In The News

Study: Falls Rate Nearly 50% for U.S. Seniors with Dementia; 3 Factors Raise Risk

McKnight’s Long-Term Care | Alicia Lasek
 
Nearly half of American seniors with dementia had one or more falls in the preceding year, according to a new analysis of 2016 data. Three factors were most highly associated with risk, the researchers say.

Data came from the National Health and Aging Trends Study from 2015 and 2016, which examined health and disability trends and outcomes in adults aged 65 years and older in the United States. Fully 45.5% of older adults living with dementia experienced one or more falls in 2016, compared to 31% of older adults without dementia, investigators found.

Impaired vision, living with a spouse versus living alone, and a history of falls within the prior year were strongly linked to greater likelihood of falls, reported the authors, from Drexel University in Philadelphia and Johns Hopkins University in Baltimore.

They also pinpointed key falls risk factors for older adults living without dementia. These included financial hardship, a history of falls, fear of falling, poor lower extremity performance, depressive symptoms and home disrepair.

The study is the first national one to compare risk factors for senior Americans living with dementia to those without dementia, according to the researchers. The results support tailored falls prevention strategies for people with dementia that consider key risk factors during screening, they added.

“Overall, our findings demonstrate the importance of understanding and addressing fall-risk among older adults living with dementia,” said Safiyyah Okoye, PhD, of Drexel. “It confirms that fall-risk is multidimensional and influenced by environmental context in addition to health and function factors.”

Full findings were published in Alzheimer’s & Dementia.

 

Blood Test for Early Alzheimer’s Detection

One of the first stages of Alzheimer’s disease involves formation of toxic aggregates, called oligomers, of the protein amyloid beta (Aβ). These oligomers can start to form more than a decade before symptoms appear and before other known disease markers form. The ability to detect these oligomers would permit early disease diagnosis. This would make strategies to intervene before irreparable brain damage occurs possible.

An NIH-funded research team led by Valerie Daggett at the University of Washington developed a method to detect toxic Aβ oligomers in patients’ blood. They tested the assay, called the soluble oligomer binding assay (SOBA), on nearly 400 banked human blood plasma samples. Results appeared on December 13, 2022, in the Proceedings of the National Academy of Sciences.

Toxic Aβ oligomers have a structure known as an alpha sheet that isn’t normally found in proteins. Alpha sheets tend to bind to each other. SOBA takes advantage of this distinct structural feature. The researchers designed a synthetic alpha sheet molecule to bind to the alpha sheets in Aβ oligomers. They showed that their designed molecule, called AP193, bound to the subset of Aβ with alpha sheets but not to other, non-toxic forms of Aβ.

Aβ oligomers normally reduce signaling in cultured neurons. Adding AP193 prevented this reduction in signaling. AP193 might thus form the basis for future therapeutic strategies.

When the team applied SOBA using AP193 to a cerebrospinal fluid sample from a person with Alzheimer’s disease, they detected Aβ oligomers. They did not detect oligomers in cerebrospinal fluid from a person who had no cognitive impairment.

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Biden Administration Renews Public Health Emergency Again

Full text of the declaration reads:

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.

 

‘Kraken’ COVID Symptoms: What to Know About the Strain Sweeping Through the U.S. and Now in at Least 28 Other Countries

Fortune Well | By Eleanor Pringle

COVID hospitalizations in the U.S. have spiked 16.1% in the past week as a new “escaped” variant of the virus has continued to sweep across the country.

XBB.1.5— dubbed ‘Kraken’ by Canadian biology professor Dr. Ryan Gregory and his following in the Twitterverse—is the most transmissible COVID variant yet, according to the World Health Organization.

A risk assessment is currently being drawn up for the new mutant strain by WHO’s technical advisory group on virus evolution, Maria Van Kerkhove, technical lead for COVID-19 response at the authority, said on Wednesday.

XBB.1.5 began alarming scientists at the tail end of last year after the number of Kraken cases in the U.S. rose from 1% of all cases at the start of December to 41% just three weeks later.

This week, the U.S. Centers for Disease Control and Prevention projected that it comprised around 75% of infections in regions 1 and 2, which include Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New York, New Jersey, Puerto Rico, and the U.S. Virgin Islands.

The strain is believed to be in at least 28 other countries—including Europe—with cases of XBB.1.5 now thought to make up 4% of COVID cases in the U.K.

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Medicare Advantage, Telehealth Expansion Allies to Helm Key House Panels

Fierce Healthcare | By Robert King
 
The new leaders of the influential House Ways and Means Committee and the House Energy and Commerce Committee have previously been fierce advocates for extending telehealth services as well as preserving Medicare Advantage (MA).
 
Rep. Cathy McMorris Rodgers, R-Washington, was selected Tuesday as the head of Energy and Commerce. Rep. Jason Smith, Missouri, will helm the House Ways and Means Committee. Both panels have major jurisdiction over healthcare issues in Congress.
 
It remains unclear what the exact priorities for both lawmakers will be in the new congressional session. 
 
McMorris Rodgers has served as the ranking member of Energy and Commerce in the last Congress and has been critical of the Biden administration’s response to the COVID-19 pandemic. She has called for information and records from the National Institutes of Health on the origins of the COVID-19 pandemic, which will likely be the source of hearings across multiple committees in the coming years.
 
She is also likely to be a sharp critic of Centers for Medicare & Medicaid Services (CMS) policies on Medicaid and the Affordable Care Act.
 
McMorris Rodgers slammed CMS for approving a waiver by Washington state to enable undocumented immigrants to get subsidized coverage. Rodgers said in a statement last month that the waiver granted by CMS to Washington was a “misuse of taxpayer dollars.”
 
Both McMorris Rodgers and Smith are aligned on a key issue of how to keep around telehealth flexibilities. Smith told Axios that a big focus of his chairmanship will be on extending telehealth and improving access to healthcare in rural areas. 
 
McMorris Rodgers has also been a big proponent of the expansion of telehealth flexibilities created at the onset of the pandemic. 
 
Both lawmakers will likely play a pivotal role in the future of telehealth. At the start of the pandemic, CMS expanded the flexibility for providers to get Medicare reimbursement for telehealth. 
 
Congress passed legislation at the tail end of 2022 that extends those benefits through 2024. It may be up to Congress again to pass another extension or to decide which flexibilities should become permanent. 

 
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