A recent test in the United Kingdom demonstrated that the practice of cognitive rehabilitation can help people with dementia preserve the ability to learn, reports the New York Times . Cognitive rehab involves therapists visiting people with dementia at home to learn which everyday activities they have problems with and which abilities they want to retain or improve. During weekly sessions conducted over several months, the therapists organize individual strategies that can help, at least in the early and moderate stages of dementia, showing subjects how to compensate for memory difficulties and to practice new techniques. The U.K. trial and other European initiatives showed that persons with dementia can enhance their ability to perform the tasks they have prioritized, with those improvements possibly persisting over as many as 12 months, even as they lose other cognitive abilities. Admittedly, even effective cognitive rehab has only a modest impact. "We never suggest this can reverse the effects of dementia," notes Linda Clare at the University of Exeter.

A meta-analysis of 20 studies on tai chi and cognition determined tai chi appears to improve executive function without any cognitive decline, reports Newsmax . The Chinese exercise decelerated the progression of dementia more than any other type of regimen, and enhanced function as well as other forms of exercise or cognitive training. Tai chi also offers other clear benefits, including better balance; relief from back, neck, arthritis, and fibromyalgia pain; mood enhancement; and lower blood pressure. Tai chi also is valued for building community and social connections. According to experts, staying active and connected with others reduces the risk of dementia, and attending tai chi classes with others helps individuals stay accountable and stick with a regular activity.

CNBC quotes AMN Healthcare Services CEO Susan Salka, who notes the health care industry is swimming upstream when it comes to unemployment. "We have a lot of things driving our industry, certainly starting with an aging population, which drives utilization of health care," says Salka. "But it also creates shortages within the health care workforce. We have really severe shortages within nursing, physician, allied, and even within leadership. So we're really seeing those two things come together right at the worst time, probably, for health care." AMN's main line of business is staffing, which often goes beyond simply assigning candidates to open positions. For AMN, optimizing hospital staff means making sure nurses and physicians are where they need to be at all times via predictive analytics and better scheduling methods. "We're in a time when the number of health-care job openings, if you just look at the Bureau of Labor Statistics data, are twice the number of hires," says Salka. "In fact, we are at record highs for vacancies and job quits. So it's really essential that we bring everything that we can to help them get the staff they need, whether it be temporary or permanent." She concludes that it is also important for AMN to help clients optimize the staff they already have.

Researchers in Sweden report that older adults on antidepressant medications are more than twice as likely to experience a hip fracture compared to peers who do not use the drugs, states MedShadow . The researchers examined a registry of 408,000 patients aged 65 and older, with an average age of 80. Half were prescribed an antidepressant and the other half were not. The study found that antidepressant users were more than twice as likely as nonusers to have suffered a hip fracture both before and after starting therapy. In the year before starting therapy, 2.8 percent in the antidepressant group experienced a hip fracture compared to 1.1 percent in the comparator group. Up to a year after going on an antidepressant, 3.5 percent in that group had a hip fracture compared with 1.3 percent in the other group. The highest odds of experiencing a hip fracture were 16 to 30 days before treatment with an antidepressant.

New York Gov. Andrew Cuomo (D) has vetoed a bill that would have required municipalities to award retirees 30 days' notice before changing health insurance plans or adjusting retirees' premiums or copays, reports Crain's New York Business . The state Legislature has passed versions of the bill in each of the past three years, but each time Cuomo has killed the legislation. Earlier versions called for 60 and 45 days' notice to the retired public employees. The bill was endorsed by the Retired Public Employees Association (RPEA), which advocates on behalf of roughly 200,000 people. The group said the bill would have helped retirees, many of whom live on fixed incomes, prepare for changes that could cause them financial hardship. "Allowing retirees to plan for changes to their health care is a small but significant courtesy, and they have earned the respect to receive notification," the RPEA said.

Officials at the National Institute on Aging and the National Institutes of Health (NIH) warn seniors are especially prone to hypothermia because their response to cold can be diminished by chronic medical conditions and certain medications, reports HealthDay News . Symptoms of incipient hypothermia can include slowed or slurred speech, sleepiness or confusion, shivering or stiffness in limbs, poor control over body movement, slow reactions, a weak pulse, or a core body temperature of 95 degrees Fahrenheit or lower. NIH says such a body temperature can lead to heart rhythm disturbances as well as kidney and liver damage. NIH officials recommend seniors wear a hat, scarf, and gloves when going outside in cold weather, and multiple layers of clothing to trap warm air between the layers. Seniors also should notify others when they are planning to spend time outside and have a fully charged cellphone on hand. Being in a warm home setting is also advised, with the thermostat set to at least 68 degrees Fahrenheit.

A potentially ground-breaking new technique using ultrasound to clear toxic protein clumps believed to cause dementia and Alzheimer's disease is moving to the first phase of human trials, reports the Yucatan Times . Developed in 2015 at the University of Queensland, this treatment has proven successful across a number of animal tests and would be a drug-free way to possibly combat dementia. Initial research focused on finding a way to use ultrasound to temporarily open the blood-brain barrier, with the objective of helping dementia-battling antibodies better reach their target in the brain. However, researchers were surprised when early tests with mice revealed the targeted ultrasound waves cleared toxic amyloid protein plaques from the brain without any additional therapeutic drugs. "The ultrasound waves oscillate tremendously quickly, activating microglial cells that digest and remove the amyloid plaques that destroy brain synapses," stated Jürgen Götz, one of the researchers on the project back in 2015. Since then, the research team has worked to further refine the technique. The latest announcement concerning the upcoming move to human trials is underpinned by a sizable funding injection from the Australian government. A phase 1 safety trial involving humans with Alzheimer's will kick off later this year. It should be noted that, in practical terms, the treatment is still probably at least a decade away from real-world clinical applications assuming everything is successful between now and then.

In MedPage Today , Dr. Zaven S. Khachaturian, editor-in­-chief of Alzheimer's & Dementia , describes the 40-year struggle to grapple with Alzheimer's disease (AD) and the important milestones achieved in the efforts to address it. He details the struggles to promulgate national policies and programs to foster prevention as a strategic public health objective. Despite the well-publicized failures of some clinical trials, he notes there are reasons for optimism about future prospects of more effective interventions being developed. "During these four decades, remarkable progress has been made to understand the neurobiology of an unknown chronic brain disorder that has now become a central contributor to a global crisis for healthcare systems," he writes. "The new knowledge generated from potential origins of neurodegenerative disorders/dementia/AD now are poised to be utilized for adaptation into the development and testing of novel therapeutic targets and strategies for treatments." The therapeutic paradigm in AD has already begun to shift towards secondary prevention, namely aiming for intervention to delay the onset of symptoms in pre-symptomatic individuals at risk of developing dementia. There is also growing evidence strongly supporting the proposition that vascular problems in midlife can take their toll on the brain decades down the line. Another promising array of new ideas to focus on "prevention" stems from the general consensus among researchers that engagement in various forms of activities to stimulate the brain, from exercise to social activities, are major factors in preserving cognitive health in older adults. Khachaturian concludes that even "the recent failure of clinical trials based on prevailing scientific orthodoxy has been a blessing in disguise, by opening the door for new thinking and alternative conceptual models."

More than one-fourth of Americans between the ages of 50 and 64 worry they will not be able to afford their insurance over the next year, and nearly half expressed little to no confidence in being able to afford their insurance when they retire, according to a new poll from the University of Michigan cited by Fierce Healthcare . Although some of these concerns include things people cannot directly control, such as policy changes, many are focused on maintaining current coverage provided through an employer while reducing personal healthcare expenses. The survey found 13 percent of respondents delayed medical care within the last year due to cost concerns, and another 15 percent postponed procedures until they could change their plan the following coverage year. Additionally, 8 percent of respondents between the ages of 60 and 64 reported delaying a procedure until they could get Medicare. Nearly one-fifth of respondents said they were keeping a job, delaying retirement, or considering delaying retirement to keep their employer-sponsored insurance. Finally, the study found that more than two-thirds said they are worried about how their coverage may change due to federal policies.

State legislatures have been active in increasing their respective minimum wage rates. In 2019, more than 20 states will increase their minimum wage rate, with 18 of those increases having taken effect on New Year's Day, reports Mondaq . The states are Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New York, Ohio, Oregon, Rhode Island, South Dakota, Vermont, and Washington. In light of these changes, employers must ensure their pay practices comply with the wage increases. Employers should also be prepared to update their state minimum wage posters, as many states require employers to post up-to-date notices of the state minimum wage. Finally, in addition to the statewide increases, 38 cities and counties also were scheduled to raise their minimum wages in 2019.