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AAA Warman Home Care’s E-Update is intended to bring to you timely and useful articles and information at the click of the mouse. It is sent monthly in an effort to keep you apprised of what is happening across the healthcare continuum of care effecting hospital, hospice and rehabilitation social workers and case managers, as well as Assisted Living, Independent Living and Skilled Nursing facility executives. Warman understands that time is limited and has undertaken to share with you important industry information without your having to search for it.
Dementia and cognitive impairment are widespread among elderly individuals in the United States, affecting more than 8 million people to some degree.
The Sweet 16, a new screening test developed by a team of geriatricians and neurologists at the Institute for Aging Research of Hebrew Senior Life and Beth Israel Deaconess Medical Center, could help clinicians more rapidly detect dementia in elderly patients. The Sweet 16 will be available without charge to any nonprofit organization, and may provide an alternative to the Mini-Mental State Examination. The findings are described in the Nov. 8, 2010 online issue of the Archives of Internal Medicine.
"A recent study showed that more than 30 percent of hospitalized patients over age 75 had some degree of cognitive impairment," says lead author Tamara Fong, M.D., Ph.D., an assistant scientist at the Institute for Aging Research. "While the public health impact of cognitive impairment, including loss of independence, decreased quality of life, and increased health-care costs, is clear, this condition is often under recognized in health-care settings."
Routine measurements of cognitive function can help clinicians detect dementia at earlier stages, which, in turn, helps them better assess the severity of the disease, as well as to identify individuals at risk of developing delirium or functional impairments that could impair driving or otherwise pose a safety risk.
The Sweet 16 screening test consists of 16 measurements, designed to be implemented in a time frame of two to three minutes. Unlike previous assessment methods, the Sweet 16 does not rely on any props and does not require pencil or paper, which makes it more useful in or at the hospital bedside. Furthermore, notes Dr. Fong, unlike other cognitive screening tests, the Sweet 16 has been specially designed to accurately characterize mental status without influence by a patient's education or other sociodemographic factors.
Using data from the Aging, Demographics and Memory Study, a substudy of the Health and Retirement Study, a nationally representative panel survey of more than 20,000 people across the U.S. designed to examine the risks and outcomes of dementia and cognitive impairment, the authors examined how well the Sweet 16 performed in this population compared with another cognitive measure, the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and clinicians' diagnoses for dementia.
"The Sweet 16 could be used in home, outpatient, hospital or long-term care settings," says Dr. Fong, who is also a neurologist at Beth Israel Deaconess Medical Center. "For frail, older or medically ill hospitalized or institutionalized patients, this type of streamlined assessment could be of particular benefit in evaluating risk of delirium or future cognitive decline and in assuring patient safety and decision-making capacity."
Study authors include Sharon K. Inouye, M.D., M.P.H. (senior author), Richard Jones, Sc.D., James Rudolph, M.D., S.M., Frances Yang, Ph.D., Douglas Tommet, M.S., Daniel Habtermariam, B.A., Edward Marcantonio, M.D., S.M., and Kenneth Langa, M.D., Ph.D.
Source: Hebrew SeniorLife Institute For Aging Research, November 10, 2010
William E. Sorfleet had a life-threatening abdominal aortic aneurysm, but at age 82, he was too old for major invasive surgery to repair the bulging blood vessel.
So vascular surgeon Dr. Ross Milner of Loyola University Hospital repaired the aneurysm with a catheter device instead of a scalpel. The catheter, inserted through an artery, deployed a device called a stent graft that repaired the aneurysm.
Sorfleet, who lives in Woodridge, Ill., is among the patients participating in a nationwide clinical trial to evaluate the device. He went home the day after the procedure.
"I feel great," he said.
An abdominal aortic aneurysm is a bulge in the aorta, the major blood vessel that extends down to the abdomen. A large aneurysm is like a ticking time bomb. At any time, it could suddenly burst, causing massive internal bleeding that is usually fatal. About 15,000 people in the United States die each year from such ruptures.
A stent graft is a Dacron tube supported by a metal webbing. It is put in place by a catheter (thin tube). Milner inserted the catheter in a groin artery, and guided it to the aneurysm. After he deployed the stent graft from the catheter, the device expanded outward to the walls of the artery. Blood now flows safely through the tube-like stent, rather than through the bulging aneurysm.
In recent years, vascular surgeons have treated an increasing percentage of aneurysms in the chest and abdomen with stent grafts. But Sorfleet had a difficult-to-treat aneurysm. The bulge, more than 2 inches wide, contained a ring of calcium deposits and therefore could not be treated with any of the four stent grafts now on the market.
Milner used a stent graft that is being evaluated in a clinical trial. (Loyola is the only center in Illinois participating in the trial.) The device, called UniFit®, is made by LeMaitre Vascular Inc.
Stent grafts now on the market can repair aneurysms in between 60 percent and 70 percent of AAA patients, Milner said. He estimates that an additional 10 percent to 15 percent of patients potentially could benefit from the new stent graft.
The aorta is the largest blood vessel in the body, and is roughly the width of a garden hose. The stent graft Milner used is 5.5 inches long and nearly an inch in diameter at its widest point.
"I felt no pain," Sorfleet said. "This is working great for me."
Milner heads a team of researchers at Loyola who are conducting clinical trials on stent grafts and other minimally invasive treatments for aortic aneurysms and other vascular diseases.
They are testing new devices designed for endovascular surgery, which is significantly less invasive than traditional open surgery. In endovascular surgery, the surgeon guides a catheter through blood vessels to reach and treat the diseased area. Patients recover more quickly, with fewer complications and smaller scars.
"This clinical research program will expand our ability to take care of our patients and add to our overall mission," Milner said.
Milner is chief of vascular surgery and an associate professor in the Department of Surgery at Loyola University Chicago Stritch School of Medicine.
Source: Loyola University Health System, November 12, 2010
The use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta.
Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage the cushioning material at the end of long bones and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.
"Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis," explains Najia Shakoor, MD; associate professor of medicine at Rush University in Chicago and lead investigator in the study. "Therefore, researchers currently investigate strategies to reduce these forces or loads on the knee joint in hopes of preventing progression of the disease." Dr. Shakoor's study recently tested these strategies, more specifically, by studying how the use of mobility shoes flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot can affect knee OA.
At the beginning of the study, researchers used a special camera system and a force plate to determine gait (how a person walks) in 16 participants (who were all diagnosed with knee OA through X-rays and based on symptoms) while they walked in their own shoes, in mobility shoes, and barefoot. After this initial evaluation, participants were instructed to wear the mobility shoes a minimum of six hours per day, six days a week for six months. To determine the progression of each participant, researchers performed the same gait analysis that was performed at the beginning of the study at six, 12 and 24 weeks.
Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants noting a reduction in knee load that increased from 3.7 percent at the beginning of the study to 9.4 percent after six weeks, and to 18 percent at six months. Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11 percent) even when wearing conventional shoes leading researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with OA walk.
"This study showed that specialized footwear was beneficial in reducing knee loads substantially over six months," says Dr. Shakoor. "It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk even once the intervention is removed. "
Source: American College of Rheumatology, November 9, 2010
Mary Muscari, associate professor in the Decker School of Nursing at Binghamton University, is author of Let Kids Be Kids: Rescuing Childhood; and a person who has avoided stress-out Thanksgivings for over 20 years.
Ways to keep stress from turning your Thanksgiving into a real turkey:
Happy Bird Day!
Source: Binghamton University, November 11, 2010
By adding heart-pumping twists to tasks already on a holiday to-do list, men and women can get daily exercise throughout the holiday season, say experts at The University of Texas MD Anderson Cancer Center.
"It's important to maintain your fitness as much as possible during the holidays, but don't worry if you're too busy to go to the gym," says Karen Basen-Engquist, Ph.D., professor in the Department of Behavioral Science at MD Anderson. "Many holiday activities offer ways to get the 30 minutes of daily moderate physical activity that your body needs to help fight off many forms of cancer and other diseases."
Exercising also helps the body burn extra holiday calories.
"You can break up your 30 minutes of daily exercise into three 10-minute or two 15-minute chunks as your schedule allows," Basen-Engquist says. Here's how to turn exercise excuses into heart rate-boosting opportunities this holiday season.
Shopping?
Stop driving around in search of a parking space near the door. Park far from the entrance or, if you're taking the bus or train, get off a stop or two early. This way, you'll pack in some extra walking.
"For walking to count as exercise, you should be a little out of breath and feel your heart beating a little faster," Basen-Engquist says. "You should be able to talk in short sentences, but not sing holiday songs."
Once you're inside, opt for the stairs instead of the elevator or escalator and, if possible, carry your purchases instead of using a shopping cart. This will help get your heart pumping and strengthen your muscles.
Hosting guests?
Readying the house for guests - and cleaning up after they leave - is a great way to sneak in aerobic activity. Basen-Engquist recommends focusing on activities that use large muscle groups, like the legs and back. This includes vacuuming, mopping, scrubbing, gardening and even taking multiple trips upstairs to put away laundry or holiday decorations.
"The most important thing is to get your heart rate up at a consistent level," Basen-Engquist says. "You should sustain the activity for at least 10 minutes without stopping."
Traveling?
Use these tips to speed up your heart rate when on the road:
None of these work for you?
If you can't fit exercise into your holiday activities, try these tips:
"Remember, it's hard to start exercising after you've gotten out of the habit," Basen-Engquist says. "By making physical activity part of your holiday plans, you'll ensure you have the momentum to keep exercising in the New Year."
Source: University of Texas MD Anderson Cancer Center, November 11, 2010
AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.
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