Researchers have discovered a feedback loop underlying brain degeneration in Alzheimer's disease that may explain why so many drug trials have failed, according to a study published in Translational Psychiatry and cited by Medical Xpress . The study also identifies a clinically approved drug which breaks the cycle and protects against memory-loss in animal models of Alzheimer's. Overproduction of the protein beta-amyloid is strongly linked to development of Alzheimer's disease but many drugs targeting beta-amyloid have failed in clinical trials. Beta-amyloid attacks and destroys synapses—the connections between nerve cells in the brain—resulting in memory problems, dementia and ultimately death. In the new study, researchers found that when beta-amyloid destroys a synapse, the nerve cells make more beta-amyloid driving yet more synapses to be destroyed.

A study has found that positron emission tomography (PET) quantification of tau protein aggregates in the brain with an 18F-labeled tracer called flortaucipir discriminated Alzheimer's disease from other neurodegenerative diseases with strong, yet imperfect, accuracy, reports MedPage Today . Researchers examined 719 individuals across three dementia centers in South Korea, Sweden, and the United States from June 2014 to November 2017. In the primary analysis, the researchers assessed the discriminative accuracy of 18F flortaucipir for Alzheimer's dementia versus all non-Alzheimer's neurodegenerative disorders. In secondary analyses, they compared 18F flortaucipir SUVR with three established MRI measures. In the medial-basal and lateral temporal cortex, 18F flortaucipir uptake showed 89.9 percent sensitivity and 90.6 percent specificity (SUVR 1.34) for distinguishing Alzheimer's dementia from all non-Alzheimer's neurodegenerative disorders. The study was recently published in JAMA .

The U.S. Centers for Medicare and Medicaid Services (CMS) needs to improve existing information technology controls to enhance the resiliency of the Medicare program's enrollment system, according to an audit by the Department of Health and Human Services' Office of Inspector General (OIG). The OIG assessed whether CMS implemented sufficient security controls within its Enrollment Database (EDB) to protect the confidentiality, integrity and availability of Medicare enrollee data, reports Health Data Management . "We found that CMS could improve its risk management oversight, and the current controls in place to ensure the availability of the EDB," said the auditors. "Based on CMS officials' estimates, we calculated the daily financial impact of a nonfunctional EDB to be approximately $47 million."

Universal life insurance, popular in the 1980s and '90s, worked as advertised for years, when interest rates were in the high single digits and above, reports the Wall Street Journal . Now, rates are completing a decade at historically low levels, crimping the savings accounts that together with insurance make up the products. Meanwhile, the aging of the earliest customers into their 70s and beyond has driven the yearly cost of insuring their lives much higher. The result is a flood of unexpectedly steep life-insurance bills that is fraying a vital safety net. Some find they owe thousands of dollars a year to keep modest policies in effect. People with million-dollar policies can owe tens of thousands annually. Some retirees are dropping policies on which they paid premiums for decades.

Glenner Town Square in Chula Vista, CA, is a new care community for people with dementia that is like entering a time warp, reports the Wall Street Journal . The 11 storefronts that surround an indoor park represent the time period from 1953 to 1961, when most of the residents were in the prime of their life. Glenner Square opened in August and is believed to be the first memory care community in the United States built entirely around the idea of reminiscence therapy, a therapy that uses prompts from a person's past to elicit memories and encourage conversation and engagement. It is 9,000-square-feet with 24-foot ceilings. The center of the village is a small, indoor park, with natural skylights, and artificial grass for a small putting green and bocce court. Parakeets from the adjacent pet store add to the ambience. A clinic where the center's registered nurse works has cribs with lifelike baby dolls that patients cradle. There is a library with a card catalog, a 1950s National Geographic set and Monopoly and Scrabble games circa-1930. A re-created home space called the "Little Blue House" has an original Philco Fridge and a record player. At the movie theater, "The Greatest Show on Earth" plays in 15-minute clips. At Joy's department store, patients can shop and even bring home a fur coat and bowling shoes. And at the Gone Fishin' Pub there's a pool table, a mini-basketball court and darts. The storefronts use graphics and pictures that can be changed to re-create different eras for different generations of patients. Staff work in a "City Hall" office space. The program is mostly geared toward patients who are in the early to moderate stages of dementia, who are typically living with family or at home with caregivers. Glenner Town Square is a partnership between the George G. Glenner Alzheimer's Family Centers—a California-based nonprofit organization—and Senior Helpers, a national in-home senior care provider. The partners have plans to franchise the concept and open up similar centers across the country. Peter Ross, CEO and co-founder of Senior Helpers, says they've already received interest in the concept and hope to have 200 Town Squares across the country in the next five years.

The U.S. Senate passed an $8.4 billion package of 70 bills aimed at addressing the nation's deadly opioid epidemic, reports the Washington Post . The House passed a similar measure in June, but a key difference between the bills involves the Institutions for Mental Diseases (IMD) exclusion rule, which bars federal Medicaid reimbursements for inpatient substance abuse treatment in centers with more than 16 beds whose patients also have mental illness. The House bill partially overturns the IMD exclusion for mental-health patients who also have an opioid use disorder, while the Senate bill ensures pregnant and postpartum women continue receiving Medicaid-covered services administered outside such facilities, but does not allow Medicaid to pay for addiction treatment in larger facilities.

Arthritis is common in individuals with varying degrees of depression, according to a study published in the International Journal of Geriatric Psychiatry and cited by EurekAlert! . The analysis of National Health and Nutrition Examination Survey on U.S. adults aged 50 years and older found that the prevalence of arthritis was 55.0 percent, 62.9 percent, and 67.8 percent in participants with minor, moderate, and severe depression, respectively. The findings highlight the importance of screening for and treating arthritis-related pain in older adults with depressive symptoms, said the researchers.

A study published in BMJ Open found that among older adults living in London, those in areas with the highest amount of annual air pollution concentration were at a subsequently higher risk of dementia compared to those living in areas with the lowest pollution. Specifically, those in the top fifth areas of exposure were 40 percent more likely to be diagnosed with dementia in the study than those in the bottom fifth, even after adjusting for other risk factors like smoking or socioeconomic status, reports CNN . The findings align with separate research that has explored associations between air pollution and aging. A study published last year in Environment International found a positive association between fine particulate matter exposure and dementia incidence among about 2.1 million older adults living in Ontario, Canada. Another study, published last month in the Proceedings of the National Academy of Sciences , found that long-term exposure to air pollution in China can impede cognitive performance in verbal and math tests.

According to a report from the Center for Retirement Research at Boston College, while the poverty status of widows has improved markedly, they remain much more vulnerable than married couples. One reason is that Social Security widow benefits have been declining, relative to the couple's benefit, due to the rising labor force activity of women. One proffered solution is to increase the widow benefit by reducing the spousal benefit, essentially shifting money from when both spouses are alive to when only one member is alive.

New rules taking effect in 2019 will allow Medicare Advantage plans to require patients to try less expensive drugs before covering costly, physician-injected treatments for serious conditions including cancer and rheumatoid arthritis, reports Kaiser Health News . While the transition to "step therapy" is part of the Trump administration's campaign to check runaway pharmaceutical pricing, some warn that critically ill Medicare Advantage patients could suffer if they do not receive the first line of treatment recommended by their doctor. A patient with macular degeneration, for example, might go blind before receiving approval for vision-saving eye injections. Step therapy is not even permitted under traditional Medicare, and insurers that take advantage of the change in Medicare Advantage will only do so as it applies to new prescriptions. However, the shift will also give them some negotiating leverage with pharmaceutical companies, according to Seema Verma, the head of the Centers for Medicare and Medicaid Services. Drugmakers looking to remain competitive might lower their prices in order to secure their product a slot of plans' formularies, which would then allow patients to get the medication without satisfying step therapy prerequisites. Medicare also is demanding that plans share any savings with subscribers.