, according to the report. Providers, employers, and health plans are offering consumers new healthcare access through telehealth, retail, and urgent-care clinics. The ultimate goal is to reduce spending, but improved access often leads to higher utilization in the short-term, PwC researchers said. To continue to lower costs, employers and health plans likely will have to address prices—and not just drug prices, according to the report. That will require employers and insurers to collaborate with numerous stakeholders, from pharmacy benefit managers to retail pharmacies. They will have to justify the price of services by demonstrating their value, get comfortable working with third parties advocating for patients, and target investments that enhance the customer experience.