A U.S. study published in Neurology suggests older adults with dementia may be less likely to get in car crashes when they are required to renew their driver's licenses in person, reports Reuters . The researchers analyzed state ordinances designed to keep cognitively impaired drivers off the road, including mandates that physicians report patients to state licensing officials and requirements for people to renew licenses in person, get vision exams, or take road tests. Researchers also studied data on 136,987 crash hospitalizations for drivers age 60 or up in 37 states from 2004 to 2009. Hospitalized crash victims in states with in-person license renewal were up to 38 percent less likely to have dementia than in other states. Crash victims also were up to 28 percent less likely to have dementia in states requiring vision testing as part of in-person renewals. The University of Pittsburgh's Yll Agimi says the study's outcomes suggest families should not depend on doctors reporting a person with dementia to the Department of Motor Vehicles (DMV) to keep their loved one safe. "The message for older drivers and their families is that the key to safe driving may be a combination of methods that includes self-monitoring of one's driving ability, continued self-regulation of driving, discussions with family and doctor on safe driving, as well as the key role of the DMV and its licensing requirements," Agimi notes.

The growing national dialogue about misogyny, sexual harassment, and assault prompted five older women in Southeast Washington, D.C., to recall their own past experiences in this vein, which indicate generational and cultural divergences from preconceived generalizations, reports the Washington Post . "Women in the old days, in the really old days, they didn't trust each other," says Mary Procter, 76. "One of the things that didn't use to happen is women sharing with each other. And now, they are." Disagreement between older and younger generations of women on what constitutes sexual harassment and the like, and whether women many be partly culpable, has complicated matters. However, author Ashton Applewhite, 65, says framing the debate as an age-driven disagreement is problematic in itself. "I'm super-resistant to the idea of framing this as, 'Yet again older feminists argue with younger feminists,'" she notes. "We are never going to learn from each other as long as we are in our age silos." Deborah Felton with the Fuller Village senior-living community in Massachusetts organized a presentation about sexual harassment for residents. She believes it is often more difficult for older people to feel confident speaking out about harassment or assault, but the #MeToo movement is emboldening them. Applewhite also says it is erroneous to assume older people are incapable of evolving. "To participate in the important issues of our day, it's incumbent on older people to stay current and learn what's out there," she contends. "You don't have to agree with it, but if you want to be part of it, you need to be an informed and helpful contributor and watch and listen to the winds of change, and feel empathy for what different people are going through."

A study published in the Journal of Occupational and Environmental Medicine found depression, anxiety, and fatigue heighten the risk of women getting injured at work, with mental health factors only affecting women's chance of work injury compared to men, reports Psych Central . The researchers examined the claims data of 314 businesses from various industries, and nearly 17,000 employees were represented. Although men were more likely to have a work-related injury than women, behavioral health factors did not directly impact their risk of injury. Women were more likely to report mental and behavioral health issues, and these conditions elevated their work injury risk. Nearly 60 percent of women with a work injury experienced a behavioral health condition prior to injury, versus 33 percent of men. "Keeping workers safe ... requires an integrated approach that connects health, well-being, and safety," says Colorado School of Public Health Professor Natalie Schwatka. However, she also notes workers who had a past injury were more likely to be injured again, regardless of sex. "There are a number of social and cultural factors that may explain why women reported having more behavioral health concerns than men did," Schwatka says. "Men generally admit to fewer health concerns. And women may face different stresses at work and at home. It's something that is worth exploring in future research."

A U.S. study published in the Journal of the American Geriatrics Society suggests older adults may be less likely to get tested for flu in the hospital, reports Reuters . Analysis of data on 1,422 adults hospitalized with a respiratory illness or a high fever at four Tennessee hospitals during the flu seasons from 2006 to 2012 found only 399 people had flu tests ordered by their doctors. Seventy-seven of these subjects actually had the virus. Tests ordered by the researchers detected flu in another 59 subjects, or nearly 6 percent of the cohort that did not have flu tests ordered by their doctors. Persons whose physicians ordered flu tests tended to skew younger, around 58 years old on average, compared to 66 years old for people who did not get tests. The implication is that many of the older adults with flu would have gone undiagnosed and untreated, says Vanderbilt University Medical Center's Dr. H. Keipp Talbot. "If influenza is not considered as a potential cause of the illness, it is unlikely that the patient will be treated for influenza," he notes. Talbot says sometimes older adults are not tested for flu because they exhibit a high fever, although the older adults in the study did have fever or other symptoms of respiratory illness that would make them good testing candidates.

A study published in Neurology found older people who are unaware they have memory problems are nearly three times more likely to develop dementia within the next two years, reports the Daily Mail . Certain brain conditions can interfere with a person's ability to understand they have a medical issue. Such memory problems are called anosognosia and are often associated with Alzheimer's disease. Analysis of data from the Alzheimer's Disease Neuroimaging Initiative examined how people rated their own cognitive abilities and compared this with similar polls filled out by close relatives. When someone said they had no cognitive problems, but the relative reported significant difficulties, they were considered to have anosognosia. This cohort was then determined to have impaired brain metabolic function and higher amounts of amyloid deposition, versus those without anosognosia. A two-year follow-up showed they were more likely to have developed dementia, which was reflected by higher brain metabolic dysfunction in regions vulnerable to Alzheimer's. "People with mild memory complaints should have an assessment that takes into account information gathered from reliable informants, such as family members or close friends," recommends McGill University Professor Serge Gauthier.

The Memory Ensemble is an eight-week intervention program for people with early-stage dementia that uses improvisational theater, arranged by partners that include the Cognitive Neurology and Alzheimer's Disease Center, the Northwestern Feinberg School of Medicine, and the Lookingglass Theater Company, reports the Administration for Community Living (ACL). A webinar scheduled for March 13 will include the history of the Memory Ensemble, a review of the literature on the impact of the arts and improvisation on dementia and aging, a review of Memory Ensemble research findings so far, an introduction to basic improvisation principles and how they relate to work with persons with dementia, examples of activities in which participants can engage in multiple environments to improve quality of life for and with people living with dementia, and suggestions for further reading. Webinar presenters will be able to list three beneficial outcomes for Memory Ensemble participants; characterize a fundamental concept of improvisation — "yes, and" — and how engaging this idea can help in working with people with dementia; and describe and implement four improvisational activities — check-in, warm-up, skill-building, and check-out — that can be used and/or adapted for working with persons with dementia in multiple settings. For this webinar series, the ACL's National Alzheimer's and Dementia Resource Center has teamed with the American Society on Aging. Registration can be found here .

The U.S. Food and Drug Administration has proposed guidelines to lower the clinical study goals of Alzheimer's disease drugs for treating earlier-stage subjects who have yet to exhibit functional disability or clinical abnormality, reports NASDAQ . This strategy suggests the agency may be amenable to an expedited approval process for such drugs. The proposal follows major Alzheimer's drug failures, including those for verubecestat and BAN2401. In January, Pfizer reportedly announced the discontinuation of its research and development efforts in the Alzheimer's and Parkinson's disease areas, while much earlier the company shelved its late-stage Alzheimer's candidate, bapineuzumab IV, after it failed two phase III studies. Last November, Lilly's LLY anti-amyloid candidate solanezumab did not meet the primary endpoint in a late-stage Alzheimer's study, and Lilly opted to terminate the development of solanezumab. The drugmaker also experienced a major setback in August 2010, when it had to stop development of another phase III Alzheimer's candidate, semagacestat.

Harlene Goodrich, 80, and Dorothy Kelly, 91, are in agreement on the fundamentals of aging well, which include organizing and reorganizing circles of supportive friends, active participation in political and non-political groups, maintaining physical activity, finding outlets for creative expression, and remaining emotionally active, reports Kaiser Health News . Former schoolteacher and Californian Goodrich continues to meet regularly with her fellow retired teacher friends, and she says humor is essential to coping with aging. "Humor is an important thing when you reach the point in your life when every week contains at least one doctor's appointment," she notes. Goodrich and Kelly concur that a fundamental to aging well is to positively begin the process when you are still youthful by staying engaged with people and with stimulating activities. Goodrich has sustained her interest in exploring the world, an activity she enjoyed with her second husband, even after his passing. Denver, Colo., author and counselor Neil Rosenthal credits a sense of wonder as key to Goodrich and Kelly's drive to continue achieving great things in their 80s and 90s. "If you don't do these kinds of things, you will grow old; and if you do do these things, you will still grow old — but much more slowly," he says.

Intergenerational care provides an environment where children and seniors inspire and learn from each other, and is seen as an opportunity to impart wisdom to the younger generation while older adults benefit from relationships and more longevity, reports CNN . The U.K.-based Jewish care community Nightingale House offers an example of such a program with its Apples and Honey Nightingale program, which offers children and residents activities such as baking, gardening, art, and exercise. Participating residents respond "to an external stimulus, which is a toddler with an adorable grin fumbling towards them, carrying a toy, trying to interact," says Apples and Honey Nightingale co-founder Ali Somers. She also notes residents "very often forget their own physical limitations, and they find that they are encouraged; they stretch themselves; they will lean up out of their chair, extend a hand, engage in conversation." The residents' average age is older than 90 while 10 percent are over 100, which makes mobility, frailty, and loneliness priorities. Somers says when residents are more engaged, they are encouraged to walk down to the nursery to see the children. "They're going outside more. They want to opt in to working with and spending time with and playing with the children." Intergenerational care is inspired by similar movements in the United States and elsewhere, with Apples and Honey Nightingale co-founder Judith Horowitz noting "people are becoming more and more aware of the age apartheid that we live with."

Data from the Centers for Disease Control and Prevention (CDC) published in the Morbidity and Mortality Weekly Report estimates 75 percent of people vaccinated for the flu this year were not protected against the H3N2 strain responsible for most infections in the current season, reports STAT . The vaccine was more effective against influenza B and H1N1 viruses, but only about 8 percent of people who tested positive this season were infected with strains from the influenza A family. "We are a bit concerned that the performance of the vaccine right now might reduce interest in getting vaccinated in the future," says Acting CDC Director Dr. Anne Schuchat. "But we have the other side that flu was just so bad so far this season, so many people have been sick and see how miserable it is." A previous study analyzing H3N2 protection over a number of years determined the vaccine's average effectiveness was about 32 percent or 33 percent. The CDC report says the H3N2 vaccine performance was less effective in older adults compared to children. Seniors aged 65 and up saw their risk of needing medical care for flu lowered by 17 percent, and in adults 50 to 64 the H3N2 component's efficacy was only 10 percent. Possible contributing factors to the vaccine's low effectiveness against H3N2 include mutations that occur in vaccine viruses when they are cultured in eggs.