A Johns Hopkins study published in JAMA Internal Medicine focused on conducting cancer screening tests in older people, and found respondents felt they understood the concept of stopping testing when they get too old to benefit, reports physician Peter Ubel in MedPage Today . However, they were unhappy at the thought of doctors telling them that their impending mortality is the reason they should no longer receive such testing. The seniors preferred doctors delivering the same information in a less harsh manner that does not force them to think about their age or how soon they are going to die. "I encourage all physicians to try this kind of language," Ubel writes. "There's no need to remind people of the obvious fact that they are getting closer to the end of their lives. When helping patients avoid the harms of unnecessary testing, physicians should also avoid hurting their feelings."

The Chan Zuckerberg Initiative is inviting applications to the CZI Neurodegeneration Challenge Network, an interdisciplinary effort to increase understanding of the basic biology of neurodegenerative disorders. The network's objectives include advancing the understanding of neurodegeneration, bringing new ideas and talent to the neurodegeneration field, and encouraging a new type of interdisciplinary collaborative research involving scientists, clinicians, and engineers. Applications are being taken for the CZI Ben Barres Early Career Acceleration Awards given to early career academic investigators, and the CZI Collaborative Science Awards for small group interdisciplinary collaborations that include a physician with active clinical engagement. The network will be formed by exceptional, innovative, forward-thinking researchers from different disciplines who would collaborate on questions related to the basic cell biological mechanisms of neurodegeneration in the context of human disease biology. CZI will ask investigators to contribute to the development, validation, and distribution of resilient, dependable, and scalable experimental and analytical tools for the wider neurodegeneration community. The initiative also will provide infrastructure support for such efforts. The network is encouraging applications for the awards from both investigators looking into underexplored topics and those focusing on more well-developed mechanisms where there remain significant gaps in understanding.

A new study published in Lancet Public Health found the risk of developing early-onset dementia could be elevated by excessive alcohol consumption, reports CNN . The researchers examined the French National Hospital Discharge database to determine alcohol-use disorders were diagnosed in 16.5 percent of men with dementia and 4 percent of women with dementia. "The most novel result is the large contribution of alcohol-use disorders to the burden of dementia over the lifespan," says Dr. Michael Schwarzinger at the Transitional Health Economics Network in Paris. The connection was especially strong for people with early-onset dementia, diagnosed when they were younger than 65. More than 50 percent of those in the early-onset group had alcohol-related dementia or an additional diagnosis of alcohol-use disorder. When other variables were not controlled for, heavy drinking was linked to a higher risk of dementia among both men and women. The risk rose by a factor of 4.7 in men, and by a factor of 4.3 in women. Even when the team controlled for factors such as high blood pressure, obesity, and tobacco smoking, heavy alcohol use was still associated with a more than threefold increase in dementia among both genders. "Men have a poorer lifestyle than women on average, in particular heavier alcohol consumption," Schwarzinger notes. "Therefore, it is somewhat unsurprising that early-onset dementia identifies a cluster of men with alcohol use disorders."

The Trump administration's new proposal to expand the availability of short-term health insurance plans is seen by many healthcare experts as another attempt to undermine Affordable Care Act (ACA) marketplaces, reports Politico . The measure follows the issuance of a rule encouraging small businesses to find coverage outside ACA marketplaces, with Health and Human Services Secretary Alex Azar saying the latest move "represents an important promise kept by the president." Critics warn the plans offer the appearance of coverage, and enrollees often fail to understand how limited their benefits are until it is too late. Short-term plans maintain lower prices than traditional insurance by not covering pre-existing conditions and certain medical services. The plans usually cap payouts, which could force enrollees with catastrophic illnesses or injuries to pay out-of-pocket for huge medical bills. "It's a quick fix, but ultimately those products don't help consumers who need them," says Georgetown University Professor Kevin Lucia. The short-term plans' backers call them an affordable insurance option for people who do not want robust coverage and have been priced out of the individual market. In January, Trump also proposed expanding the availability of association health plans, in which small businesses and self-employed individuals combine to purchase coverage. These plans are exempt from some ACA regulations, including the requirement to cover a set of health benefits deemed "essential," such as prescription drugs and emergency care. "There won't be a death spiral, but the people who really lose in that scenario are basically middle-class people who are sick," says Michael Miller with Community Catalyst.

The West Tisbury Public Library in Martha's Vineyard, Mass., is a popular gathering place for older adults with enhanced programming, reports Next Avenue . Three years ago, the library conducted a survey to gauge patrons' needs, and three-quarters of respondents were 51 and older. Last year the library issued a strategic plan which envisioned the place as "a community center where life-long learning happens in a blended environment of quiet and collaborative space allowing self-discovery and connections between people." "We share a campus with the Up-Island Council on Aging, and most of our patrons use both services," says West Tisbury Public Library Director Beth Kramer. "On Tuesday mornings, they host a popular discussion group, and after that's over, many people come over to the library to read the paper, check out books, or just visit with each other." In 2016, the library and the Up-Island Council established a small core group of locals who met regularly to talk about hat they were interested in learning about aging and healthy lifestyles. "Rather than offer a dry series of presentations, we wanted to feature programs that were really of interest," Kramer notes. To improve the library's comforting ambiance, coffee and biscotti are available at minimal cost, while quiet rooms have been set aside for writers to work.

A bipartisan bill in the Wisconsin Legislature would set up a $1,000 tax credit for family caregiver expense, reports the Wisconsin State Journal . The bill is part of a package of proposals related to dementia and caregivers. Other measures would establish a certified dementia care specialist program, distribute Alzheimer's awareness grants, and allow Wisconsin courts to communicate with courts in other states about guardianship issues. "This is an attempt to ease the burden and the stress on the caregivers," says AARP Wisconsin's Helen Marks Dicks. The tax credit bill would permit adult family members with Alzheimer's or other conditions requiring assistance with daily living to claim half of qualified expenses for a credit of up to $1,000; the caregiver's annual income could not top $75,000 for an individual or $150,000 for a couple. Medicaid's Family Care and IRIS programs cover caregiving costs for low-income people, and some families can afford long-term care insurance, but many people pay out of pocket. "In many ways, these caregivers save taxpayers money by keeping loved ones out of costly nursing communities that are funded or subsidized by state tax dollars," notes Sen. Patrick Testin (R-Wis.). The Department of Revenue estimates the bill would cost $179 million annually, assuming 363,000 people claimed an average credit of $494. Marks Dicks says lawmakers want to reduce the cost by lowering the bill's income cap, reducing the tax credit amount for people with incomes near the cap, and requiring the care recipient be a Wisconsin resident.

A growing number of companies are paying employees to get their financial lives in order, reports the Wall Street Journal , reflecting concern over the impact money problems are having on employees' stress and productivity levels. The companies are handing out cash and other inducements to workers who take steps to shore up their finances by paying down debt, funding emergency-savings accounts, and attending financial-education classes with advisers. Among American corporations with so-called financial-wellness programs, 17 percent offered incentives for participation in 2016, an increase from 10.7 percent two years earlier. An additional 8 percent said they were considering such a move, according to the International Foundation of Employee Benefit Plans.

Managing increased stress for the long term entails nurturing resilience skills before seeking outside solutions, and these skills include adaptability, a healthy relationship to control, ongoing learning, a sense of purpose, and knowing how to leverage support and appropriate resources, reports the Harvard Business Review . One immediate action is to reframe perception of stress as something that can strengthen job coping skills in the future, while also not overlooking signs of burnout. A healthy relationship to control can be cultivated by separating out what is and is not controllable, and recognizing your ability to choose how to interpret or frame the latter. Employees also should take pains to reflect on their personal context as well as the larger business and global context to better identify the root causes and possible ways to mitigate and avoid future stress. Awareness of habits and instinctual responses and seeking additional support to build skills to more comfortably navigate conflict would be of benefit. Finally, connecting learning with action can be done by first analyzing what could be learned from stress, and then making conscious choices to help build up coping skills.

A study published in JAMA Internal Medicine suggests the herpes zoster subunit vaccine (HZ/su) is an effective, cost-saving option for shingles prevention in comparison with live-attenuated herpes zoster vaccine (ZVL) among adults aged 60 years or older, reports Healio . The researchers used a Markov decision model to compare the cost-effectiveness of HZ/su to no vaccination and vaccination with ZVL among immunocompetent adults aged 60 years or older. At all ages, HZ/su was more effective and less costly than ZVL. Based on vaccination age, the incremental cost-effectiveness ratios for HZ/su ranged from $20,038 to $30,084 per quality-adjusted life-year (QALY) versus no vaccination. The researchers observed that HZ/su would have lower overall costs than ZVL up to a price of $350 per series. For older adults, HZ/su was 73 percent likely to be cost-effective at $50,000 per QALY. However, the team caution that the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommendation of preferring HZ/su over ZVL could lead to future price hikes, which would neutralize the vaccine's cost-effectiveness. "Therefore, a recommendation linked to periodic reassessment of cost-effectiveness based on the vaccine price might help to mitigate the effect of the recommendation on vaccine affordability," they note.

A new audit from the Social Security Administration's (SSA) Office of the Inspector General (OIG) found 82 percent of widows and widowers entitled to spousal benefits are being underpaid, reports Financial Advisor . The agency failed to notify widowed spouses that they can claim survivor benefits while still delaying their own benefits until age 70. "Based on our random sample of 50 beneficiaries, we estimate 11,123 would have been eligible for a higher monthly benefit amount had they delayed their retirement application for their own benefits until age 70," OIG noted. "Of these, we estimate SSA underpaid about $131.8 million to 9,224 beneficiaries who are now age 70 and older." The audit determined although it is up to eligible claimants to ascertain whether they want to take benefits before age 70, "SSA needs to improve controls to ensure it informs widowed beneficiaries of their option to delay their application for retirement benefits." When they apply for those, it is automatically viewed by the SSA as an application for both benefits. In nearly all cases, agency employees did not inform claimants of their age-based options and the growing benefits available for each year the claimants waited to apply. "We did not find any evidence SSA had informed claimants of the option to delay their retirement application when they applied for benefits, as required," OIG said. "We also found that SSA did not have systems controls in place to alert its employees when they should inform widows of their option to delay their applications for retirement benefits."