A study in the Journal of Clinical Sleep Medicine considered whether tailored lighting intervention can mitigate the effect of sleep disturbances, depression, and agitation in older adults with Alzheimer's disease and related dementias (ADRD), reports Medical Xpress . The 14-week randomized trial administered an all-day active or control lighting intervention to 46 subjects with moderate to late-stage ADRD in eight long-term care centers, with wrist-worn actigraphy and standardized measures of sleep quality, mood, and behavior utilized. The outcomes showed that in comparison with baseline, the active lighting intervention significantly enhanced sleep quality, and reduced depressive symptoms and agitation. Older adults in long-term care communities typically spend their days and nights in dimly-lit rooms with minimal time spent outdoors, and therefore do not experience the robust daily patterns of light and dark that synchronize the body's circadian rhythms to local sunrise and sunset. One example of successful tailored lighting intervention is the light table, which can deliver a strong dose of light to the eyes, and help stimulate the circadian system. "When delivered appropriately, using circadian stimulus and different delivery modes, and accurately measured, using calibrated personal light meter devices, a lighting intervention tailored to maximally entrain the circadian system will significantly improve sleep quality, depressive symptoms, and agitation behavior in patients with ADRD," concluded Rensselaer Polytechnic Institute Professor Mariana Figueiro.

A research review in the British Journal of Sports Medicine suggests older adults who exercise may lower their risk of falls by more than a third compared to inactive seniors, reports Reuters Health . "Frailer people should see a health professional for such exercise to be prescribed but fitter people can attend a local gym or community exercise class," said the University of Sydney's Cathie Sherrington."The trick is to find an exercise regimen that you enjoy and will stick to as it fits with your other priorities and commitments." The researchers reviewed findings from 25 countries, covering 59 trials with a total of nearly 13,000 participants. There was "high certainty" that exercise reduces the rate of falls by 23 percent among adults 60 and older. The risk reduction with exercise was similar when considering adults 75 and older, as well as those at a high risk for falls. Balance and functional exercises correlated with a 24 percent reduced risk of falls, while mixing balance and functional workouts with resistance training cut the risk by 34 percent versus sedentary people. Regimens supervised by physical therapists or other health professionals seemed to reduce the risk of falls more effectively than unsupervised workouts.

A new Dynamic Signal study learned it is crucial for employers to find the right time to engage workers, reports Business 2 Community . The study found employee engagement increases 13 percent in October to November compared to September to October. This creates opportunities for CEOs to become more familiar with employees, using Talent Optimization and other approaches to determine what works best for workers, and how they can modify their business strategy to bring employees' needs and concerns into closer alignment. Meanwhile, a Peakon study found leading business management can expect employee engagement to decrease significantly shortly before someone is about to quit the business. Reasons for leaving include "unchallenging work, cultures that suppress conversations about pay, toxic managers, and a lack of personal development opportunities." This knowledge can help CEOs preempt and reverse disengagement. Employees' happiness strongly correlates with their engagement, and Talent Optimization can help employers maintain this by understanding and developing job requirements, candidates, and team dynamics. Maximizing human capital during critical times in the business cycle through such strategies will augur well for meeting end-of-year goals.

A study in the Journal of Alzheimer's Disease suggests lifetime exposure to lead may be linked to dementia risk, as declining rates of exposure in North America and parts of Europe may underpin falling dementia incidence in those regions, reports United Press International . University of Toronto researchers found the mean blood lead level (BLL) in the United States was 12.8 µg/dL from 1976 to 1980, but fell to 2.8 µg/dL from 1988 to 1991 and then to 0.84 µg/dL in 2013-2014. Of particular interest to the investigators is a potential connection between lifetime lead exposure and a subtype of dementia called Limbic-predominant Age-related TDP-43 Encephalopathy (LATE). Studies imply that LATE is the cause of about 20 percent of dementia cases. To verify this linkage, the researchers recommend future studies compare BLLs in the 1990s to current Medicare records by evaluating lead levels in teeth and tibia bones when performing post-mortems of brains for dementia. "If lifetime lead exposure is found to be a major contributor to dementia, we can expect continued improvements in the incidence of dementia for many more decades as each succeeding generation had fewer years of exposure to the neurotoxin," said the University of Toronto's ZhiDi Deng.

A Stanford University study in Acta Neuropathologica Communications has associated the gene responsible for "Asian glow" — a condition in which a person's face flushes red after drinking alcohol — with faster Alzheimer's disease progression, reports NBC News . Persons who carry a defective variant of an enzyme that metabolizes alcohol can experience an increased accumulation of toxins, which can damage cells and may accelerate Alzheimer's. About 560 million individuals of East Asian descent carry this mutant enzyme, which also is linked to higher incidences of esophageal cancer, heart attacks, and osteoporosis. The findings imply that alcohol boosts injury to brain cells, expedites Alzheimer's symptoms in animals, and compounds cell damage in Alzheimer's carriers. "The science means that it is a bad idea if you have this mutation and have a family history of Alzheimer's disease to drink excessively," noted Stanford Professor Daria Mochly-Rosen. She hopes this research will lead to a clinical study that investigates changing the recommendation of alcohol use in people with Alzheimer's.

The U.S. Centers for Medicare and Medicaid Services (CMS) estimates that more private payers will enroll in Medicare Advantage's voluntary value-based insurance design (VBID) in 2020, reports MedCity News . Participating organizations will increase from 10 to 14, concurrent with a doubling of beneficiaries from 440,000 this year to 1.2 million next year. Coverage also will expand from seven states to 30 states and Puerto Rico. A CMS report found nine of 23 eligible organizations participated in the VBID model two years ago, and 61 percent of the 96,000 beneficiaries that qualified for the new model received VBID benefits. In January, CMS extended the VBID model to plans in all 50 states, and made revisions to permit participating organizations to design plans according to socioeconomic status or health condition, offer rewards and incentives programs, provide telehealth services, and better coordinate wellness and care planning. Beginning in 2021, CMS will start testing the inclusion of the Medicare hospice benefit in Medicare Advantage plans, and Medicare Advantage organizations that wish to participate in the VBID model then have until June 1 to finalize their plan benefit designs.

The Association of Community Cancer Centers (ACCC) has collaborated with the Gerontological Society of America and the International Society of Geriatric Oncology on new tools and resources to help prepare the multidisciplinary cancer care community for the growing prevalence of cancer and comorbidities among U.S. seniors, reports News-Medical . The kit includes a six-part webinar series on care for older adults with cancer; a curated resource list; and a publication that summarizes the challenges, successes, and effective practices to ensure implementation of quality care. An ACCC analysis revealed that just 32 percent of respondent practitioners have received specialized geriatric oncology training, and research increasingly supports the usefulness of geriatric assessments. The multidisciplinary Approaches to Caring for Geriatric Patients with Cancer program was made possible with backing from Pfizer Oncology. "I strongly believe that this project will serve as a model for other organizations whose goals are to improve care in the geriatric oncology population," said ACCC advisory committee member Melissa Kah Poh Loh.

A study in Neurology detailed a simple tool developed by Swedish and Dutch researchers that predicts the life expectancy of a person with dementia, reports EurekAlert . The researchers monitored more than 50,000 people older than 65 who were diagnosed with dementia and registered in the Swedish Dementia Registry between 2007 and 2015. By 2016, 20,000 subjects had died, on average after a median time of 4.8 years following diagnosis. Analysis yielded two schematic tables: one table is for primary care doctors that produces a prognosis according to sex, age, cognitive ability, and comorbidity; the other is for specialist clinics and also accounts for the specific subtype of dementia. With this tool, doctors can place an individual case in the schematic table to indicate the likelihood of a person's death within three years of diagnosis. The tool is designed give doctors and caregivers a better understanding of who is in urgent need of a care plan and who may benefit from additional monitoring. Also intended is helping doctors and other care providers to engage in a dialogue with beneficiaries about their disease and the mortality risk.

Employee engagement strategies for companies to consider for next year include encouraging free dialogue and employee feedback, reports HR Technologist . Also considered important is promoting diversity, inclusiveness, and equality in the workplace. Other suggestions include taking an active interest in workers' career development, instilling flexibility to accommodate employees' schedules and other circumstances, and upgrading rewards and recognition methods. A transparent workplace culture is deemed essential, as is bringing workers' goals into alignment with those of the organization. A job candidate experience that is similar to the experience of future employees should encourage engagement, with fair screening processes, faster feedback, and meaningful onboarding experiences playing key roles. A culture of continuous improvement also should be set up for workers, to fuel a workforce that is motivated to improve each day. Finally, regular interaction between company leaders and employees should benefit engagement overall.