It may seem a simple solution to the brewing U.S. retirement crisis: Get people to work until 70 before retiring and 85 percent will have the money they need for retirement. But despite the math that attracts economists and lawmakers worried about funding Social Security and Medicare, it turns out that it is not so easy, reports Reuters . James Poterba, an MIT economics professor, pointed to the problem at a Brookings Institution forum on the topic last week. "Not everybody can work longer," said Poterba. He contrasted workers in physically demanding or unpleasant jobs to economists in academic offices comfortably churning out studies on Social Security fixes. The Urban Institute noted in a new study that about 10 percent of those over 50 had to leave their jobs because of health reasons. But Urban Institute economist Richard W. Johnson, who studied work records of people over 50 in the federally funded Health and Retirement Study, said ageism is driving far more older workers away from their jobs regardless of education, race, or gender.

A study published in the Journal of Alzheimer's Disease found exercise training changes brain blood flow and improves cognitive performance in older adults in unexpected ways, reports ScienceDaily . The researchers learned that exercise was connected to improved brain function in a group of adults diagnosed with mild cognitive impairment (MCI) and a decrease in the blood flow in key brain areas. "A reduction in blood flow may seem a little contrary to what you would assume happens after going on an exercise program," says University of Maryland School of Public Health Professor J. Carson Smith. "But after 12 weeks of exercise, adults with MCI experienced decreases in cerebral blood flow. They simultaneously improved significantly in their scores on cognitive tests." Smith notes the brains of persons starting to experience early-stage memory loss are in "crisis mode," and may attempt to compensate for the deterioration by increasing cerebral blood flow. Higher cerebral blood flow is typically considered beneficial to brain function, yet there is evidence suggesting it may in fact signify further memory loss in those diagnosed with MCI. The study's findings might be able to reduce this compensatory blood flow and improve cognitive efficiency in those in the earliest early stages of Alzheimer's.

A study of older men by the University of Western Australia (UWA) published in Clinical Endocrinology uncovered a link between men with higher levels of the testosterone-derived sex hormone estradiol and slower aging, reports Medical Xpress . Estradiol is associated with longer telomeres, or proteins that shield chromosomes from damage. The researchers compiled data from 2,913 men between 70 and 89, measuring both testosterone and estradiol levels in their blood, as well as telomere length in their DNA from white blood cells. UWA Professor Bu Yeap says the protection of chromosomes from longer telomeres slowed the aging process. "The research suggests higher testosterone levels in older men, which is then converted to estradiol, might sustain youthfulness," he notes. "We know from the study that testosterone, estradiol, and telomeres are linked. However, further research is needed to explore how this relationship works. Testosterone is converted to estradiol, but it's still unclear what determines the level of production."

An aging U.S. workforce is forcing employers to navigate difficult conversations about dementia with workers facing that prospect, reports the Washington Post . Employees 65 and older are most likely to face dementia diagnoses, while the vast number of older employees expected to continue working increasingly leaves employees and employers struggling with the possibility of dementia in the office. "It's about managing workers' frustration with everything that's changing," says Sarah Wood at Workplace Options of North Carolina. "If this person has been a dependable employee for 40 years and is now missing meetings, they'll be beating themselves up over this." The Americans with Disabilities Act covers individuals with Alzheimer's diagnoses and certain other kinds of dementia, depending on the employee's position and degree of impairment. "The trick is figuring out what tasks they can still perform and what they can still do safely to continue to contribute," Wood notes. Americans with Disabilities Act Director David Fram lists issuing written instructions rather than verbal commands as a possible accommodation. "The next question is whether employees are qualified for their job," he says. "And that's the tougher point, depending on how advanced the dementia is."

A Japanese study found persons with dementia have a different constitution of gut bacteria from people without dementia, reports United Press International . One suggestion is that this difference is the cause of dementia, and not a consequence. For one thing, diet plays a critical role in the makeup of the gut microbiome, and people with dementia often experience changes in appetite and malnourishment. Analysis of stool samples from 128 older adults, with and without dementia, determined that overall, those with dementia had more concentrations of certain compounds — like ammonia, indole, and phenol — but lower levels of beneficial Bacteroides. Mary Sano with the Alzheimer's Disease Research Center at Mount Sinai in New York City says although the presence of certain infectious bugs has been associated with dementia, it might not be the infections themselves that are relevant. She instead suggests a factor within the body's general response to "insult or injury" could be the culprit.

The Trump administration has proposed new steps to discourage opioid abuse in Medicare Advantage and Part D, including extra surveillance and expanded use of non-opioid pain treatments, reports Politico Pro . As part of its 2020 draft call letter , the U.S. Centers for Medicare and Medicaid Services (CMS) encouraged private Medicare plans to adapt benefit designs to promote non-opioid therapies and treatments such as peer support services, cognitive behavioral therapy, and therapeutic massage, if recommended by a physician. The agency also is urging Part D sponsors to supply overdose treatments, including at a lower cost-sharing rate to encourage access. CMS also advises co-prescribing naloxone with opioids to persons deemed high-risk, and has requested comments on how to feasibly implement co-prescribing. CMS vowed that it would not approve benefit designs that discouraged enrollment by beneficiaries that require medication-assisted treatment for their addiction. Star Ratings for Medicare Advantage sponsors also will have more varied language on potential opioid misuse. Ratings currently featuring a measure for high-dosage opioids use from multiple providers would be divided into two separate measures, and be capable of flagging concurrent use of opioids and benzodiazepines. Over the coming months, CMS' National Committee for Quality Assurance will discuss non-opioid chronic pain options with plans and providers to potentially develop new measures for therapy rollout in 2021.

Several Democratic presidential hopefuls are touting "Medicare-for-all" as a plank for their campaigns, reports National Public Radio . Sen. Kamala Harris (D-Calif.) has promoted the approach in her push to eliminate all private insurance. Sens. Elizabeth Warren (D-Mass.) and Kirsten Gillibrand (D-N.Y.), in addition to Harris, co-sponsored Sen. Bernie Sanders' (I-Vt.) 2017 proposal for setting up a national, single-payer health system. The bill would mandate that all beneficiaries get a Medicare card, while participating physicians would have to sign annual agreements. How government would pay for the system remains a sticking point, as it already covers a lot of healthcare spending via Medicare, Medicaid, military healthcare, and the Department of Veterans Affairs. Much of the remainder is paid via employer health insurance plans and individual health insurance and payments by beneficiaries. Among Sanders' suggested payment scheme options are increasing taxes on employers who would no longer be paying insurance premiums, raising individual income taxes, and higher taxes on the wealthy. Warren has proposed a 2 percent tax on the wealth of an individual that tops $50 million and 3 percent on assets of more than $1 billion.

A report from the U.S. Joint Economic Committee found older Americans today have less of a social circle than previous generations, leaving many to resort to private care or government-paid resources, according to BenefitsPro . The report found private care — especially long-term care — can be prohibitively expensive, and government-paid resources such as Medicaid and Medicare are on an unsustainable path as their funding continues to be based on outdated assumptions that informal care is still more widely available. The report authors' analysis revealed that 69 percent of "retiring adults" in 2014 lived with a spouse or partner versus 75 percent of retiring adults in 1994. Retiring adults in 2014 also were less likely to live within 10 miles of an adult child than retiring adults in 1994.

A survey from Harris Insights & Analytics determined Canadian baby boomers are eager to remain employed in retirement, but few employers make this option available, reports Benefits Canada . Roughly 50 percent of boomers doubt that a proper successor is in place for when they retire, while 40 percent of employed boomers said they will retire later than they initially expected either due to insufficient savings or because they wish to keep working. Seventy-six percent of working boomers said they would like to semi-retire by having a flexible work schedule, and 60 percent expressed a desire for reduced working hours with fewer benefits. But just 30 percent noted their company offers a semi-retirement option. Meanwhile, a CIBC poll estimated that 27 percent of retired Canadians regret retiring and 23 percent have attempted to resume employment. Fifty-nine percent said they decided to return to work for intellectual stimulation, while half did so for financial reasons. Only 32 percent of retirees who tried to re-enter the workforce successfully secured a position at a similar level and salary than the job they had left.

A study published in Communications Biology determined the most prevalent chronic diseases like cancer, diabetes, chronic obstructive pulmonary disease, stroke, and dementia apparently have aging in common, reports Medical Xpress . "By analyzing the dynamics of disease incidence in the clinical data available from UK Biobank, we observed that the risks of age-related diseases grow exponentially with age and double at a rate compatible with the Gompertz mortality law," says Gero founder Peter Fedichev. "This close relation between the most prevalent chronic diseases and mortality suggests that their risks could be driven by the same process ... aging. This is why healthspan can be used as a natural proxy for investigation of the genetic factors controlling the rate of aging, the 'holy grail' target for anti-aging interventions." The researchers studied the genomes of 300,477 Britons, and found 12 genetic loci affecting healthy life expectancy. Eleven of the 12 single-nucleotide polymorphisms elevated the risk both in discovery and in replication groups. Three of the genes affecting healthspan, HLA-DBQ, LPA, and CDKN2B, were previously associated with parental longevity. A minimum of three genetic loci were linked to the risk of multiple diseases and healthspan concurrently, and thus could form the genetic signature of aging.