The Centers for Medicare and Medicaid Services (CMS) is considering the expansion of Medicare coverage for ambulatory blood pressure monitoring (ABPM) devices following requests from the American Heart Association (AHA) and the American Medical Association (AMA), reports Modern Healthcare . The agency currently covers the devices in limited circumstances for individuals who experienced three high blood pressure readings during doctor visits. Researchers say these individuals have white coat hypertension and account for 15 percent to 25 percent of persons with elevated blood pressure. AHA and AMA want more people to have access to ABPM devices, even if they exhibit no symptoms of high blood pressure during an office visit. In a joint coverage request , both groups claimed that "ABPM has been shown to be effective at diagnosing a number of blood pressure patterns and comorbid conditions prevalent in the Medicare population which can help ensure Medicare beneficiaries receive appropriate treatment tailored to their individual health needs." According to federal data, up to 55 percent of the Medicare population has hypertension, including almost 40 percent of disabled Medicare beneficiaries. AHA estimates that individuals with high blood pressure accrue inpatient costs at 2.5 times the rate of those without high blood pressure and incur almost twice the outpatient costs, while average inpatient and outpatient costs can be as much as $5,400 annually. CMS will accept comments on the proposed expansion through Nov. 8, and it expects to release a proposed decision by next April and a final decision by July 2019.

A study published in Neurology suggests people with atrial fibrillation may undergo a faster decline in thinking and memory skills and be at a higher risk of dementia, reports Medical Xpress . The researchers analyzed data on 2,685 participants with an average age of 73 who were tracked for an average of six years. Participants were examined and interviewed at the beginning of the study and then once after six years for those younger than 78 and once every three years for those 78 and older. All subjects had no dementia at the start of the study, but 243 people exhibited atrial fibrillation. Another 279 people developed atrial fibrillation, and 399 developed dementia. Individuals who had atrial fibrillation had a faster rate of decline in thinking and memory skills than those lacking the condition, and were 40 percent more likely to develop dementia. Of the 2,163 people who did not have irregular heartbeat, 278 developed dementia, while 121 of the 522 people with irregular heartbeat developed dementia. Moreover, people who took blood thinners for atrial fibrillation had a 60 percent decreased risk of dementia.

Neo Mohsenvand with the Fluid Interfaces team at the Massachusetts Institute of Technology Media Lab is developing and testing wearable technology designed to improve emotion regulation, decision-making, or memory retrieval, reports Quartz . The Mnemo project may also have potential to help people burdened by memory loss. Mohsenvand is collecting an archive of information, including the faces he sees, the objects he interacts with, and the patterns surrounding him to help this research. He says he has amassed a "collection of his memories" by wearing equipment that allows him to record video and his physiological changes. Mohsenvand has built a "sort of memory amplification system," which condenses the day into five minutes while highlighting "important moments." He notes he has learned to appreciate the little things that make him happy thanks to this research. Mohsenvand also says his work was inspired by his time looking after his grandmother, who was afflicted with Alzheimer's disease. He thinks a virtual reality experience such as the kind he is developing could help such persons by making their memories instantly accessible externally.

Nearly 20 percent of Americans 65 or older are still working, and holders of college degrees are finding this extended employment period easier compared to their less-educated peers, reports the New York Post . According to financial experts, both groups would benefit from working at least an additional year to bolster their retirement security. Less-educated Americans often do not have this option even though their retirement savings trend lower. Many are forced into retirement before their mid-60s for reasons such as poor health or the inability to do jobs that require a lot of physical activity. Boston College's Matt Rutledge cites a growing gap in retirement ages between college and high school graduates, which is most apparent when studying the average age of retirement for men. Men with college degrees are retiring at an average age of 65.7, nearly three years later than men with only high school degrees. "We see people intending to work a whole lot longer, but the problem is that for the most part, it's a lot easier for the college graduates to fulfill that plan," Rutledge notes. He says health plays a large role in deciding when to retire, and less-educated Americans tend to have poorer health, and more physically demanding jobs, than their higher-educated counterparts.

A study published in the International Journal of Geriatric Psychiatry assessed arthritis rates among older U.S. adults with depressive symptoms, reports Specialty Pharmacy Times . The researchers analyzed National Health and Nutrition Examination Survey data from 2011 to 2014, which included 2,483 women and 2,309 men, to identify participants aged 50 years and older with depressive symptoms and self-reported physician-diagnosed arthritis. This condition occurred in 24.3 percent of adults older than 45 and 47.4 percent in adults 65 years and older. The prevalence rates of depression in U.S. adults aged 45 and older with arthritis are 18 percent, but depressive symptoms are often under-treated and poorly understood when it comes to this demographic. A total of 43.7 percent of participants reported physician-diagnosed arthritis and 55 percent in a subgroup with minor depression reported an arthritis diagnosis, while prevalence rates of depression were similar across the various age subgroups. In general, 62.8 percent and 67.8 percent of participants with moderate and severe depression, respectively, reported an arthritis diagnosis. Arthritis rates among those with moderate-to-severe depression rose between 50 to 59 and 60 to 69, and stabilized in advancing age groups. The investigators verified that higher rates of arthritis were reported by older adults with various levels of depression versus those without sub-clinical and clinical levels of depressive symptoms, which is consistent with other studies on the link between depression and arthritis in older men and women.

Best Buy is planning to gain a piece of the market for digital health, especially for older Americans, with the recent appointment of veteran healthcare executive Cindy Kent to its board of directors, reports WXPI . Best Buy recently announced its planned acquisition of Greatcall for $800 million. Greatcall manufactures Jitterbug cellphones designed with big buttons and bright screens for seniors, as well as medical alert devices that can detect falls and summon help. This merger would be Best Buy's biggest in its 52-year history. Health and senior care are potentially massive markets for the retailer, as about 50 million Americans are older than 65 — a number expected to double within the next 20 years as baby boomers retire.

A study published in the American Journal of Clinical Nutrition compared the effect of different forms of protein supplements on older adults struggling to rebuild muscle loss due to inactivity associated with illness or long hospital stays, reports Medical Xpress . The researchers determined that protein did not halt lean muscle loss caused by inactivity, but whey supplements helped rebuild muscle once participants resumed activities. Whey is rich in all essential amino acids and is higher in leucine, which the body cannot produce itself. The researchers enrolled men and women who were non-smokers, non-diabetic, and between 65 and 80 years old. One cohort consumed whey protein and the other collagen peptides. Participants' diet was controlled over five weeks, including two weeks where their daily steps were limited to 750 daily and their calorie intake reduced by 500 calories daily. Over a one-week recovery period, participants returned to normal activity levels. The team's prediction that the collagen peptide group would experience a significantly greater muscle loss than the whey protein group did not pan out, as both cohorts lost the same amount of muscle. Although protein did not mitigate muscle loss, when participants returned to normal activity levels, the whey group recovered more skeletal muscle. "When we consider measures that can be taken to help seniors as they age, it's clear that whey is an important ingredient," remarks McMaster University's Sara Oikawa.

A Kaiser Health News investigation with PBS NewsHour published in June detailed more than 100 cases in the United States since 2012 in which persons with dementia used guns to kill themselves or others, reports the New York Times . The shooters often acted while wracked with confusion, paranoia, delusion, or aggression, and ended up shooting spouses, children, and caregivers. Despite this, healthcare providers across the nation say they have not received sufficient guidance on whether, when, and how to counsel families on gun safety. A lack of data on national gun safety translates to no scientific standards for when a healthcare provider should discuss gun access for people with cognitive impairment or at what point in the disease's progression a person becomes unfit to handle a gun. Johns Hopkins School of Medicine's Colleen Christmas notes firearms are the most common method of suicide among seniors. Following the 2017 Las Vegas shooting, more than 1,300 healthcare providers publicly vowed to ask customers about gun ownership and gun safety when risk factors exist. The University of California, Davis' Violence Prevention Research Program has now developed a tool kit to offer health professionals guidance on lowering the risk of gun violence. Issues that doctors and family members should be aware of is the fact that neither state nor federal law prohibit health professionals from raising the issue of gun safety, while the Veterans Health Administration recommends asking about firearms as part of a safety screening when "investigating or establishing the suspected diagnosis of dementia."

In a Nationwide survey of well-off older adults, 47 percent of respondents said they worry about becoming a burden to their loved ones as they age, while 71 percent wanted the option of relying on family members to provide care as needed, although most would not want or expect such care unless they were able to financially compensate them for it, reports the Casper Star-Tribune . Furthermore, most older wealthy Americans do not know what their long-term care costs might involve, and only 27 percent have a long-term care insurance policy. Estimates say about 15 percent of people who turn or turned 65 between 2015 and 2019 will spend more than $250,000 out of pocket on long-term care. In addition, Genworth Financial's 2017 Cost of Care Survey found the average U.S. assisted living community costs $45,000 annually, while the average nursing community costs $85,775 a year for a shared room and $97,455 a year for a private one. Meanwhile, a typical long-term care insurance premium only costs about $3,500 annually. It would also pay for older persons to have a conversation with family members who might one day act as their caregivers. That discussion should have realistic expectations of their needs in order to inform a care plan.

A U.S. National Institutes of Health-supported study published in the New England Journal of Medicine determined that daily, low-dose aspirin has no effect on the lifespan of healthy older people, reports the Richmond Register . The ASPirin in Reducing Events in the Elderly (ASPREE) trial enrolled more than 16,000 persons in the United States and Australia in 2010 and tracked their health over several years. Daily treatment with 100 mg of low-dose aspirin did not impact survival free of dementia or disability. Among the seniors randomly assigned to take aspirin, 90.3 percent were still alive at the end of the treatment without persistent physical disability or dementia, versus 90.5 percent of those taking a placebo. Rates of physical disability were similar and rates of dementia were almost identical in both cohorts. Analysis of the ASPREE results showed the rates for major cardiovascular events — including coronary heart disease, nonfatal heart attacks, and fatal and nonfatal ischemic stroke — were similar in the aspirin and the placebo groups. In the aspirin group, 448 people had cardiovascular events, compared with 474 in the placebo group. The risk of death from a range of causes, including cancer and heart disease, was variable.