The largest known brain imaging study published in the Journal of Alzheimer's Disease involved the assessment of 62,454 brain single photon emission computed tomography scans of more than 30,000 individuals between nine months and 105 years old to investigate factors that accelerate brain aging, reports ScienceDaily . The scans were taken from a large multi-site psychiatric clinic involving persons with many different psychiatric disorders, including bipolar disorder, schizophrenia, and attention deficit hyperactivity disorder. The researchers analyzed 128 brain regions to predict chronological age, and older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging. A number of brain disorders and behaviors forecast accelerated aging, especially schizophrenia, which showed an average of four years of premature aging. Accelerated aging was not observed in depression and aging, which the team theorizes may be on account of different types of brain patterns for these disorders. "These large studies are essential to answer how to maintain brain structure and function during aging," says the University of Texas at San Antonio's George Perry. "The effect of modifiable and non-modifiable factors of brain aging will further guide advice to maintain cognitive function."

A study of 6,626 seniors published in the Journal of the American Medical Association found that the better they scored on seven measures of cardiovascular health, the lower their risk of dementia over the ensuing years, reports the Los Angeles Times . Those metrics include diet, exercise, weight management, smoking status, blood pressure, blood sugar, and cholesterol. There were few high scores, with only 6.5 percent of study participants having optimal measurements for at least five of the seven categories. Meanwhile, 36.4 percent of participants got optimal scores in no more than two categories. Among those with the lowest scores, dementia developed at a rate of 13.3 cases per 100 people; there were only 7.1 cases per 100 people among those with the highest scores. Among those with optimal levels for none or just one of the seven metrics, the diagnosis rate was 1.76 dementia cases per 100 person-years, which fell by about 10 percent for each additional metric that was at optimal levels.

Anthem and Walmart have announced the January 2019 launch of an over-the-counter drug access program for Medicare Advantage beneficiaries in a move expected to improve seniors' access to medications and reduce out-of-pocket expenses, reports Healthcare Finance News . The program will enable enrollees in an Anthem-affiliated MA plan to use their over-the-counter plan allowances to buy drugs and health-related items such as first aid supplies, support braces, and pain relievers at Walmart's 4,700 stores and on Walmart.com. "We believe that programs like this can make a tremendous difference for healthcare consumers who often live on a fixed income or are managing chronic medical conditions," says Anthem's Felicia Norwood.

Artist Laurence Aëgerter has begun a project she calls "Photographic Treatment," which seeks to improve the quality of life of older adults with dementia by staging "photo interventions," or individual or group sessions that focus conversations on images Aëgerter curated over three years, reports CNN . Aëgerter notes all too frequently people with dementia are infantilized by caregivers and relatives, which can add to their frustration and unhappiness. "A mistake often made by spouses of people of dementia is asking them things they cannot reply to because of their illness," says the Haagse Hogeschool's Frans Hoogeveen. The Alzheimer's Association's Ruth Drew notes people might not know where to begin when trying to engage and connect with those with dementia. She thinks activities such as discussing a photo can help such individuals and their loved ones. "Using these photographs may also help the person who wants to connect with a family member with Alzheimer's to have a jumping-off point that can help engage that person," Drew suggests. Aëgerter collaborated with dementia experts and people with dementia to create guidelines for the photos. She found 90 percent of the photos online by searching copyright-free images, while the other 10 percent she took herself when she could find no suitable alternative. Aëgerter learned early on that people with dementia preferred photos of natural smiles, rather than posed or doctored ones.

Amazon's plans to build clinics for employees would make it one of a roster of organizations setting up health centers at the worksite, according to Forbes . CNBC reports the first Amazon clinic would be at its Seattle headquarters, and the company "is starting small with a pilot, but is looking to expand the effort early next year." Meanwhile, Mercer's 2017 National Survey of Employer-Sponsored Plans says at least 33 percent of employers with a minimum of 5,000 employees are offering them "a general medical clinic," up from 24 percent of large employers five years ago. Furthermore, Amazon, Berkshire Hathaway, and JPMorgan Chase announced in January that they intend to establish an "independent company" to improve healthcare and reduce costs for their more than 1 million employees. Amazon and its partners also hired Dr. Atul Gawande, who is known for promoting value-based medical care and population health, to lead this company. Worksite clinics would be in keeping with the mission of Gawande's Ariadne Labs "to create scalable healthcare solutions that deliver better care at the most critical moments of people's lives, everywhere." Worksite clinics typically involve a local healthcare provider managing or staffing them, and more and more are delivering a wider array of healthcare services beyond occupational care, such as chronic condition management, physical therapy, chiropractic care, mental health, and pharmacy.

The Internal Revenue Service (IRS) on Aug. 17 okayed an employer's plan to tie 401(k) contributions to student loan repayment contributions, which will likely mollify employers interested in offering a student loan benefit in this way who are worried about complying with the law, reports Bloomberg Law . A 2017 American Student Assistance survey found 86 percent of young workers would stay with their employer for five years if they helped pay off their student loans. However, only 4 percent of employers offered a student loan repayment benefit as of 2017, according to the Society for Human Resource Management (SHRM). The program approved by the IRS would allow the employer to make a 401(k) contribution on a worker's behalf if the employee was making a student loan payment of at least 2 percent of their salary for a given pay period. The contribution would be made regardless of an employee's 401(k) contribution. "The individual for whom this is a real benefit is an employee who wasn't otherwise making 401(k) contributions," says McDermott Will & Emery partner Jeffrey Holdvogt. He notes it was uncertain before the ruling as to whether a pathway to providing a tax-free student loan repayment option through a 401(k) contribution existed, because tax code does not specifically permit employers to provide student loan repayment tax-free like it does for tuition assistance. "The ruling will be helpful for other companies because we have seen in recent months other employers tying 401(k) and student loan repayments together," says SHRM's Chatrane Birbal.

Veritas Genetics is among a handful of emerging companies providing the tools for humans to map their genome at a price, $1,000 each. But in addition to selling kits to consumers who want to dive deep into their biological code, Veritas is doing research into people to try and understand how and why extraordinary individuals are different. One of the company's research efforts, spearheaded by Preston Estep, Veritas' co-founder and chief scientific officer, involves the study of people who live for more than a hundred years, reports CNBC.com . As their contemporaries have succumbed to cancer, heart attacks, and a myriad of other diseases, these folks are still going. Estep wants to sequence their DNA to uncover what they are doing right. Estep has a few theories about what he might find, based on his previous research. Diets that involve a lot of fresh fruit and fish are clearly a factor, given the parts of the world where these people tend to reside. He says that longevity tends to be the result of both genetics and environment.

A study published in the Journal of Alzheimer's Disease sought to explore the impact of osteoporosis on the risk of developing dementia in almost 60,000 persons followed for up to 20 years in more than 1,200 general practices in Germany, reports ScienceDaily . The team used data from the Disease Analyzer database, which included 29,983 patients with osteoporosis and 29,983 controls who lacked it. After 20 years of follow-up, 20.5 percent of women with osteoporosis and 16.4 percent of controls had been diagnosed with dementia. At the end of follow-up, dementia was found in 22 percent of men previously diagnosed with osteoporosis and 14.9 percent of men who were not. Osteoporosis was linked to a 1.2-fold increase in the risk of being diagnosed with dementia in women and a 1.3-fold increase in the risk of diagnosis in men. "The major hypothesis to explain the association between osteoporosis and dementia is that these two conditions have similar risk factors," says Paris 5's Louis Jacob. "These factors include APOE4 allele of the apolipoprotein E, a major cholesterol carrier, lower vitamin K levels, vitamin D deficiency, but also androgens and estrogens."

A new study published in the Journal of Alzheimer's Disease has identified a protein signature in the brains of people with accumulated plaques but no dementia that appears to stop plaques congesting communication channels between neurons, reports ScienceAlert . Researchers analyzed frozen brain tissue donated by volunteers in brain aging studies. They found 15 distinct proteins that set this group of people apart from those with plaque and tau accumulation that do develop Alzheimer's, and those without any brain blockages or dementia. "We don't yet fully understand the exact mechanisms responsible for this protection," says the University of Texas' Giulio Taglialatela. "Understanding such protective biological processes could reveal new targets for developing effective Alzheimer's treatments." Later studies will have to more closely investigate why this protein signature has the effect it does, and what creates the combination of proteins in the first place.

Nord Architects in Copenhagen, Denmark, is building a series of nursing communities for persons with Alzheimer's and dementia that feel more like villages or cities, reports Fast Company . The design also is being adopted elsewhere in Europe and the United States. One "Alzheimer's Village" Nord is constructing in France is arranged into small neighborhoods oriented around shared services that will be open to the public, a decision that helps integrate the nursing community into the town of Dax. The design, with small groups of apartments and a series of more central villages, mirrors the layout and look of the surrounding French towns. "It's very much about creating a noninstitutional atmosphere that is based on the traditions of the local architectural works," says Nord partner Morten Gregersen. He suggests being in an environment that is similar to what they are used to could ease residents' transition from at-home living to a care community. "As their cognitive level slowly degenerates and their ability to read new things disappears, they relate to things they know much better, and things they knew in their childhood," Gregersen notes. "All of these things need to be incorporated into the design so we don't create places where people get lost and confused." In Denmark, Nord is planning a sprawling, village-like nursing community on a hillside featuring two inner courtyards, so residents can go outside without staff needing to worry about them getting lost.