Members of Congress are calling on the Centers for Medicare and Medicaid Services (CMS) to finalize the Program of All-Inclusive Care for the Elderly (PACE), which could keep more older adults out of nursing communities when their health worsens. Projections indicate that by 2030, one in five U.S. residents will have hit retirement age. "We've found that there are more efficient ways to do the PACE program that allows us to grow faster, to provide people better care and to do things more efficiently," says Robert Greenwood, a senior vice president with the National PACE Association, which represents providers. The Obama administration proposed a set of changes in 2016 that would let program administrators customize an enrollee's care team, provide more services in community settings outside of PACE centers, and make it easier for community providers to participate. Two bills introduced in the House and Senate this summer would require the agency to finalize new rules by Dec. 31. The House Ways and Means Committee plans to mark up the House bill Wednesday, according to Politico Pro . "The PACE program is long overdue for an update, and this bipartisan, commonsense legislation will ensure improvements are made quickly so more seniors can live at home longer," says Rep. Jackie Walorski (R-Ind.), the lead sponsor of the House bill.

A survey by Home Instead found 53 percent of employees approaching retirement in the next five years believe they will likely return to work, reports the Lincoln Journal Star . Sixty-eight percent of those nearing retirement and 65 percent of those who have "unretired" announced that they will change or have changed industries. Almost 80 percent of both groups expressed a desire to make a meaningful impact in their communities in their post-retirement years, such as through volunteerism or a role involving caregiving, teaching, or giving back. Key motivators for returning to work for retirees included combating boredom or keeping their minds sharp, while finding new challenges and fulfillment were the most common drivers for those pending retirement. "With Baby Boomers blazing the way, full retirement is no longer a point in time," says Transamerica Center for Retirement Studies CEO Catherine Collinson. "The transition could be a decade or more, and involve shifting gears and working in a different capacity or finding a flexible arrangement, all with more time for family."

This summer, the U.S. Department of Agriculture added another $60,000 in funding for the Maine Senior FarmShare Program, allowing the program's manager to clear a waiting list and make the program available to an additional 1,000 Maine seniors, reports the Portland Press Herald . Program manager Donna Murray says she is collaborating with senior agencies throughout Maine to find new participants in addition to the 17,000 or so who have already enrolled. To qualify, men and women must be at least 60 years old and have household incomes of no more than 185 percent of the poverty level. The program is run similar to community-supported agriculture initiatives offered by many farms. Seniors enroll and choose a farm to work with; the farm receives $50 per participant and seniors can buy fresh vegetables and draw down against that credit over the course of the growing season. "It not only helps the seniors, it helps our local farmers," Murray notes. She says the program addresses older adults' nutritional needs by ensuring they can at least get some fresh vegetables in their diets, especially in the fall as the crops are coming in. A 2016 poll found almost 92 percent of seniors said they ate more fruits and vegetables thanks to the program. Murray also says in most cases seniors must travel to farms or farmers markets to get their vegetables, which means they get out of the house and overcome the growing problem of social isolation.

A study published in the Proceedings of the National Academy of Sciences determined that poor air quality causes cognitive impairment in older adults, reports Tech Times . An international team of researchers surveyed about 50,000 people who took standardized tests in 2010 and later in 2014. They noted pollution can impact a person's cognition in both verbal and math tests, with the damage more profound in older men and in men who had no education beyond primary school. The study also warned cognitive decline or impairment is one of the risk factors of dementia in seniors, while the side effects of poor air quality might affect older adults' ability to make the right decisions, especially in a host of complex tasks such as retirement planning.

A study published in the Journal of Molecular Biology found an existing liver disease drug also could be employed in Alzheimer's disease therapy, reports Medical News Today . An earlier study suggested ursodeoxycholic acid (UDCA) has potential in halting the progression of Parkinson's by improving the functioning of mitochondria in certain individuals. Mitochondrial dysfunction is often a factor in Alzheimer's, and these changes appear to occur even before toxic protein plaques begin to accumulate in the brain. Using tissue from different Alzheimer's subjects, the researchers verified that UDCA enhances mitochondrial function by "correcting" the shape of the affected mitochondria. It achieves this by redistributing Dynamin-related protein 1, which plays a critical role in supporting the healthy dynamics of mitochondria and which the researchers think may shield against neurodegeneration. "We also found that the drug, which is already in clinical use for liver disease, acts by changing the shape of the mitochondria which could tell us more about how other drugs can be beneficial in Alzheimer's," says the University of Sheffield's Heather Mortiboys. "Most importantly, we found the drug to be active in cells from people with the most common type of the devastating disease — sporadic Alzheimer's — which could mean it has potential for thousands of people."

Congress has tripled the National Institutes of Health's (NIH) annual budget for Alzheimer's and related dementias over three years to $1.9 billion, which would be upped to $2.3 billion if two draft 2019 spending bills for NIH go through, reports Science . This funding boom aims to spur research into new treatments via grants from the National Institute on Aging (NIA). Alliance for Aging Research CEO Sue Peschin says this funding explosion was driven by intersecting trends that include families becoming more open about the disease and advocates lobbying for more funding. Congress in 2015 ordered NIH to prepare a "professional judgment" budget on Alzheimer's research, a wish list of needs to meet the 2025 target that would skip the federal budget process and go directly to the president and Congress. Peschin says advocates also pushed the Obama administration to include additional funding in the White House budget request. Some of NIA's recent funding opportunities solicit research on alternatives to the belief that ß-amyloid deposits outside brain cells and "tangles" of the protein tau within neurons are the key drivers of Alzheimer's and the best treatment targets. The announcements call for proposals in areas such as the role of protective genes, how neurodegeneration impacts other animal species, and how metabolic changes might affect Alzheimer's.

A recent opinion letter issued by the U.S. Department of Labor's (DOL) Wage and Hour Division concerns whether employees must be paid for time spent participating in wellness-related activities under the Fair Labor Standards Act (FLSA), reports JD Supra . The letter specifies whether an employer must pay employees for time spent undergoing biometric screenings — including blood pressure, cholesterol levels, and nicotine usage — both during and outside regular work hours, as well as for wellness activities like nutrition classes, employer-facilitated gym classes, telephonic health coaching, participation in Weight Watchers, and Fitbit challenges. The letter also addresses this concern in reference to attendance at benefits fairs to learn about employer-provided benefits, financial planning, and college attendance opportunities. It is the letter's conclusion that workers need not be compensated for participating in such activities if their participation is strictly voluntary, if they perform no job-related duties while participating, and if the activities mainly benefit the employee rather than the employer. The DOL also notes participating employees may enjoy reduced health insurance deductibles while also learning how to make "more informed decisions" about non-job related health issues. Furthermore, since employees are relieved of all job duties while participating, they are "off duty" as defined in DOL regulations.

Microsoft announced yesterday it will soon require that its suppliers and contractors provide at least 12 weeks of paid time off to new parents, reports the Wall Street Journal . This mandate is applicable to vendors with more than 50 employees and includes workers given substantial assignments for Microsoft. The company anticipates that this new policy will affect thousands of workers across the United States. The paid leave benefit requirement will be limited to $1,000 weekly in compensation, and Microsoft suppliers have one year to implement the change. The change seeks to alleviate criticism leveled against large corporations as they outsource more operations to contracting firms, staffing agencies, and other third parties. This practice allows them to frequently avoid paying the gold-standard salaries and benefits they provide to their internal workers. Third-party companies compete on price for valuable contracts, which reduces their incentive to provide higher pay and more benefits to their own employees. Microsoft general counsel Dev Stahlkopf says when the company implemented the 2015 requirement for paid time off, some suppliers indicated that they had wanted to offer more benefits to employees but were hesitant because competitors with fewer benefits would sell their services at a lower price.

A study published in the British Journal of Nutrition suggests rigorously following a Mediterranean diet in senior years could help people live longer, reports Medical Daily . The diet involves high consumption of fruit, vegetables, fish, pulses, olive oil, and cereals, and less intake of meat and dairy products as well as a moderate amount of wine during meals. The researchers examined 5,200 older adults from Italy 65 or over, who were followed for eight years. They also included data from other epidemiological studies for a total of 12,000 subjects. A strong adherence to the diet was linked to a 25 percent lower risk of any cause of death. In addition, people who followed this diet were more likely to get sufficient exercise. When the influence of the diet was analyzed by excluding various components, the benefits appeared to decline when data showed an increase in saturated fats, less fish, a decrease of moderate alcohol, or less cereals.

A study published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association reports that a stroke raises the odds of developing dementia about twofold, according to EurekAlert . The researchers analyzed data on stroke and dementia risk from 3.2 million people worldwide. They reviewed 36 studies where participants had a history of stroke, totaling data from 1.9 million people, as well as 12 additional studies that looked at whether participants had a recent stroke over the study period, adding another 1.3 million people. "We found that a history of stroke increases dementia risk by around 70 percent, and recent strokes more than doubled the risk," says the University of Exeter Medical School's Ilianna Lourida. "Given how common both stroke and dementia are, this strong link is an important finding. Improvements in stroke prevention and post-stroke care may therefore play a key role in dementia prevention." Stroke traits such as the location and extent of brain damage may help to explain variation in dementia risk between studies, and there were implications that dementia risk may be higher for men after stroke. Further research is needed to clarify whether ethnicity and education alter dementia risk following stroke. Also required is further research concerning whether differences in post-stroke care and lifestyle can reduce the risk of dementia even more.