A growing body of evidence indicates that rates of dementia may be declining, in part because older adults' cognitive abilities, such as learning and memory functions, are better than those of older adults in the past, according to ScienceDaily . But most data have come from almost entirely white cohorts living in high-income countries, calling into question the universality of the trend. A study of a majority-black cohort, published in a special supplement to the Journal of Gerontology , found no clear upward trend in cognitive abilities among older adults. The study used data from the Chicago Health and Aging Project (CHAP), which has followed a total of 10,802 individuals 65 years old or older living on the south side of Chicago since 1993. The cohort is 60 percent black and 40 percent white. Participants underwent cognitive assessments in six three-year study cycles from 1993-1996 through 2010-2012. The researchers computed three measures of cognitive performance: episodic memory, perceptual speed, and a "global" measure of cognition that summarized performance on the entire battery of four tests.

The Centers for Medicare and Medicaid Services' (CMS) Center for Medicare & Medicaid Innovation is soliciting feedback on the creation of a program that allows providers to contract directly with patients for care, sidestepping insurers and the Medicare program, in a new request for information published Monday. Under one scenario outlined by CMS, a medical practice could receive a lump sum payment from Medicare for each patient to cover basic primary care services with a chance to earn bonuses from CMS for additional care or quality. The model would give doctors the alternative of avoiding claims submission. Responses are due May 25.

One of the major reasons women save less than men is that they spend 44 percent of their adult lives out of the workforce, compared to just 28 percent for men, according to a study from Merrill Lynch on Women and Financial Wellness. The result is a potential cumulative wage gap of over $1 million, Reuters reports. To combat this, working women need think about the long-term impact of stopping work. "Retirement is no longer a switch that you turn on and off," said Maddy Dychtwald, co-founder of Age Wave, which conducted the study with Merrill Lynch. The study also noted that two-thirds of care provided to older adults is done by women. A separate study from Fidelity Investments found that the top reason women leave the workforce early is because of a health concern. This health matter typically relates to a spouse, but also sometimes to older parents or even grandchildren.

Research published in the Canadian Medical Association Journal finds that opioid use is linked to an increased risk of falls and death in older adults, reports EurekaAlert . The researchers examined opioid prescriptions in the two weeks before an injury. They found that the people who had filled a prescription for opioids during this time period were 2.4 times more likely to have a fall resulting in an injury. Individuals who had falls linked to opioid use were also more likely to die while in the hospital. The study included 67,929 participants with an average age of 81. The majority of the people studied were women.

U.S. Health and Human Services Secretary Alex Azar has announced that James Parker, former CEO of MDWise, a Medicaid managed care organization in Indiana, will serve as senior advisor to the Secretary of Health Reform and director of the Office of Health Reform, reports Healthcare Finance News . In his new role, Parker will address the cost and availability of health insurance. Parker's appointment follows that of Daniel M. Best as senior advisor to the secretary for Drug Pricing Reform and of Brett Giroir as senior advisor to the secretary for Mental Health and Opioid Policy, as well as assistant secretary for Health.

New technologies have emerged that can help companies obtain a more diverse staff, reports Business News Daily . Hundred5 is software that allows job applicants to take a skills-based test. Potential hires who score low are eliminated before employers can make generalizations based on race or gender. Other tools like Pymetrics and Gapjumpers use online surveys and quizzes to determine ideal candidates without seeking demographic information. There are also platforms that allow employers to review applications with information like names, gender, and ethnicity hidden. Finally, Textio can be used to improve the effectiveness of job postings by recommending different wording to eliminate gender or culture bias.

Aiming to better understand how older drivers' crash risk changes over time and to identify tools to measure this risk, University of Washington researchers applied a specific cognitive test to a group of 2,615 licensed drivers age 65 and older, reports ScienceBlog . In a study published in the Journal of the American Geriatrics Society , the researchers employed the Cognitive Abilities Screening Instrument using item response theory (CASI-IRT), which assigns a score based on cognitive skills such as attention, concentration, short-term memory, visual construction, and judgment. The study did not include any individuals who had been diagnosed with dementia or Alzheimer's. The findings suggest that CASI-IRT may be useful to evaluate crash risk.

60 Minutes took a composite look at how one couple coped with Alzheimer's disease both in the early years of the diagnosis and then year-by-year thereafter. For a decade, CBS News chief medical contributor Dr. Jon LaPook has been checking in on Carol Daly, a woman diagnosed with Alzheimer's, and her caregiver husband, Mike. In "For Better or Worse," viewers will meet the loving couple who, over the course of seven interviews in 10 years, both face the devastating health consequences of the disease. The story begins in 2008 when Carol's dementia was just becoming obvious, and then traces her decline as well as Mike's dramatic journey. The story shines a light on the physical, emotional, and financial consequences of chronic dementia on both the individual and the caregiver, and LaPook says he hopes the story will offer comfort to the families of the 5.4 million Americans living with the disease.

The Trump administration says it plans to roll back a rule issued by President Barack Obama that prevents doctors, hospitals, and health insurance companies from discriminating against transgender people, reports the New York Times . The rule was adopted in 2016 to carry out a civil rights law embedded in the Affordable Care Act that prohibits discrimination based on race, color, national origin, sex, age, or disability in "any health program or activity" that receives federal financial assistance. The Obama administration said the rule covered "almost all practicing physicians in the United States" because they accept some form of federal remuneration or reimbursement. It applies, for example, to hospitals that accept Medicare and doctors who receive Medicaid payments, as well as to insurers that participate in health insurance marketplaces. Trump administration officials said they believed they had to modify the rule because a federal judge in Texas had found that parts of it were unlawful. The judge temporarily stopped enforcement of the protections for transgender patients, saying that Congress had outlawed discrimination based on sex — "the biological differences between males and females" — but not transgender status.

60 Minutes this weekend will air a decade-in-the-making video by New York University Langone Medical Center Professor Jon LaPook documenting the long-term effects of Alzheimer's disease on a woman and her husband-caregiver, reports Forbes . The film chronicles how the husband's caregiving burden grows as his wife's memory steadily deteriorates, thus demonstrating what people in similar situations may eventually face. Her ordeal also took a toll on her husband, who gained weight and struggled with anxiety and panic attacks. According to LaPook, the Alzheimer's Association told 60 Minutes it is not aware of any other video study of such length documenting the progression of the disease. "People need to discuss while they are still with it what they would want if they became demented," LaPook says. "And because it's often easier to say what you would want or not want when you're young and healthy and far from death, they need to keep having those conversations as their realities keep changing." The Alzheimer's Association reports the development of biomarkers for Alzheimer's is making it possible to identify the disease and make an accurate diagnosis earlier than at any other time in history. Early diagnosis lets individuals prepare legal, financial, and end-of-life plans while they are still cognitively able to do so. LaPook says as researchers keep looking for a cure, he thinks the solution will lie in much earlier diagnosis and medication that will keep Alzheimer's at bay.