A study published in the Journal of the American Medical Association suggests dramatically reducing blood pressure may help protect memory and thinking skills later in life, reports NBC News . The researchers examined more than 9,000 people over 50 years old, and those who cut their blood pressure to 120 were 19 percent less likely to develop mild cognitive impairment (MCI), which usually precedes Alzheimer's. "It offers genuine, concrete hope," says the Alzheimer's Association's Maria C. Carrillo. "Mild cognitive impairment is a known risk factor for dementia, and everyone who experiences dementia passes through MCI." According to preliminary findings, participants were 17 percent less likely to develop dementia. However, these results were not statistically significant because the study was stopped abruptly. "In very old people, we know that lowering blood pressure aggressively may not be good because they have rust in the pipes and they need the pressure," says Ronald Petersen at the Mayo Clinic Alzheimer's Disease Research Center. "What you don't want people to do is double their blood pressure medicine tomorrow. They need to have a discussion with their primary care physician so they can get their blood pressure down in a controlled way."

An editorial from University of California, San Francisco (UCSF) neurologists published in JAMA warns older Americans are particularly vulnerable to the promises of so-called "brain-boosting" dietary supplements, reports Medical Xpress . The authors recommend doctors provide an "honest scientific interpretation" of any evidence, along with associated risks and costs, in dialogue with seniors and families considering such supplements or other unproven treatments. "We have also seen a rise in personalized protocols to reverse cognitive decline and dementia," says UCSF's Joanna Hellmuth. "Unfortunately, these interventions currently lack data proving they are effective." UCSF's Bruce Miller adds that "While unethical forces promote pseudomedicine, an educated community of doctors and seniors can combat these practices." The editorial calls on doctors to educate their clients about the difference between the positive testimonials used in promoting over-the-counter supplements and other direct-to-consumer pseudomedicine, compared to the rigorous safety and effectiveness data required by the U.S. Food and Drug Administration before prescription drug commercialization.

African Americans are far more likely to be afflicted with Alzheimer's disease or dementia than whites, which may be partly attributed to health issues that are more common in the African-American community, reports USA Today . Indiana University School of Medicine Professor Daniel Bateman notes multiple studies indicate a higher rate of Alzheimer's in African Americans, which may be linked to higher rates of diabetes, hypertension, high cholesterol, heart disease, and diabetes in that ethnic group compared to whites. One 2018 study determined African Americans had an increased rate for all five types of dementia, with contributing factors such as genetics, lifestyle, social variables, education, and income being evaluated at some point. Bateman blames the stigma surrounding diseases like dementia on a lack of public awareness and understanding. Joanne Pike with the Alzheimer's Association in Chicago says the stigma of dementia is discouraging too many people from getting treatment or diagnosis.

Republicans on the Joint Economic Committee have issued a report estimating that aging Americans have fewer available caregivers compared to 20 years ago, and Medicare/Medicaid spending projections may be too low because they do not account for baby boomers' declining social networks, reports the Washington Post . "That generation is going to have many fewer friends and children and spouses and people from church to care for them as they get old," said Harvard University Professor Robert Putnam. "We're not going to just leave them on the street, so more of them will have to be cared for through paid care." The study found adults 61 to 63 are less likely to be in close geographical proximity to their loved ones, and 75 percent were married or cohabitating in 1994 versus 69 percent in 2014. Meanwhile, the portion of adults attending church at least three times monthly slipped from 56 percent to 41 percent, and the percentage of those with a child living within 10 miles fell from 68 percent to 55 percent. The Medicaid program is making efforts to better account for beneficiaries' nonmedical needs, including access to transportation or food insecurity. This fall, North Carolina received White House approval for a pilot program in which health plans will identify and direct high-need Medicaid enrollees toward an array of special services.

The Trump administration is striving to cut Medicaid spending via block grants, a strategy that hinges on coaxing states to accept fewer federal dollars than they currently receive, reports the Washington Post . A small unit within the U.S. Centers for Medicare and Medicaid Services (CMS) is developing a plan to allow states to request consent for federal Medicaid funding delivered in a single lump sum rather than as a percentage of states' total costs. CMS leaders are remaining low-key on this initiative, given political fallout from past Republican efforts to rein in Medicare spending. Healthcare providers, especially those serving low-income beneficiaries, are not enthused by the prospect of block grants, since Medicaid already compensates them at significantly lower rates than Medicare or private insurers, and block-granting the program could prompt states to further slash Medicaid enrollment or reduce payments. American Hospital Association President Rick Pollack says his organization questions whether CMS is legally authorized to allocate Medicaid finding through block grants. "We have long voiced concerns about how block-granting Medicaid could ultimately result in losses of coverage and negatively impact access to quality care," he notes. However, CMS has wide latitude to permit states to experiment with Medicaid programs and the marketplaces by applying for waivers, with CMS Administrator Seema Verma passing work requirements in multiple states and soliciting states to seek ways of bypassing certain Affordable Care Act coverage mandates.

Many disabled Americans are joining or rejoining the U.S. workforce, thanks to a tight economy with an extremely low overall unemployment rate as companies in various industries contend with a shortage of available workers, reports the Wall Street Journal . The population of U.S. employees receiving federal disability benefits fell to 8.5 million in December from a peak of 9 million in 2014; the average monthly jobless rate for the handicapped was 8 percent last year, down 4.6 percentage points from 2014. Joblessness for the disabled also is declining faster than the broader population. In addition to the tight labor market, the increasing difficulty of accessing Social Security disability benefits has driven the growth in disabled employment. The latest Social Security data estimates that the percentage of applying workers whose disability claims were permitted following a medical review in 2016 fell to 48 percent. This marks the first time the rate fell below 50 percent on records dating to 1992, while allowances topped out at 62 percent in 2001. Another contributor is employers increasingly seeing a need for creative solutions to labor shortages. The larger employment pool has been an essential lifeline for disabled Americans who have been denied benefits at a higher rate in recent years.

A study from Deloitte Insights analyzed the U.S. workforce's oldest employees, their needs and motivators, and how companies can create jobs that utilize the valuable set of skills older workers can offer, reports Ladders . "The current volume and rapid increase of people remaining well past traditional retirement age is unprecedented," Deloitte said. The U.S. Senate's 2017 Special Committee on Aging report determined 85 percent of the baby boomer population plans to work until their 70s and even 80s. Deloitte found many older workers are creating second careers, or working bridge jobs, out of a desire to work and stay connected to the wider world, rather than simply to earn money and meet financial needs. Deloitte also discredited the notion that boomers are impeding younger employees, finding instead that they tend to be more engaged and are thus more valuable than millennials in that category. Their long work experience means their work product is generally better than their younger peers', and they also possess better social skills and good "organizational citizenship." Deloitte recommended employers have mature workers serve as mentors for younger employees, develop phased retirement plans so workers can retire flexibly and intentionally, and organize strategies to re-skill older workers.

A study published in Neurology determined any kind of physical activity may shield a person's brain against dementia, reports Medical News Today . More than 450 older men and women, 191 of whom had a dementia diagnosis, were analyzed. All participants used an accelerometer about two years prior to death, and the researchers used a week's worth of accelerometer data to calculate an average daily activity score; the average of the entire cohort was 160,000 counts daily, but those with dementia averaged a daily count of 130,000, and those lacking dementia had an average daily count of 180,000. The implication was that more daily movement is connected with better memory and thinking abilities, as are higher levels of motor skills. Moreover, participants were 31 percent less likely to develop dementia for every standard deviation of increase in physical activity, and the same deviation increase in motor skills equated to a person being 55 percent less likely to develop dementia. Post-mortem brain analysis also supported the links between physical activity and dementia and motor skills and dementia, with Alzheimer's biomarkers apparently having no effect on the results.

E-commerce has been tumultuous for brands that have long marketed to older consumers via traditional media channels like print and TV, a problem compounded by their target audience's reluctance to adopt social media, reports Forbes . Tapping the senior community hinges on social channels determining whether enough seniors actually use social media, shop online, and are amenable to brand appeals through social channels. According to Pew Research, 65 percent of consumers 50 to 64 and 41 percent of consumers older than 65 use Facebook, while Instagram also has garnered respectable numbers of older users. Meanwhile, Nielsen calculated that the segment of total weekly media time spent on social media by persons 50 and older climbed 64 percent between 2015 and 2016. Pew also suggested the high-income seniors brands most want to reach via social media are the most reachable, with fewer than 25 percent of those making less than $30,000 annually using social media, versus almost 60 percent of those earning more than $75,000 a year. E-commerce data also implies that, in theory, brands can reach seniors and push purchase decisions before they leave a digital storefront. The feasibility of using social channels to get older customers is complicated by findings that the cost of acquiring seniors is significantly higher than for millennials or Generation Z consumers. However, they also suggest older customers will have more brand loyalty over time, relative to other customers.

Government data indicates that American banks reported a record 24,454 suspected cases of senior financial abuse to the Treasury Department last year, more than twice the number five years earlier, reports the Wall Street Journal . The surge occurred as new federal and state laws are spurring banks to more proactively remediate frauds and scams that target older customers. Banks are fortifying training for employees on how to identify, stop, and report issues without violating customer privacy, as well as recognize early signs of cognitive decline. "Anything having to do with senior financial abuse or exploitation affects a huge part of our customer base," says the American Bankers Association's Rob Rowe. Such exploitation is not always obvious and can raise privacy issues, or risk estranging customers. The delay or cancellation of transactions due to fraud also could cause customers to lose legitimate opportunities such as timely investments. The Senior Safe Act permits bank employees to report suspected cases of senior financial abuse to police and adult protective services, while certain states allow bank employees to refuse or delay transactions, or alert family members when senior customers request suspicious money transfers. Some bankers blame a boom in fraud cases targeting seniors on growing social-media use by older Americans.