Twenty years after the initial boom in assisted living — which now houses more than 800,000 people — the traditional approach of not having healthcare professionals on site or on call to assess residents and provide treatment may be shifting, according to the New York Times . Early on, assisted living companies planned to serve fairly healthy retirees, offering meals, social activities and freedom from home maintenance and housekeeping — the so-called hospitality model. But from the start, the assisted living population was older and sicker than expected. Now, most residents are over age 85, according to government data. About two-thirds need help with bathing, half with dressing, 20 percent with eating. Like most older Americans, they also generally contend with chronic illnesses and take long lists of prescription drugs — and more than 80 percent need help taking them correctly. Moreover, "these places became the primary residential setting for people with dementia," says Sheryl Zimmerman, an expert on assisted living at the University of North Carolina at Chapel Hill. The Society for Post-Acute and Long-Term Care Medicine is mulling the development of model agreements to integrate medical care into assisted living. The National Center for Assisted Living's Lindsay Schwartz notes, "Assisted living has certainly expanded its role in providing medical care over the years by adding nursing staff and partnering with other healthcare providers, among other ways." Doctors Making Housecalls provides one example of how assisted living communities can offer medical care. The practice dispatches 120 clinicians — 60 doctors, along with an equal number of physician assistants, nurse-practitioners, and social workers — to nearly 400 assisted living communities throughout North Carolina.

The Nebraska Department of Insurance and the Senior Health Insurance Information Program is warning of a scam in which fraudsters offer cheek-swab DNA tests to screen for cancer at senior residences and communities, reports the Omaha World-Herald . Department director Bruce Ramge said complaints suggest seniors think the cost of testing will be covered by Medicare. "We don't want individuals to be misled about what is covered and what is not," he noted. Ramge recommended seniors approach such offers with caution, especially if the entity requests that they agree to pay the costs if Medicare does not. Department officials have heard that testing organizations are charging fees of up to $1,300, and the department is still probing whether anyone has been billed.

A 71-year-old Scottish woman with insensitivity to pain owes her condition to two genetic mutations, which a new study published in the British Journal of Anaesthesia suggests could open new avenues to pain treatment. ABC News reports that Jo Cameron was diagnosed with this insensitivity in her mid-60s, and it has allowed her to live with virtually no pain or anxiety. One of the two mutations was a "microdeletion" in a pseudogene, or a DNA sequence that resembles a gene, but has been altered into an inactive form over the course of evolution. The other mutation was in the neighboring FAAH gene, which generates an enzyme that breaks down a chemical in the body central to pain sensation, mood, and memory. The so-called "FAAH-OUT" pseudogene was thought to be inactive, but the study implies it mediates the FAAH gene. "We found this woman has a particular genotype that reduces activity of a gene already considered to be a possible target for pain and anxiety treatments," says University College London Medical School James Cox. "Now that we are uncovering how this newly identified gene works, we hope to make further progress on new treatment targets."

A study published in the Journal of the American Osteopathic Association found inexpensive ultrasound screenings for osteoporosis can accumulate as much data as dual/energy x-ray absorptiometry (DXA) for bone health assessments. The researchers employed the ultrasound procedure to scan the left and right calcaneus of participants and collected blood samples for vitamin D analysis. Information was obtained regarding Fracture Risk Assessment tool parameters, menstrual history, and drug and supplement use. The team determined data from the calcaneus was equal to data gathered from the DXA. West Virginia School of Osteopathic Medicine Professor Carolyn Komar acknowledged ultrasound does not yield the same information as a full DXA scan, but said it offers a clear enough perspective for concerned healthcare recipients and has potential as a tool for evaluating more people across multiple demographics.

A study published in Cell Reports notes a protein factor, CBX4, could help cure osteoarthritis in mice, according to Medical Xpress . The researchers determined CBX4 protected mesenchymal stem cells (hMSCs) against cellular senescence via regulation of nucleolar architecture and function. Specifically, CBX4 overexpression attenuated the development of osteoarthritis in mice. The team downregulated the CBX4 protein in aged hMSCs, while CBX4 upregulation in hMSCs destabilized nucleolar heterochromatin, enhanced ribosome biogenesis, heightened protein translation, and expedited cellular senescence. CBX4 sustained nucleolar homeostasis by harnessing nucleolar protein fibrillarin and heterochromatin protein KRAB-associated protein 1 at nucleolar rDNA, restricting excessive expression of rRNAs, thus alleviating physiological hMSC aging and attenuating osteoarthritis development in mice. The researchers hope these findings will lead to interventions to prevent aging-associated stem cell depletion and treat age-related disorders in the future.

The New Hampshire state Senate has approved legislation for a prescription drug assistance program to help with out-of-pocket costs for low-income seniors, reports WCAX . The bill targets seniors who have reached the gap, or "doughnut hole," in standard Medicare Part D coverage by setting up a 12-month pilot program to cover their out-of-pocket prescription costs.

A study led by researchers at the Stanford University School of Medicine published in Gastroenterology found more participation of older adults in colorectal cancer screening would help prevent more deaths than expanding testing to people in their 40s, reports the Stanford Medicine News Center . According to the investigators, starting routine colorectal cancer screening at 45 rather than 50 would cut U.S. cancer deaths by as much as 11,100 over five years, and would lower the number of cancer cases nationwide by as much as 29,400. However, screening a bigger number of older and high-risk adults would avoid nearly three times as many diagnoses and deaths at less cost. The researchers determined initiating colonoscopy screening at age 45 would require 758 additional colonoscopies per 1,000 people, leading to a reduction of four cancer cases and two deaths per 1,000 people. When those procedures are instead used to screen 231 previously unscreened 55-year-olds or 342 previously unscreened 65-year-olds through age 75, 13 to 14 cases and six to seven deaths could be averted per 1,000 people. They also would save $163,700 to $445,800 on balance, thanks to averted treatment costs.

Technology is changing how Americans prepare for retirement, led by advancements in automation and data analysis, reports Forbes . Last year, the Georgetown University Center for Retirement Initiatives brought together industry leaders, policymakers, and stakeholders to discuss how technology is transforming retirement savings. Many 401(k) retirement savings plans for employees now feature standard auto-enrollment and automatic payroll deductions, as well as "set it and forget it" target date funds, while individuals increasingly use mobile apps to track their investments and online tools to enable financial planning and budgeting. These various tools boost participation by making it easier to save and invest for retirement. To reap the maximum benefits of technology in retirement savings, Americans must be comfortable sharing details with providers who can use that data responsibly to improve recommendations for savings and investment options. According to Bain & Co., 73 percent of individuals age 18 to 34 are willing to buy financial products from technology companies, versus 42 percent of those 55 and older. Meanwhile, artificial intelligence and machine learning can help improve investment yields, and let retirees have more cash available to sustain a desired quality of life after retirement.

A study by the National Council on the Aging determined untreated hearing loss can lead to severe depression and social isolation among older adults, reports WOTV . A poll of 2,300 hearing-impaired adults 50 and older found those with untreated hearing loss were more likely to report depression, anxiety, and paranoia, and less likely to engage in organized social activities, compared to those who wear hearing aids. A significantly greater number of seniors with untreated hearing loss noted feeling sad or depressed, with episodes lasting two or more weeks during the previous years. Thirty percent of non-hearing aid users with more severe hearing loss reported sadness, versus 22 percent of hearing aid users. Older non-users also were more likely to agree that "people get angry with me usually for no reason," as were non-users with more severe hearing loss. Non-users also were considerably less likely to participate in social activities. "This survey is groundbreaking not only in the large size of the sample but also in the inclusion of 2,090 close family members or friends of the hearing-impaired respondents who were asked a parallel set of questions," said Carolyn Holmes with the Seniors Research Group.

A study published in Science Translational Medicine suggests lonafarnib, a U.S. Federal Food and Drug Administration (FDA)-cleared liver infection drug, could have unexpected therapeutic benefits for people with Alzheimer's, reports the London Daily Mail . Mice were engineered to develop tangles of tau, a protein thought to cause Alzheimer's, which lonafarnib prevented. The drug was originally designed to treat hepatitis D, and University of California researchers observed a new pathway in lonafarnib that promotes the degradation of tau via lysosomes, which breaks up tau proteins by preventing certain enzymes and proteins from interacting with neurons. Regular lonafarnib doses boosted tau degradation in the mice, while also preserving brain size and preventing behavioral deficits, like obsessive circling in mice with dementia. The researchers think the pathway could be a "druggable target" in tauopathies and other neurodegenerative maladies marked by dysfunctional protein degradation.