A new algorithm created by the University of Waterloo is designed to help first responders and home care providers better aid seniors during natural disasters, reports News-Medical . The algorithm uses data from the interRAI research network's home care assessment to produce an up-to-date list of vulnerable seniors using home care services. It accounts for disability, health status, social isolation, and the amount of support an individual may receive from informal caregivers. Eight Canadian provinces/territories already require the use of the interRAI assessment for long-stay home care clients, who are assessed every six to 12 months to determine their health status and service needs. "Older adults living on their own are more difficult to locate and assist than those living in healthcare communities," notes algorithm developer Sandy Van Solm, the Emergency Management Coordinator at the Region of Waterloo. "This algorithm helps us to plan for disasters in advance and allows responders to quickly generate an accurate list of those who may need help during a disaster." Van Solm and the University of Waterloo's John Hirdes are collaborating with the Canadian Institute for Health Information to implement the algorithm into interRAI home care software used across Canada beginning next year. "It has the potential to save hundreds of lives," Hirdes says. "It's a tool that should be top of mind for any part of the country at risk of natural disasters."

A study published in Dementia determined the direct involvement of the thousands of "informal carers" for persons with dementia in the evaluation of individual symptoms and behavior could offer better insights for healthcare professionals and help alleviate feelings of stress, guilt, and isolation, reports ScienceDaily . Earlier research found informal caregivers often exhibit higher levels of depression and stress and poor self-rated health, as well as greater feelings of entrapment and guilt leading to further depression and a lack of self-belief in the quality of the care that they can provide. "Our study has recognized a need for better information and education not only for carers but for healthcare professionals to create a better and more empathetic understanding of the physical and behavioral deterioration of the disease as well as surrounding issues like financial pressures and modifying the home environment to compensate for individuals' every day difficulties," says University of Lincoln Professor Niroshan Siriwardena. The study also demonstrated that caregivers have a key role to play in the monitoring of care recipients' behavior and behavioral triggers, notes University of Lincoln Professor Terence Karran. "It was felt that keeping a daily diary of symptoms and behaviour could help to empower caregivers as well as improving communications with healthcare professionals," he says.

A study published in Neurology found seniors who consume leafy green vegetables daily exhibited a slower rate of cognitive decline, compared to those who eat little or no greens, reports National Public Radio . Included in the study were 960 participants of the Memory and Aging Project. Their average age was 81, and none of them had dementia. The researchers assigned each participant to one of five groups based on the amount of greens eaten. Those who tended to eat the most greens were in the top quintile, consuming about 1.3 servings daily. Those in the bottom quintile reported eating little or no greens. After approximately five years of follow-up/observation, "the rate of decline for those in the top quintile was about half the decline rate of those in the lowest quintile," says Rush Medical College Professor Clare Morris. She notes even after adjusting for other variables that might play a role, including lifestyle, education, and overall health, "we saw this association between greens and a slower rate of cognitive decline over and above accounting for all those factors." Green vegetables contain a range of nutrients and bioactive compounds such as vitamin E and K, lutein, beta carotene, and folate. "They have different roles and different biological mechanisms to protect the brain," Morris says. She notes further study is needed to fully understand their effect, but researchers are aware that consuming too little of these nutrients can cause problems.

A study published in Neurology found in-person license renewal and driver vision testing laws to be more effective than mandatory doctor reporting of persons with dementia in keeping drivers with the condition off the road, reports HealthDay News . The researchers analyzed 2004-2009 data on nearly 137,000 older drivers in the U.S. who were hospitalized following a crash. Hospitalized drivers, aged 60 to 69, in states with in-person license renewal laws were approximately 38 percent less likely to have dementia than those in states lacking such laws. In addition, in states with vision testing at license renewal, drivers were 23 percent to 28 percent less likely to have dementia than those in states without vision testing requirements. Statutes requiring doctors to report drivers with dementia were not connected with reduced chance of dementia among hospitalized older drivers. "The results of our study point to age-based licensing requirements as an effective way to improve safety," say Steven Albert with the University of Pittsburgh's Graduate School of Public Health. "But such requirements also may cause social isolation and depression, and may be seen as ageist and discriminatory."

Senators from both parties are urging President Trump to increase funding for Alzheimer's research in his fiscal 2019 budget, reports The Hill . "At a time when the United States is spending more than $200 billion a year to care for people with Alzheimer's, we are spending less than two thirds of 1 percent of that amount on research," says the senators' letter to the president. "Although we have made progress in increasing funding, Alzheimer's research funding remains disproportionately low compared to its human and economic toll." The goal of the National Plan to Address Alzheimer's Disease is preventing and treating the disease by 2025. A bill passed in 2011 set up an Alzheimer's panel of experts, which has estimated that $2 billion is needed annually to help meet that goal. The Senate proposed boosting Alzheimer's research by $414 million in its fiscal 2018 bill, bringing the total budget to $1.8 billion. However, the measure has not been approved, as Congress has been passing short-term funding measures in view of fierce partisan bickering over federal funding. "Federal funding for Alzheimer's research is a wise investment," argue the senators in their letter to Trump. "We urge you to support efforts to meet the research investment objective set forth in the National Plan by boosting the current investment in Alzheimer's research in the fiscal year 2019 budget request."

EngageRocket CEO CheeTung Leong writes that employee engagement efforts, with the associated annual cycle of measurement via a poll, usually end in failure, reports Forbes . "For the average manager, the survey is an unwelcome aberration to their 'business-as-usual' (BAU) baseline," Leong notes. "They track what directly affects how their performance is measured: number of widgets produced, the yield on materials used, safety incidents, project milestones, budget, and others. Therefore, the steps they take directly impact some or all of these numbers. They don't base their plans on six-month-old survey data." Leong cites the work of Huggy Rao and Robert Sutton on how companies can scale excellence by handling the "cognitive load" of an organization. "While collecting employee engagement data is important in helping leaders motivate their teams better, the load created may not always be worth the insight generated," he says. "It also can create a drag on productivity as capacity that could be used in alternative programs is channeled towards the administrative burden of running surveys." Leong thinks "pulse surveying" is a more effective employee engagement model, in that it allows teams to self-regulate, managers to monitor the impact of their leadership style, and human resources to stage interventions to be more strategically targeted at workers that consistently find themselves needing help.

A study published in the Journal of the American Geriatrics Society found older adults with metabolic syndrome have more severe symptoms and chronicity of depression, and take longer to respond to antidepressant drugs, reports Healio . A secondary analysis of a randomized controlled trial involved 435 adults aged 60 years or older with major depressive disorder who were taking extended-release venlafaxine for at least 12 weeks. If a participant's depression levels remained high after six weeks of medication, they received a higher dose. The outcomes showed 222 participants had metabolic syndrome at baseline, and they also exhibited greater severity and chronicity of depression. A total of 182 participants had remission of depression. Those with metabolic syndrome experienced a longer time to remission, but this association was not significant in the adjusted analysis. Diastolic BP was the only significant predictor of time to remission in both the adjusted and unadjusted analysis, and participants with a higher diastolic BP were more likely to have longer time to remission. Time to remission could not be forecast by insulin sensitivity. "The results of this study should be interpreted with caution," the researchers note. "We do not recommend that clinicians treat older adults with depression differently in the face of co-occurring metabolic syndrome. Further verification of these findings is indicated using more reliable markers of insulin resistance and other classes of antidepressants in racially diverse populations in the hopes of better informing treatment decisions in late-life depression."

Some U.S. hospitals are adopting a new approach to older persons in U.S. emergency rooms that often entails asking more questions, asking them earlier and, when possible, avoiding hospitalization, reports ABC News . "The doctors are not comfortable sending you home unless you're safe," says Northwestern Medicine's Dwayne Dobschuetz. "It's easier to admit older persons than to send them home." Research at Northwestern and other hospitals demonstrates how care from geriatrics-trained nurses in the ER can lower the chances of a hospital stay after an emergency visit and for a month afterward. About 100 U.S. hospitals have opened geriatric emergency departments or trained ER teams in geriatrics care. These teams can arrange home services such as light housekeeping or breaks for caregivers. This new emergency medicine model is based on a 2007 article describing the emergency department of the future, designed to prevent confusion and falls in seniors and to increase their comfort. Such a department would have windows and skylights instead of windowless spaces with bright bulbs, replace thin mattresses with pressure-reducing ones, and install soundproofing. In addition, it would hire nurses trained to address the complaints of aging, slowing down the frenzied pace of the ER enough to fully assess each visitor. Physical therapists and pharmacists also would be ready to assist.

The U.S. Senate has just cleared a bill providing tracking and training for law enforcement for people with Alzheimer's, and it now must be passed by the House, reports CBS New York . "Alzheimer's and dementia — that's a big storm coming; that we need to recognize that more and more families are going to be affected by this as time goes on," says U.S. Rep. Thomas Suozzi (D-NY). The bipartisan Missing Americans Alert Act would allocate $10 million for Alzheimer's assistance. "You need dementia-specific training for best practices on how to deal with somebody who's living with Alzheimer's or even autism," says Alzheimer's Foundation of America CEO Charles Fuschillo. "That is why this legislation is critically important."

The U.S. Centers for Medicare and Medicaid Services (CMS) has proposed regulations establishing new limits on pharmacies for filling opioid prescriptions for Medicare beneficiaries "to reduce seniors' risk of being addicted to or overdoing it on opioids while still having access to important treatment options," says the Center for Medicare's Demetrios Kouzoukas, as reported in MedPage Today . "We believe these actions will reduce the oversupply of opioids in our communities." The proposal mandates that Part D plans should implement "hard formulary levels" at pharmacies which would restrict the amount of opioids that beneficiaries could get. "These are triggers ... that can prompt conversations between physicians, beneficiaries, and plans about appropriate opioid use and prescribing," Kouzoukas says. "The trigger can only be overridden by the plan sponsor after efforts to consult with the prescribing physician." The safety level would be a 90 morphine-mg equivalent with a seven-day supply allowance. The regulations also would limit the number of pills in an initial prescription for acute pain, "possibly with or without a daily dose maximum," Kouzoukas notes. He says CMS is accepting comments on the proposals through March 5, and the agency also "expects sponsors to implement 'soft' safety edits" to flag a potential problem, although those could be overridden by the pharmacist. Kouzoukas also notes CMS "is ... enhancing our very successful opioid utilization monitoring system by adding flags for beneficiaries who use certain drugs in combination with prescription opioids. And we're considering a new measure on the concurrent use of opioids and benzodiazepines."