A pilot study published in the American Journal of Alzheimer's Disease & Other Dementias detailed the first cluster, randomized controlled trial of the effects of chair yoga on older adults with moderate to severe dementia who cannot participate in regular exercise or standing yoga, reports ScienceDaily . Participants in three groups attended 45-minute sessions of chair yoga, chair-based exercise, or music therapy twice weekly for 12 weeks. According to the researchers, over 97 percent of participants fully engaged in each session. The chair yoga group's quality of life improved significantly compared to the music intervention group. Both the chair yoga and chair-exercise cohorts improved over time, while the music intervention group experienced a decline. Moreover, both the chair yoga and chair-based exercise groups exhibited lower depression across three time points in comparison with the music intervention group. "We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study," said Florida Atlantic University Professor Juyoung Park. No significant between-group differences in anxiety was observed at any time point, or differences in change in depression and anxiety.

A study published in JAMA Neurology found stroke rates among older Americans have been steadily declining since the late 1980s, reports WebMD . Between 1987 and 2017, the rate of stroke incidence among Americans 65 and older fell by 33 percent in each decade, with no leveling off in recent years. The number of older adults who smoked fell over time, although blood pressure and type 2 diabetes incidence grew. "At the population level, we found that the decline in strokes was larger than what would be predicted from risk factor control alone," said Johns Hopkins School of Public Health Professor Josef Coresh. A total of 1,028 strokes among participants aged 65 and older was recorded over 30 years, which dropped by 32 percent over time. Coresh suggested factors excluded by the study — like exercise, salt intake, and overall diet — might play a role in this phenomenon. American Heart Association/American Stroke Association spokesperson Larry Goldstein also noted the study did not factor in exactly how well controlled participants' blood pressure and other risk factors were.

Scientists at the University of Pennsylvania's Center for Neurodegenerative Disease Research will look for linkages between Alzheimer's disease, dementia, and Parkinson's with an $18.1 million grant from the U.S. National Institute of Aging, reports Philly Voice . The money will underwrite projects to analyze genetic factors that cause these disorders to worsen. All three diseases have the presence of alpha-synuclein proteins in common. Distorted alpha-synuclein proteins that are not purged from the brain accrue into Lewy bodies and disrupt chemical signaling of dopamine and acetylcholine — which can impact thinking, memory, and movement. The researchers will explore how normal alpha-synuclein proteins become misshaped, to better understand the development of Parkinson's into dementia, as well as the reverse. The team also will seek to identify genetic risk factors for all three conditions through tissue sample analysis.

A global study by Alzheimer's Disease International (ADI) found 62 percent of healthcare professionals consider dementia to be a natural risk of aging, which could be limiting assistive services, reports Medical News Today . The researchers polled 70,000 people in 155 countries, and estimated that just 16 percent of respondents are receiving regular cognitive evaluations, even though early diagnosis can be helpful. The stigma associated with dementia could be restricting people from getting advice, medical assistance, and support. People's goals and lifestyles also may be constrained, with the study finding that 35 percent of caregivers conceal a diagnosis of dementia in family members from others. "What the report confirmed for us was that stigma and negative attitudes around dementia exist in every setting, although this may present itself in many different ways," said ADI's Annie Bliss. Forty percent of people think healthcare practitioners ignore those with dementia, while as many as 55.8 percent of health professionals concur that their colleagues overlook those living with the disease.

Citrix's Donna Kimmel offers four human resource strategies to help employees combat burnout, reports HR Technologist . One recommendation she suggests is for employers to "simplify access to the technologies and insights employees need to get work done . . . through intelligent digital workspaces that automatically deliver all of the insights and applications people need to be productive in a single, unified experience." Another suggestion is to improve work flexibility options, such as telecommuting. "To deliver these benefits, recognize and accommodate new models for work and trust employees to work where and when they need to perform at their best," Kimmel writes. A third option is to encourage employees to embed mindfulness within their workday. "Paying attention, on purpose, without judgment . . . keeps people focused on the things that matter in their lives — both personal and professional," Kimmel says. Her fourth recommendation is to give employees the flexibility they need "to create the right balance of benefits depending on their needs at a given point in their life." This will alleviate anxiety. "In giving them the tools to work when, where, and how they want, you can help them to better integrate their work and lives and ultimately, reduce their chances of burning out," Kimmel concludes.

A national survey of more than 2,250 adults found Americans older than 50 remain hesitant to use telemedicine, reports Futurity . Just 4 percent of respondents had had a virtual visit with a doctor via smartphone or computer in the past year, and their feelings were mixed. Meanwhile, more than 50 percent were unaware if their health providers offered telehealth visits, over 80 percent had at least one concern about telehealth, and 47 percent were concerned about technical difficulties. Still, more than half were willing to try telehealth in certain scenarios, like if they became ill while traveling or needed follow-up on previous care. Among the 33 percent of respondents whose providers have yet to offer telehealth, 48 percent were interested in trying it out with their primary care doctor — although fewer would try it for specialty or mental healthcare. "Telehealth won't replace in-person medical examinations completely, but for situations where in-person visits aren't essential, they can save time and resources for customers and providers alike," says University of Michigan Professor Preeti Malani. "Providers shouldn't assume older adults aren't receptive to virtual visits, but they should understand and work to overcome some of the reasons for hesitation."

Although telehealth backers claim virtual consults save money, research has yet to validate this assertion, reports Politico Pro . A recent U.S. Congressional Budget Office (CBO) evaluation found telehealth coverage sometimes increases and sometimes lowers spending for private payers, although "the effects on spending tend to be small." Susan Pantely with the American Academy of Actuaries' Telehealth Work Group said insurers' willingness to cover telehealth reflects their view of "do they want to try something or do they want to wait until it's proven?" Some studies indicate that telemedicine will lead to a hike in medical costs, while others point to a decrease. A 2017 study in Health Affairs of a California public employee benefit program contracting with Teladoc learned that spending was increasing because beneficiaries were consulting doctors about acute respiratory illnesses more than they would have had the service been unavailable — although the cost per visit was lower for telehealth than for in-person check-ups. Harvard University's Ateev Mehrotra suggested the medical specialty could cause telehealth spending to rise or fall. For example, beneficiaries hesitant to meet therapists in person may do so only via telehealth, which could influence costs.

Florida State University (FSU) Professor Walter Boot will use a $4.6 million grant from the National Institute on Disability, Independent Living, and Rehabilitation Research to establish a center for developing technologies to improve the lives of older adults, reports FSU News . His team of scientists at FSU, the University of Illinois, and Weill Cornell Medicine will be tasked with launching the Enhancing Neurocognitive Health, Abilities, Networks, & Community Engagement (ENHANCE) research center. Its concentration of study will be older adults living with cognitive impairment, including traumatic brain injury. The ENHANCE center's mission is to understand the challenges older adults with cognitive impairment face with their daily activities and how they vary based on type of impairment. The center also will identify, develop, and evaluate potential technology solutions; disseminate its findings to multiple stakeholders; and further knowledge of aging, cognitive disability, and technology. Boot remarks, "A one-size-fits-all approach can't work because of the varying needs of individuals and how those needs change with time."

A study in JAMA Internal Medicine found a trained, unlicensed care team navigator and an advanced-practice nurse, social worker, and pharmacist improved multiple aspects of care for people with dementia, reports MedPage Today . Improvement was observed in quality of life, emergency department visits, caregiver depression, and caregiver burden. "Effective phone-based dementia care that addresses the needs of the person with dementia and the caregiver can be provided from a hub across large geographic areas, irrespective of . . . healthcare system affiliations," said the University of California, San Francisco's Katherine Possin. "The Care Ecosystem addresses gaps in our healthcare system around dementia. While the Care Ecosystem won't cure dementia, it changes the experience of dementia for both the beneficiaries and the caregivers, so that they may live as well as possible." Previous data from the Care Ecosystem research group indicated that caregiver and dementia health were interconnected, as persons with dementia were almost twice as likely to visit an emergency department if their caregiver had depression, for instance.

Ohio Musculoskeletal and Neurological Institute Executive Director Brian Clark says the loss of muscle strength in older adults only has a modest association with loss of muscle mass, reports Medical Research . He cites a study whose aim was "to determine whether, and to what extent, older adults with clinically meaningful leg extensor muscle weakness exhibit differences in voluntary neural activation capacity when compared to stronger older adults." Clark says the research involved voluntary and electrically stimulated contractions of the quadriceps femoris to measure the nervous system's ability to completely activate the muscles. Supramaximal stimulation was undertaken, along with quantification of "added force" during maximal voluntary contraction, to measure neural inactivation levels. "This work presents evidence indicating that weak older adults have significant deficits in their nervous systems ability to fully activate their leg extensor muscles," Clark said. "While these data do not point to the underlying mechanism per se, they do suggest that medical treatments targeting the nervous system could be used to enhance muscle strength to prevent future heal risks in weak older adults."