Health and Disability

Like spicy food? If so, you might live longer, say researchers at the Larner College of Medicine at the University of Vermont, who found that consumption of hot red chili peppers is associated with a 13 percent reduction in total mortality - primarily in deaths due to heart disease or stroke—in a large prospective study.

There are some possible explanations for red chili peppers' health benefits, state Chopan and Littenberg in the study. Among them are the fact that capsaicin - the principal component in chili peppers - is believed to play a role in cellular and molecular mechanisms that prevent obesity and modulate coronary blood flow, and also possesses antimicrobial properties that "may indirectly affect the host by altering the gut microbiota."

"Because our study adds to the generalizability of previous findings, chili pepper—or even spicy food - consumption may become a dietary recommendation and/or fuel further research in the form of clinical trials," says Chopan.

The Physical Activity Guidelines for Americans state that older adults should engage in around 150 minutes of moderate-intensity aerobic activity, or 75 minutes of vigorous-intensity activity, every week.

However, a 2015 review published in the Journal of Aging and Physical Activity found that adults aged 60 and older spend approximately 9.4 hours a day sedentary, which is equivalent to about 65-80 percent of their waking day.

For their study, Heisz and colleagues set out to investigate the association between physical activity and dementia risk among older adults with and without the APOE e4 gene.

The researchers came to their findings by analyzing the physical activity and dementia development of 1,646 older adults who were part of the Canadian Study of Health and Aging. All participants were free of dementia at study baseline and followed up for around 5 years.

Among adults who did not carry the APOE e4 gene, the researchers found that those who did not exercise were more likely to develop dementia than those who exercised.

For APOE e4 gene carriers, however, there was no significant difference in dementia risk between those who exercised and those who did not.

According to the researchers, these findings indicate that a lack of exercise may be just as risky for dementia development than carrying the APOE e4 gene.

My health care story isn’t necessarily dramatic. I don’t have cancer. I’m not disabled. I’m not dying. And I’m not in danger of those things any time soon, hopefully.

Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. Now, that argument’s premise is facing serious questions in federal court and in the Medicare appeals process.

The first case that successfully pushed back against the policy involved Wisconsin resident Jill Whitcomb, who has had Type 1 diabetes for 40 years. Ms. Whitcomb was first prescribed a CGM by a nurse practitioner, and she used it successfully during a six-month trial. In 2011, she sought to have the device covered under her UnitedHealthcare Securehorizons Medicare plan. The Medicare-insuring contractor denied the claim.

On April 29, 2016, an administrative law judge in the Medicare Civil Remedies Division ruling on a similar case invalidated an insurance benefit exclusion – again, the insuror had tried to argue that CGMs were precautionary equipment. The order again took insurors to task for failing to use scientific data to back up this argument.

“The contractor and CMS [Center for Medicare Services] have not produced any record in the form of peer-reviewed literature, medical opinions, or even an analysis from an individual with a medical background that supports a conclusion that a CGM is never reasonable and necessary irrespective of the beneficiary’s condition,” the judge wrote.

In this case, the judge had reviewed all of Medicare’s requirements for coverage and determined that CGMs in fact meet the coverage requirements, said Parrish. In a practical sense, then, wider acceptance of CGMs by practitioners, patients, and private insurors is forcing the Medicare program and Medicare insurors to revisit their justifications for denying the benefit, she said. Approximately 95 percent of commercial insurors cover CGMs, according to an article appearing in American Journal of Managed Care.

Hundreds of thousands of state residents would likely be affected by a repeal of the Affordable Care Act, including those in counties that went hard for the law’s critic-in-chief, President-Elect Donald Trump, according to a Bridge Magazine analysis of government data.

The implications of an immediate repeal of the ACA could be felt by nearly 1-in-10 Michigan residents, and as much as 13 percent of the population in places as different from one another as the Detroit-area and rural Emmet County.

Consider: In Wayne County, dominated by Democratic-heavy Detroit, 12.7 percent of county residents receive health care through a combination of ACA enrollment or Medicaid expansion. In Cheboygan County, at the top of the mitt, where Trump trounced Democratic nominee Hillary Clinton by a 2-to-1 margin, 13.1 percent of residents depend on ACA coverage or Medicaid expansion.

If the Republican-led Congress, with a likeminded president, also change the way that traditional Medicaid is funded, as many as two million Michiganders could be impacted by Washington’s dramatic health-care changes, enrollment data show.

Impact of ACA repeal in Michigan

Congress is considering repeal of the Affordable Care Act and major changes to Medicaid. Nearly a million people in Michigan get their health coverage through the ACA or Medicaid expansion, helping cut in half the percent of people who don’t have health insurance. Click or tap on a county or congressional district to see how many people are covered by Medicaid expansion and the ACA.

Several research studies and analyses have been conducted regarding yoga and fibromyalgia:

• A 2011 study published in the International Journal of Yoga Therapy, summarized the effects an 8-week course of yoga and meditation had on 11 people with fibromyalgia. Following the study, participants reported significant improvements in the number of days they "felt good" and did not miss work for reasons related to fibromyalgia. However, participants did not report decreased incidences of pain and fatigue.
• A 2013 analysis of three research studies, published in the Journal of Pain Research, found that yoga helped to reduce sleep disturbances, fatigue, and depression while also improving quality of life. However, the authors noted that there are not enough significant studies to confirm a link between yoga and reduced symptoms of fibromyalgia.
• A 2010 research study published in the journal Pain studied 53 female fibromyalgia patients who participated in an 8-week Yoga of Awareness program. This program included meditation, breathing exercises, gentle poses, and yoga-based instructions for coping with symptoms. After finishing the program, the participants reported significant improvements in measures of pain, fatigue, and mood associated with fibromyalgia.

Antidepressant use nearly doubles the risk of hip fracture among community-dwelling persons with Alzheimer's disease, according to a new study from the University of Eastern Finland. The increased risk was highest at the beginning of antidepressant use and remained elevated even 4 years later. The findings were published in the International Journal of Geriatric Psychiatry.

A comprehensive review of research published in The Journal of the American Osteopathic Association finds delirium to be an often-undiagnosed syndrome, affecting nearly 18 percent of long-term care residents, with a staggering 40 percent one-year mortality rate.

"It is unclear whether delirium itself causes deterioration in brain functionality that ultimately can result in premature death, or if delirium is a symptom indicating a mind and body already in decline," said author Martin Forsberg, MD, an assistant professor in the Department of Geriatrics & Gerontology at Rowan University School of Osteopathic Medicine, who conducted the review.

Delirium is a syndrome of altered mental status characterized by disorganized thinking, deficits in attention and a fluctuating course. The similarity of its symptoms to those of dementia cause delirium to often go undiagnosed or misdiagnosed in elderly patients with dementia.

The most acute symptoms typically last one week; however, it can take weeks or months for patients to get back to baseline. Persisting delirium can accelerate dementia, making it difficult to accurately determine whether the patient still has delirium or a worsened baseline of dementia.

Also important is that, while delirium often has medical causes, it can persist even after the initial medical condition has been resolved.

As the 115th U.S. Congress deliberates the future of the Affordable Care Act, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January.

The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in 2015 in states that implemented the ACA Medicaid expansion, along with the political parties of their governors and U.S. senators. As of January 2017, among states that adopted the Medicaid expansion, 16 have Republican governors, 14 have Democratic governors, and one has an Independent governor. In Washington, D.C., which also expanded Medicaid, the mayor is a Democrat.

The map below shows estimates of ACA Marketplace enrollment as of March 2016 by congressional district, with red and blue districts representing those with a Republican or Democratic congressional representative.  Districts with darker shading have a greater number of Marketplace enrollees.  Of the 11.5 million Marketplace enrollees nationally, 6.3 million live in Republican districts and 5.2 million live in Democratic districts. Marketplace enrollees per Republican district range from 10,200 enrollees in West Virginia’s District 3 to 96,300 enrollees in Florida’s District 27, with a median of 24,300 enrollees per district. Marketplace enrollees per Democratic district range from 5,200 enrollees in Hawaii’s District 1 to 94,100 enrollees in Florida’s District 10, with a median of 23,600 enrollees per district. The ten congressional districts with the highest number of Marketplace enrollees are all in Florida. There are 17 congressional districts (8 Republican districts and 9 Democratic districts) with over 50,000 enrollees, located in the following states: Florida, North Carolina, Georgia, and Montana.

A comprehensive vision assessment should be part of return-to-learn protocols to help determine when children are ready to return to the classroom following concussions — particularly in children reporting academic difficulty.

Researchers from the University of Alabama at Birmingham reported these findings in the January 2017 feature issue of Optometry and Vision Science Journal — Eye and Vision Changes from Head Trauma.

“As we continue to try to improve concussion protocols, specifically when it comes to children, it is important that we understand the effects of a concussion on a child’s ability to learn,” said Mark Swanson, O.D., associate professor in the UAB School of Optometry. “Concussed children with vision symptoms, hearing disturbances and difficulty concentrating often have academic difficulty post-concussion.”