Prolonged sitting and frailty a deadly combination

https://goo.gl/9GiC4k

The Physical Activity Guidelines for Americans state that adults aged 18 to 64 and those aged 65 and older should aim to get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity every week.

For adults who are unable to meet these guidelines, it is recommended that "they should be as physically active as their abilities and conditions allow."

According to statistics from the 2016 National Health Interview Survey, just 44.9 percent of older adults aged 65 to 74 met the physical activity guidelines last year.

What is more, previous research has shown that older adults spend more than 9 hours of their day sitting down.

The harms of sedentary behavior have been well documented. A study reported by Medical News Today last year, for example, suggested that sitting for more than 3 hours daily is responsible for more than 430,000 deaths across 54 countries every year.

The study included the data of 3,141 adults aged 50 and older who participated in the 2003-2004 and 2005-2006 United States National Health and Nutrition Examination Survey.

As part of the survey, subjects were required to wear activity trackers during waking hours, and the researchers used these data to calculate how much time each adult spent sedentary.

The team also used a 46-item index to assess the frailty of each subject. Frailty is generally defined as an aging-related process characterized by weakness, unintended weight loss, slowness, and fatigue.

Participants were followed up until 2011, or until their date of death.

Among adults who scored highly on the frailty index and did not meet the physical activity guidelines, the researchers found that prolonged sitting was associated with an increased risk of death. This was not the case for adults with low frailty who met exercise guidelines.

"Thus, among people who are inactive and vulnerable or frail, sitting time increases mortality risk, but among those who are non-frail or active, sitting time does not affect the risk of mortality," say the researchers.


The Walgreens Center for Health & Well being Research

Interesting to me because the focus is on community retailers as a source of improved healthcare.
https://goo.gl/vuVgcG

Welcome to the Walgreens Center for Health & Wellbeing Research.

Walgreens strives to impact the Triple Aim by improving the experience of care, improving the health of populations and reducing total healthcare costs. Our dedicated team works to demonstrate the impact and effectiveness of various pharmacy-led programs and services and how they can benefit patients, providers, and payers.

Here you will find summaries, links and original documents related to our research in peer-reviewed publications and presentations at scientific conferences.

We look forward to your feedback and our efforts to improve health and wellness in America! If you have questions or suggestions, please contact us at research@walgreens.com.

Research Initiatives:

Access to Care & Patient Experience
Adherence & Clinical Outcomes
Common Chronic Conditions
Digital Health & Member Engagement
Healthcare Costs
HIV & Specialty Pharmacy
Vaccinations
Value of the Pharmacist


Asthma, on rise in older adults, tends to be ignored

https://goo.gl/vX2hTf

In early June, Donna Bilgore Robins stood on a patio in Beaver Creek, Colo., under a crystal-clear blue sky and tried to catch her breath.

She couldn't.
With mountain vistas around her, Robins felt as if she was drowning. She gasped for air hungrily again and again.
    Robins knew all too well what was happening. Something -- some kind of plant? something in the mountain air? -- had triggered her asthma, a lifelong condition.
    She also knew she was in danger, even with a rescue inhaler at hand. "I don't slowly get sick -- I just drop," said Robins, who with help from her husband was soon on the road to seek medical attention over 100 miles away at National Jewish Health in Denver, a leading hospital for people with respiratory conditions.


    Researchers discover fundamental pathology behind ALS

    https://goo.gl/nVbaUt

    A team led by scientists at St. Jude Children's Research Hospital and Mayo Clinic has identified a basic biological mechanism that kills neurons in amyotrophic lateral sclerosis (ALS) and in a related genetic disorder, frontotemporal dementia (FTD), found in some ALS patients. ALS is popularly known as Lou Gehrig's disease.

    In further studies, the researchers found that TIA1 mutations occurred frequently in ALS patients. The scientists also found that people carrying the mutation had the disease. When the investigators analyzed brain tissue from deceased ALS patients with the mutations, the scientists detected a buildup of TIA1-containing organelles called stress granules in the neurons. Such granules form when the cell experiences such stresses as heat, chemical exposure and aging. To survive, the cell sequesters in the granules' genetic material that codes for cell proteins not necessary for survival-critical processes.

    The granules also contained a protein called TDP-43, another building block of stress granules, whose abnormality has been implicated in causing ALS. In test tube studies and experiments with cells, the researchers found that the TIA1 mutation causes the protein to become more "sticky," delaying the normal disassembly of stress granules, trapping TDP-43.

    "This paper provides the first 'smoking gun,' showing that the disease-causing mutation changes the phase transition behavior of proteins," Taylor said. "And the change in the phase transition behavior changes the biology of the cell."

    "We know that these material properties are under tight regulation, so perhaps we don't have to target the disease-causing mutation itself," Taylor said. "Perhaps we can restore balance by targeting any of a large number of regulatory molecules in the cell. There are already therapeutic approaches in laboratory testing that seek to do just that."


    CMS Releases Hospice Compare Website to Improve Consumer Experiences, Empower Patients

    https://goo.gl/JrNFgL

    Today, as part of our continuing commitment to greater data transparency, Centers for Medicare & Medicaid Services (CMS) unveiled the Hospice Compare website. The site displays information in a ready-to­­-use format and provides a snapshot of the quality of care each hospice facility offers to its patients. CMS is working diligently to make healthcare quality information more transparent and understandable for consumers to empower them to take ownership of their health. By ensuring patients have the information they need to understand their options, CMS is helping individuals make informed healthcare decisions for themselves and their families based on objective measures of quality.

    “The Hospice Compare website is an important tool for the American people and will help empower them in a time of vulnerability as they look for information necessary to make important decisions about hospice care for loved ones,” said CMS Administrator Seema Verma. “The CMS Hospice Compare website is a reliable resource for family members and care givers who are looking for facilities that will provide quality care.”

    Hospice facilities offer specialized care and support to individuals with a terminal illness and a prognosis of six months or less if the illness runs its normal course. Once a patient elects hospice care, the focus shifts from curative treatment to palliative care for relief of pain and symptom management, and care is generally provided where the patient lives. Additionally, caregivers can get support through the hospice benefit, such as grief and loss counseling. Hospice Compare helps patients and caregivers find hospice providers in their area and compare them on quality of care metrics.


    Studies: Biologic Proves Worth as Monotherapy in RA

    https://goo.gl/ajHyf1

    Rheumatoid arthritis (RA) patients who received tocilizumab (Actemra) with methotrexate achieved low disease activity and could discontinue methotrexate while maintaining disease control, researchers said here.

    In a study designed to evaluate whether tocilizumab monotherapy was non-inferior to the combination, patients who achieved a DAS28-ESR (Disease Activity Score) of 3.2 or lower at week 24 were eligible for the trial to determine if they could safely discontinue methotrexate, according to Joel Kremer, MD, of Albany Medical College and The Center for Rheumatology in Albany, N.Y., and colleagues in a presentation at the Rheumatology Nurses Society annual meeting.


    Out-of-pocket costs exceed what many insured cancer patients expect to pay

    https://goo.gl/cuHtky

    Some patients spend a third of household income on cancer care, despite insurance.

    A third of insured people with cancer end up paying more out-of-pocket than they expected, despite having health coverage, researchers at the Duke Cancer Institute have found.

    The data showed that costs such as copays and deductibles could lead to financial distress among insured patients of all income levels and with all stages of cancer. Findings will be published in the journal JAMA Oncology.

    Many cancer patients can be burdened by 'financial toxicity' that can erode their mental and physical state, especially if they stop pursuing treatment because they feel they can't afford it, said senior author Yousuf Zafar, M.D., a medical oncologist at Duke.

    "This study adds to the growing evidence that we need to intervene," Zafar said. "We know there are a lot of barriers that prevent patients from talking about cost with their providers. We need to create tools for patients at risk of financial toxicity and connect them with resources in a timely fashion so they can afford their care."


    Does Widespread Pain Spread From the Brain?

    https://goo.gl/Tw423s

    Pain is the most common reason people seek medical care, according to the National Institutes of Health.

    “Sometimes we can easily pinpoint what is causing a person pain,” says Richard Harris, Ph.D., associate professor of anesthesiology and rheumatology at Michigan Medicine. “But, there are still 1 in 5 Americans who suffer from persistent pain that is not easily identifiable.”

    Whenever someone experiences pain, they often think about how intense the pain is — but rarely do they also consider how widespread the pain is.

    “Surprisingly, many of the individuals, in addition to having pain located in the pelvic region, had pain also widely distributed throughout their body,” Harris says. “Interestingly, when we put these individuals into the brain imaging scanner, we found that those who had widespread pain had increased gray matter and brain connectivity within sensory and motor cortical areas, when compared to pain-free controls.”

    Urological chronic pelvic pain syndrome patients with widespread pain showed increased brain gray matter volume and functional connectivity involving the sensorimotor and insular cortices.

    “What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Harris says.

    The team notes the changes in brain gray matter volume and functional connectivity were identical to outcomes present in fibromyalgia patients, but were not seen in the pain-free control group.


    Antidepressant use increases risk of head injuries among persons with Alzheimer's disease

    https://goo.gl/5XgvQ5

    Antidepressant use is associated with an increased risk of head injuries and traumatic brain injuries among persons with Alzheimer's disease, according to a new study from the University of Eastern Finland. Antidepressant use has previously been linked with an increased risk of falls and hip fractures, but the risk of head injuries has not been studied before. The results were published in Alzheimer's Research & Therapy.

    Antidepressant use was associated with a higher risk of head injuries especially at the beginning of use - during the first 30 days, but the risk persisted even longer, up to two years. The association was also confirmed in a study design comparing time periods within the same person, thus eliminating selective factors. The association with traumatic brain injuries was not as clear as for head injuries, which may be due to a smaller number of these events in the study population. The use of other psychotropic drugs did not explain the observed associations.

    Head injuries are more common among older people than younger ones, and they are usually caused by falling. As antidepressant use has previously been associated with an increased risk of falling, the researchers were not surprised that the use of antidepressants also increased the risk of head injuries.

    "However, our findings give cause for concern because persons with Alzheimer's disease frequently use antidepressants, which have been considered a safer alternative to, for example, benzodiazepines," says Senior Researcher Heidi Taipale from the University of Eastern Finland.