A study published in the British Journal of Clinical Pharmacology found potentially dangerous prescriptions are common at the time when older adults are released from hospitals, with 83.8 percent of 259 older adults receiving at least one potentially inappropriate medication (PIM) or having a potential prescribing omission (PPO), reports Medscape . "PIMs and PPOs identified using the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert Doctors to the Right Treatment (STOPP/START) have been associated with increased frequency of adverse drug reactions, increased morbidity and mortality, and reduced quality of life," note the researchers. "Interventional studies applying these criteria to reduce PIMs and PPOs have reported reduced incidence of adverse drug events, falls, and delirium with reduced duration of hospitalization and healthcare costs." When they were released, the study subjects had an average of 5.4 comorbidities. They were prescribed an average of 9.3 distinct medications when they were released, with 88.8 percent receiving five or more distinct medications and 44 percent receiving 10 or more distinct medications. Subjects had an average of two re-hospitalizations, and 50.2 percent died during follow-up. Persons who had more than five medications prescribed were more than twice as likely to have PIMs and more than three times as likely to have PPOs, versus those prescribed fewer than five medications. Those with a PIM were twice as likely to have three or more re-hospitalizations and those with PPOs also were more likely to die. "It is possible that the failure to commence evidence-based therapies may result in increased morbidity and mortality or that in a population with high inherent mortality and poor prognosis prescribers are less willing to add to their medication burden," the researchers suggest.

A study published in Multisensory Research found older people's brains do not warn them to grip heavy objects tight enough, reports BBC News . The researchers assessed 20 adults with an average age of 71, and 20 with an average age of 23, by showing them black plastic cylinders of different sizes, but that weighed the same. Each cylinder had sensors atop it to measure the grip forces that each person used when grasping and lifting them. The scientists say both cohorts were equally susceptible to "size-weight illusion," believing the smaller cylinders felt heavier than the larger ones. However, while the younger cohort adjusted the amount of force they used to pick up the cylinders depending on what size they were, the older group failed to. "Not only do we experience objects partly based on how they look, this changes as we get older," says Heriot-Watt University Professor Lauren Potter. "To compensate for 'normal' age-related decline in physical and cognitive ability, older adults may use mental shortcuts to guide how they act. "They may be redirecting their cognitive resources away from using visual cues to predict an object's properties towards more demanding aspects of the task, such as having a steady lifting action."

A review published in JAMA Internal Medicine found psychological interventions have small benefits for older adults with chronic pain, reports HealthDay News . The researchers analyzed data from 22 studies with 2,608 participants, and noted differences of standardized mean differences at post-treatment for pain intensity, pain interference, depressive symptoms, anxiety, catastrophizing beliefs, self-efficacy, physical function, and physical health. For pain only, there was proof of effects continuing beyond post-treatment assessment. Only mode of therapy had a consistent impact in favor of group-based therapy in moderator analyses. "Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain," the team notes. "These results were strongest when delivered using group-based approaches. Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain."

A study published in Neurology found a vegetable-, fruit-, nut,- and fish-rich diet may give older adults bigger brains, reports Medical Xpress . "People with greater brain volume have been shown in other studies to have better cognitive abilities, so initiatives that help improve diet quality may be a good strategy to maintain thinking skills in older adults," says the Erasmus University Medical Center's Meike W. Vernooij. Included in the study were 4,213 dementia-free Dutch people, average age 66. The researchers studied their diet quality based on Dutch guidelines by examining intake of vegetables, fruit, whole grain products, legumes, nuts, dairy, fish, tea, unsaturated fats and oils of total fats, red and processed meat, sugary beverages, alcohol, and salt. The optimal diet consisted of vegetables, fruit, nuts, whole grains, dairy, and fish, and limited consumption of sugary drinks. All participants underwent magnetic resonance imaging brain scans to determine brain volume, the number of brain white matter lesions, and small brain bleeds. Subjects had an average total brain volume of 932 milliliters. Following adjustment for age, sex, education, smoking, and physical activity, the team found a higher diet score was associated with larger total brain volume. Consumers on a better diet had an average two milliliters more total brain volume than those who were not. No association was seen between diet and brain white matter lesions or small brain bleeds.

A study published in the British Medical Journal determined exercise regimens for people with mild to moderate dementia yield no benefits in terms of improving thinking skills or behavior, reports BBC News . Involved in the study were 329 people with dementia in their 70s who performed aerobic and strength exercises over four months. Their twice-weekly sessions lasted 60 to 90 minutes each, and the subjects spent at least 20 minutes on a fixed cycle and lifted weights while getting out of a chair. They were encouraged to perform these exercises at home for another hour each week. Oxford University Professor Sallie Lamb says the results demonstrated that people who had had dementia for two or three years could follow simple exercise instructions and improve their fitness and muscle strength, but there were no perceived improvements in cognitive impairment, daily living activities, behavior, or health-related quality of life. After one year, cognitive impairment had declined in both the exercise group and a non-exercising control group with dementia, but only slightly. "The message remains that exercise is good, but to start an exercise regime once the disease is well established may be of limited value," says University College London Professor Martin Rossor.

The U.S. House is expected to vote on reconciliation of the Senior Safe Act as part of its bigger reform package next week, reports Financial Advisor . The law would encourage financial advisers and their firms to disclose the financial exploitation of senior clients by shielding them from liability and the violation of privacy laws. "We are encouraged this legislation is advancing and urge Congress to move it forward to become law," says Lisa Bleier with the Securities Industry and Financial Markets Association. The bill also encourages financial services companies to offer standardized training to frontline employees and producers to help them spot and report instances of suspected abuse. By granting immunity, the Senior Safe Act would enlist advisers to help staunch the flow of financial fraud against seniors, according to Financial Services Institute CEO Dale Brown. "By encouraging the reporting of suspected fraud, the Senior Safe Act improves the ability of companies to work with regulators to protect seniors from losing their retirement savings," notes American Council of Life Insurers President Dirk Kempthorne. The National Association of Insurance and Financial Advisers (NAIFA) also has been working with lawmakers in support of the legislation. "NAIFA worked hard with lawmakers to craft legislation that encourages advisers to protect their senior clients and give them mechanisms for doing so while shielding advisers who act in good faith and with reasonable care from liability," says NAIFA President Keith Gillies.

The amount of time off spent by employees can be monitored via a "no-fault" attendance policy, in which workers accrue "points" for unexcused absences, late arrivals, or early departures that can be applied toward discipline or even dismissal once a certain threshold is reached, reports CNN Money . Sometimes employees have to miss work for a reason, such as disability or childbirth, which is legally protected, and this can create problems for employers with inconsistent no-fault policies. For example, two former AT&T Mobility workers recently filed a proposed nationwide class action suit claiming the company's no-fault attendance policy for retail employees unlawfully discriminates against pregnant women. No-fault attendance policies can help supervisors avoid having to make judgment calls and remove any perceived prejudice when it comes to granting time off. When drafted and applied properly, the policies also provide clear guidance on how much time off employees receive and help employers and employees better track missed days. Still, the policies have become less popular in the last five years due to potential legal issues and high-profile litigation, says Jennifer Sims at the Kullman Firm. "Problems occur when not everyone applies the policy consistently, especially when you have a major company with thousands and thousands of employees," notes Janica Pierce Tucker with Taft Stettinius & Hollister. Supervisors should be educated to ask correct questions to determine when absences are federally protected.

A study published in Lancet Psychiatry analyzed how work conditions may impact mental health among 6,870 employees, and determined that people experiencing job stress at 45 years old were more likely to develop depression, anxiety, or other mental disorders by age 50, reports MarketWatch . "These findings serve as a wake-up call for the role workplace initiatives should play in our efforts to curb the rising costs of mental disorders," says University of New South Wales Professor Samuel Harvey. The researchers examined employees' decision authority, skill discretion, job pace, intensity, and conflicting demands to rate their level of job strain. More strain translated into higher rates of mental illness irrespective of gender, occupation, or class. "This research provides strong evidence that organizations can improve employee well-being by modifying their workplaces to make them more mentally healthy," Harvey notes. Employers are increasingly permitting workers to treat mental health days like normal sick days, and every $1 spent on mental health training yields a return of investment of nearly $10, according to an earlier study from the Black Dog Institute.

Software developed at Imperial College London (ICL) and the University of Edinburgh has helped enhance stroke and dementia diagnosis by quantifying the severity of small vessel disease (SVD), according to a study published in Radiology . "This is the first time that machine learning methods have been able to accurately measure a marker of small vessel disease in people presenting with stroke or memory impairment who undergo computed tomography (CT) scanning," says ICL's Paul Bentley. The researchers used the historical data of 1,082 CTs of people who had strokes across 70 U.K. hospitals over 14 years. The software identified and measured an SVD marker, producing a severity score. The team compared the results to a committee of expert physicians, whose estimated SVD severity matched the software's. In addition, the application of magnetic resonance imaging to estimate SVD in 60 subjects demonstrated that the software is 85 percent accurate at predicting severity.

A new study published in JAMA Psychiatry suggests low-income seniors may be more susceptible to developing dementia, reports HealthDay News . "Public health strategies for dementia prevention should target socioeconomic gaps to reduce health disparities and protect those who are particularly disadvantaged," says University College London's Dorina Cadar. Differences in lifestyle and overall health are contributing factors, and wealthier people have greater social and cultural opportunities allowing them to remain actively engaged with the world. The team collected data on more than 6,200 men and women aged 65 and older. Seven percent developed dementia in the 12 years between 2002-2003 and 2014-2015. The risk of dementia was 50 percent higher among the poorest people versus the most affluent. "Poor financial management may be an early sign of dementia, such that financial resources are depleted late in life," notes Dr. Dr. Sam Gandy with the Mount Sinai Center for Cognitive Health and NFL Neurological Care. "This may also be a manifestation of executive thinking dysfunction, such as paying bills multiple times, or poor judgment and vulnerability to scam artists."