A study published in the Journal of Alzheimer's Disease found that persons older than 65 continue to derive the most benefit from Deep Brain Stimulation (DBS) of the fornix, reports ScienceDaily . The results stem from data compiled from 42 people with mild Alzheimer's enrolled in a randomized, double-blind multicenter phase II clinical trial and implanted with DBS electrodes directed at the fornix, and tracked for two years. In the trial's first year, to better quantify the impact of electrical stimulation, subjects were randomly assigned to either the "on" or "off" stimulation cohort after their procedure and monitored. Once this phase of follow-up was done, all subjects had their electrodes activated and were followed for another year. In that year, researchers saw similar observations to what they had seen in the first phase. There were no differences overall in cognitive outcomes between study participants who had their device turned on just after surgery and those who had it turned on after 12 months, although those 65 years and older seemed to exhibit a slower progression of Alzheimer's than younger individuals, regardless of when their device was activated. "The next phase of our research will help determine whether this observed benefit is something we continue to see in this age group," says University of Toronto Professor Andres Lozano. "If it does, this could potentially give us a treatment for mild, late-onset Alzheimer's disease."

A new study from Vanguard claims framing healthcare costs in retirement as a yearly expense rather than a lifetime lump sum can help investors better understand total annual expenditures and plan accordingly during their retirement years, reports InvestmentNews . "Most analyses available today point to a daunting out-of-pocket healthcare expense over the lifetime of a retiree," notes Vanguard's Jean Young. "These large dollar values can be demotivating for investors from a psychological and behavioral perspective. Instead, our model focuses on the more manageable task of planning for incremental, annual health care costs, while separately considering and integrating the potential for long-term care expenses." Research found a key input in understanding potential costs is the amount of healthcare services a person may consume in retirement, which can be estimated based on pre-existing chronic conditions and family health history. Also impacting out-of-pocket costs is the type of Medicare coverage that a retiree chooses, and whether their income dictates additional surcharges. Vanguard estimated that 50 percent of individuals will incur no long-term care costs, but 15 percent could incur more than $250,000. Vanguard recommends all retirees consider the possibility of an extended, costly long-term care stay, given the magnitude of the potential expense.

The U.S. Senate Special Committee on Aging will hold a hearing today on Alzheimer's disease, concentrating on risk reduction and early detection. Officials from the Centers for Disease Control and Prevention as well as the Pennsylvania Department of Aging will be testifying, as will actress Marcia Gay Harden, who has written about her mother's Alzheimer's.

The House expects to complete voting on almost 20 bills for combating the opioid epidemic, with plans to hold a conference with the Senate over the summer, reports the Washington Examiner . The House passed about 30 bills last week ranging from increasing treatment options to curbing shipments of illegal opioids from abroad. Next week, the House will consider about 20 bills and a legislative vehicle that would integrate the legislation in a single package. "Altogether, this will be the most significant congressional effort against a single drug crisis in history," wrote Rep. Paul Ryan (R-Wis.). A bipartisan coalition of committee leaders has issued H.R. 6, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, which will function as a legislative vehicle to bundle all of the opioid legislation that the House passes. However, Democrats warn the bills will be ineffective without additional funding. In response, Sen. Rob Portman (R-Ohio) has said Congress has passed billions in new funding to fight the opioid crisis, including $4 billion in a March spending deal. He also thinks the Senate is "moving towards a package."

A new RAND Corporation study published in the Journal of General Internal Medicine is the first to examine various subtypes of risky prescribing of opioids and tie such prescribing to a broad array of deadly outcomes, reports ScienceDaily . The researchers examined prescription records for residents of Massachusetts over five years, identifying six types of risky prescriptions. More than 6 percent of Massachusetts adults were given a risky opioid prescription during the study period. The subtypes of risky prescribing of opioids included high-dose opioid prescriptions; prescribing of opioids along with the anti-anxiety medication benzodiazepines; opioids prescribed to someone by four or more prescribers in a calendar year; filling opioid prescriptions at four or more pharmacies per annum; paying cash for an opioid prescription three or more times over three months; and prescribing opioids without documentation of a pain diagnosis. More than 50 percent of Massachusetts adults received at least one opioid prescription between 2011 and 2015, and more than 11 percent of those individuals experienced at least one kind of risky opioid prescription. Moreover, more than 13 percent of subjects age 80 and older received at least one prescription, which contradicts the public image of the opioid crisis as a problem among young people. The strongest linkage to any cause of death was receiving a high-dose prescription for opioids and lacking a documented pain diagnosis. Five of the six risky prescription subtypes were associated with a fatal opioid overdose, with the exception being making cash payments for opioids.

LGBT advocates in San Francisco hope policy changes stemming from growing awareness of gender identities and sexual orientation will lead to beneficial changes in professional caregiving for LGBT seniors, especially those with dementia, reports the San Francisco Chronicle . The city, via its Department of Aging and Adult Services, is funding a $400,000 effort to train hundreds of workers at companies and public agencies on how to better communicate with LGBT seniors. The training is offered to home care aides and staffers at senior communities, as well as to organizations that engage with seniors regularly, such as Meals on Wheels and public transit employees. San Francisco's Human Services Agency reports that about 12 percent of seniors age 60 and older in the Bay Area identify as LGBT, amounting to about 19,200 persons. LGBT seniors are more likely to live by themselves, and only 15 percent have children, who are often their default caregivers. The Alzheimer's Association of Northern California's Edie Yau says many worry that disclosing their sexual orientation or gender identity to caregivers or peers in a care community may lead to discrimination, while some with dementia revert to a previous period in their life, before they came out, making talks with family and aides confusing and frustrating. On July 1, a new state law will come into effect requiring programs funded by some state health and aging agencies to gather data on the gender identity and sexual orientation of people who use their services. Disclosure is voluntary, with the data aggregated and anonymized to help spot gaps in care for older LGBT adults in the health and social services system.

A study published in the Journal of Neuroinflammation suggests alcohol alters gene expression in microglial cells and the immune system, impairing the ability of phagocytes to clear amyloid plaque, reports Medscape . "Our results demonstrate that microglial phagocytosis of Aß1-42 the 42-amino acid version of amyloid ß is significantly suppressed following one-day exposure to 75 mM ethanol," note the researchers. "This dose of ethanol is in the high range and is attained in humans following binge drinking or in heavy drinkers." The University of Illinois at Chicago's Douglas L. Feinstein says for their study the team "activated cells with alcohol alone or with a strong inflammatory combination. The two responses were very different. Alcohol is causing some type of activation in microglial cells, and it's different from typical inflammation." The researchers exposed rat microglial cells to alcohol or to a mixture of the proinflammatory cytokines tumor necrosis factor-a, interleukin-1ß, and interferon-y. They then compared genetic activation at 24 hours. Outcomes showed that 312 messenger RNAs (mRNAs) expressed differently after alcohol exposure. "Observations that alcohol induces changes in mRNAs involved in phagocytosis including members of the immune complement system is a novel finding suggesting that alcohol consumption can lead to dysregulation of clearance processes in the CNS central nervous system," the researchers say.

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb is being urged to give Congress recommendations on how to deal with drug shortages across the United States, reports The Hill . A bipartisan coalition of 31 senators, led by Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.), has called on the agency to have its Drug Shortages Task Force probe the cause of the shortages and develop policy recommendations on how to resolve the issues before the end of next year. Their letter to Gottlieb especially notes shortages of some routinely used medicines, including local anesthetics and sterile intravenous fluids. "These are essential products used every day, and for many of them there are no suitable alternatives that are readily available," the senators wrote. "This can result in suboptimal pain control or sedation for persons, and ultimately limit ... access to the most appropriate care."

The Circles of Caring adult day health program in Pullman, Wash., has evolved from a pilot program originally designed to address a gap in services for people with dementia and Alzheimer's to provide health services for adults with various chronic illnesses, reports the Associated Press . Circles also provides respite care for participants' caregivers. Medicare was supposed to assume funding for the program after the conclusion of a three-year federal rural health outreach grant secured in 2001. Instead, the Gritman Medical Center underwrote Circles until 2012, investing some $3.8 million. "The number of people with dementia and Alzheimer's increases every year, and there's still no availability of funding for these services," notes former Circles co-director Sharon Benson. "I hope at some point Medicare will come to their senses and realize these programs are less expensive." Circles is currently run by participants' families with the help of local donors, and Executive Director Hollie Mooney says the program concentrates on holistic health, with staff monitoring participants' physical, social, and cognitive functioning. "You need to be able to laugh and be social and support one another," Mooney says. "I see people that maybe can't fully be leaders out in the community, but they come here and they can help each other out."

Microsoft researchers conducted an employee survey to gain insights into new hires' experiences and first impressions of their company, reports the Harvard Business Review . "The little things matter most to new hires — like having a working computer and immediate access to the building, email, and the intranet on day one," the authors note. "Based on this, we pulled individuals together from payroll, IT, immigration, legal, global security, learning, procurement, recruiting, and HR to land on a common goal: Make sure new employees are productive on day one. Every member of the team contributed to the shared goal, and as a result all the organizational barriers were broken down. Now we review progress monthly, learning and sharing ideas and feedback to guarantee the success of all new employees." The investigators teamed with Microsoft's Workplace Analytics division to match anonymous calendar and email metadata with engagement data to better understand how early behaviors impact the new hires' engagement. Having a one-on-one meeting with a manager during their first week was essential, with early growth witnessed in the areas of internal networks and network centrality, higher-quality meetings, and team collaboration. "These and other insights are helping us shine a spotlight on the employee experience and guide us on where to adjust to make a new hire's experience even better," the authors write. "And this is just the beginning at Microsoft. We are now experimenting with other ways to improve the onboarding experience, with a focus on the new employees' network — particularly when the manager works in a different location."