A decline of our five senses can predict poor health comes and even death in older adults

World, give me more bay area seniors who need 24/7 caregivers

I can refer them to care homes and other care team from hospice nurses, massage therapist, doctors, home helpers , companion, drivers, cook to caregivers.

There is a gap in health care. You cannot leave nursing homes or skilled nursing facilities without 24/7 care at home. You cannot heal at the hospital for you need loving care at home.

You cannot be alone, now that you are older, home bound and needing 24/7 non medical in home care.

You need a cook, massage therapist, driver, house cleaner and assistance in daily living.

What good is a house worth so much when your body is needing 24/7 care.

Some of your family members might have no time with their 2 jobs, big family and life.

They might give up on you.

But Motherhealth caregivers will not give up on you.

We are looking for business partners, families who wanted to share their homes with seniors, those who wanted to donate their real estate in promoting senior health with no limits, boundaries or high cost. We need seniors who need 24/7 non medical in home care. We need marketers and seniors to volunteer. We give free training online and in person.

We monitor caregivers and seniors. We give massage to seniors and train all people in the care team to give massage based on senior health care needs.

Contact Connie at 408-854-1883 or motherhealth@gmail.com if you want to help a senior, a neighbor or the community where you live, the bay area.

1708 Hallmark Lane, San Jose CA 95124

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Reaction Time Variation May Be a Marker That Predicts Mortality in Old Age

Reaction Time Variation May Be a Marker That Predicts Mortality in Old Age

Source: PLOS.

A common indicator of neurobiological disturbance among the elderly may also be associated with mortality, according to a study published August 9, 2017 in the open access journal PLOS ONE by Nicole A. Kochan at the Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney.

Intraindividual reaction time variability (IIVRT), defined as an individual’s variation in reaction times when completing a single cognitive task across several trials, has been associated with mild cognitive decline, dementia and Parkinson’s disease. The authors of this study investigated whether IIVRT is also associated with mortality in old age by following a cohort of 861 adults aged 70 years to 90 years over an eight-year period.

Kochan and colleagues tested the participants’ baseline reaction time by having them complete two brief computerized cognitive tasks comprising 76 trials to measure the average reaction time and the extent of variation over the trials. Every two years, research psychologists followed up on the participants and conducted a comprehensive medical assessment including a battery of neuropsychological tests to assess the participants’ cognitive function. Cases were also reviewed by a panel of experts to determine a dementia diagnosis in each two year follow-up, and mortality data was collected from the state registry.

Study results indicate that greater IIVRT predicted all-cause mortality, but the average RT did not predict time to death. Researchers found that other risks factors associated with mortality such as dementia, cardiovascular risk and age could not explain the association between IIVRT and mortality prediction. The authors suggested that IIVRT could therefore be an independent predictor of shorter time death.

Image shows an old person.

“The study was the first to comprehensively account for effects of overall cognitive level and dementia on the relationship between intraindividual variability of reaction time and mortality,” says Kochan. “Our findings suggest that greater intraindividual reaction time variability is a behavioural marker that uniquely predicts shorter time to death.”

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Funding: Funded by National Health and Medical Research Council of Australia Program Grant (grant number 350833) (HB PS), National Health and Medical Research Council of Australia Early Career Fellowship (grant number 123148) (NK), and Dementia Collaborative Research Centre (NK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Source: Sara Kassabian – PLOS
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Full open access research for “Is intraindividual reaction time variability an independent cognitive predictor of mortality in old age? Findings from the Sydney Memory and Ageing Study” by Nicole A. Kochan, David Bunce, Sarah Pont, John D. Crawford, Henry Brodaty, Perminder S. Sachdev in PLOS ONE. Published online August 9 2017doi:10.1371/journal.pone.0181719

PLOS “Reaction Time Variation May Be a Marker That Predicts Mortality in Old Age.” NeuroscienceNews. NeuroscienceNews, 10 August 2017.
<http://neurosciencenews.com/Reaction Time Variation May Be a Marker That Predicts Mortality in Old Age/>.

Abstract

Is intraindividual reaction time variability an independent cognitive predictor of mortality in old age? Findings from the Sydney Memory and Ageing Study

Intraindividual variability of reaction time (IIVRT), a proposed cognitive marker of neurobiological disturbance, increases in old age, and has been associated with dementia and mortality.

The extent to which IIVRT is an independent predictor of mortality, however, is unclear. This study investigated the association of IIVRT and all-cause mortality while accounting for cognitive level, incident dementia and biomedical risk factors in 861 participants aged 70–90 from the Sydney Memory and Ageing Study. Participants completed two computerised reaction time (RT) tasks (76 trials in total) at baseline, and comprehensive medical and neuropsychological assessments every 2 years.

Composite RT measures were derived from the two tasks—the mean RT and the IIVRT measure computed from the intraindividual standard deviation of the RTs (with age and time-on-task effects partialled out). Consensus dementia diagnoses were made by an expert panel of clinicians using clinical criteria, and mortality data were obtained from a state registry.

Cox proportional hazards models estimated the association of IIVRT and mean RT with survival time over 8 years during which 191 (22.2%) participants died. Greater IIVRT but not mean RT significantly predicted survival time after adjusting for age, sex, global cognition score, cardiovascular risk index and apolipoprotein ɛ4 status. After excluding incident dementia cases, the association of IIVRT with mortality changed very little. Our findings suggest that greater IIVRT uniquely predicts shorter time to death and that lower global cognition and prodromal dementia in older individuals do not explain this relationship.

“Is intra-individual reaction time variability an independent cognitive predictor of mortality in old age? Findings from the Sydney Memory and Ageing Study” by Nicole A. Kochan, David Bunce, Sarah Pont, John D. Crawford, Henry Brodaty, Perminder S. Sachdev in PLOS ONE. Published online August 9 2017 doi:10.1371/journal.pone.0181719

7 million premature deaths annually linked to air pollution – 2012

7 million premature deaths annually linked to air pollution – 2012

In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.

New estimates

In particular, the new data reveal a stronger link between both indoor and outdoor air pollution exposure and cardiovascular diseases, such as strokes and ischaemic heart disease, as well as between air pollution and cancer. This is in addition to air pollution’s role in the development of respiratory diseases, including acute respiratory infections and chronic obstructive pulmonary diseases.

The new estimates are not only based on more knowledge about the diseases caused by air pollution, but also upon better assessment of human exposure to air pollutants through the use of improved measurements and technology. This has enabled scientists to make a more detailed analysis of health risks from a wider demographic spread that now includes rural as well as urban areas.

Regionally, low- and middle-income countries in the WHO South-East Asia and Western Pacific Regions had the largest air pollution-related burden in 2012, with a total of 3.3 million deaths linked to indoor air pollution and 2.6 million deaths related to outdoor air pollution.

“Cleaning up the air we breathe prevents non-communicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly…”

Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health

“Cleaning up the air we breathe prevents noncommunicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly,” says Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health. “Poor women and children pay a heavy price from indoor air pollution since they spend more time at home breathing in smoke and soot from leaky coal and wood cook stoves.”

Included in the assessment is a breakdown of deaths attributed to specific diseases, underlining that the vast majority of air pollution deaths are due to cardiovascular diseases as follows:

Outdoor air pollution-caused deaths – breakdown by disease:

  • 40% – ischaemic heart disease;
  • 40% – stroke;
  • 11% – chronic obstructive pulmonary disease (COPD);
  • 6% – lung cancer; and
  • 3% – acute lower respiratory infections in children.

Indoor air pollution-caused deaths – breakdown by disease:

  • 34% – stroke;
  • 26% – ischaemic heart disease;
  • 22% – COPD;
  • 12% – acute lower respiratory infections in children; and
  • 6% – lung cancer.

The new estimates are based on the latest WHO mortality data from 2012 as well as evidence of health risks from air pollution exposures. Estimates of people’s exposure to outdoor air pollution in different parts of the world were formulated through a new global data mapping. This incorporated satellite data, ground-level monitoring measurements and data on pollution emissions from key sources, as well as modelling of how pollution drifts in the air.

Risks factors are greater than expected

“The risks from air pollution are now far greater than previously thought or understood, particularly for heart disease and strokes,” says Dr Maria Neira, Director of WHO’s Department for Public Health, Environmental and Social Determinants of Health. “Few risks have a greater impact on global health today than air pollution; the evidence signals the need for concerted action to clean up the air we all breathe.”

After analysing the risk factors and taking into account revisions in methodology, WHO estimates indoor air pollution was linked to 4.3 million deaths in 2012 in households cooking over coal, wood and biomass stoves. The new estimate is explained by better information about pollution exposures among the estimated 2.9 billion people living in homes using wood, coal or dung as their primary cooking fuel, as well as evidence about air pollution’s role in the development of cardiovascular and respiratory diseases, and cancers.

In the case of outdoor air pollution, WHO estimates there were 3.7 million deaths in 2012 from urban and rural sources worldwide.

Many people are exposed to both indoor and outdoor air pollution. Due to this overlap, mortality attributed to the two sources cannot simply be added together, hence the total estimate of around 7 million deaths in 2012.

“Excessive air pollution is often a by-product of unsustainable policies in sectors such as transport, energy, waste management and industry. In most cases, healthier strategies will also be more economical in the long term due to health-care cost savings as well as climate gains,” says Dr Carlos Dora, WHO Coordinator for Public Health, Environmental and Social Determinants of Health. “WHO and health sectors have a unique role in translating scientific evidence on air pollution into policies that can deliver impact and improvements that will save lives.”

The release of today’s data is a significant step in advancing a WHO roadmap for preventing diseases related to air pollution. This involves the development of a WHO-hosted global platform on air quality and health to generate better data on air pollution-related diseases and strengthened support to countries and cities through guidance, information and evidence about health gains from key interventions.

Later this year, WHO will release indoor air quality guidelines on household fuel combustion, as well as country data on outdoor and indoor air pollution exposures and related mortality, plus an update of air quality measurements in 1600 cities from all regions of the world.

For more information, contact

Mr Tarik Jasarevic
Mobile: +41 79 367 6214
Telephone: +41 22 791 5099
E-mail: jasarevict@who.int

Glenn Thomas
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int


Outdoor Air Pollution

Key facts

  • Air pollution is a major environmental risk to health. By reducing air pollution levels, countries can reduce the burden of disease from stroke, heart disease, lung cancer, and both chronic and acute respiratory diseases, including asthma.
  • The lower the levels of air pollution, the better the cardiovascular and respiratory health of the population will be, both long- and short-term.
  • The “WHO Air quality guidelines” provide an assessment of health effects of air pollution and thresholds for health-harmful pollution levels.
  • In 2014, 92% of the world population was living in places where the WHO air quality guidelines levels were not met.
  • Ambient (outdoor air pollution) in both cities and rural areas was estimated to cause 3 million premature deaths worldwide in 2012.
  • Some 88% of those premature deaths occurred in low- and middle-income countries, and the greatest number in the WHO Western Pacific and South-East Asia regions.
  • Policies and investments supporting cleaner transport, energy-efficient housing, power generation, industry and better municipal waste management would reduce key sources of urban outdoor air pollution.
  • Reducing outdoor emissions from household coal and biomass energy systems, agricultural waste incineration, forest fires and certain agro-forestry activities (e.g. charcoal production) would reduce key rural and peri-urban air pollution sources in developing regions.
  • Reducing outdoor air pollution also reduces emissions of CO2 and short-lived climate pollutants such as black carbon particles and methane, thus contributing to the near- and long-term mitigation of climate change.
  • In addition to outdoor air pollution, indoor smoke is a serious health risk for some 3 billion people who cook and heat their homes with biomass fuels and coal.

Reducing Antipsychotic Medication Use in Nursing Homes: A Qualitative Study of Nursing Staff Perceptions

Background and Objectives:

The purpose of this study was to use qualitative methods to explore nursing home staff perceptions of antipsychotic medication use and identify both benefits and barriers to reducing inappropriate use from their perspective.

Research Design and Methods:

Focus groups were conducted with a total of 29 staff in three community nursing homes that served both short and long-stay resident populations.

Results:

 

The majority (69%) of the staff participants were licensed nurses. Participants expressed many potential benefits of antipsychotic medication reduction with four primary themes:

(a) Improvement in quality of life,

(b) Improvement in family satisfaction,

(c) Reduction in falls, and

(d) Improvement in the facility Quality Indicator score (regulatory compliance).

Participants also highlighted important barriers they face when attempting to reduce or withdraw antipsychotic medications including:

(a) Family resistance,

(b) Potential for worsening or return of symptoms or behaviors,

c) Lack of effectiveness and/or lack of staff resources to consistently implement nonpharmacological management strategies, and

(d) Risk aversion of staff and environmental safety concerns.

Discussion and Implications:

Nursing home staff recognize the value of reducing antipsychotic medications; however, they also experience multiple barriers to reduction in routine clinical practice.

Achievement of further reductions in antipsychotic medication use will require significant additional efforts and adequate clinical personnel to address these barriers.

https://academic.oup.com/gerontologist/article-abstract/doi/10.1093/geront/gnx083/3858251/Reducing-Antipsychotic-Medication-Use-in-Nursing?redirectedFrom=fulltext


Connie’s comments : Family members must evaluate effectiveness and side effects of meds. It is easy for nursing homes to give Antipsychotic meds to calm the patient.

Ativan or Benzodiazepine oxidation is decreased in persons with liver disease

atiAlcohol withdrawal syndrome (AWS) may result in nausea, vomiting, diarrhea, weakness, sweating, tremors, tachycardia, hypertension, agitation, delirium, hallucinations, seizures, and death beginning 6 hours after alcohol cessation in alcoholics.

Benzodiazepines are cross-tolerant with ethanol and are considered first-line therapy for treating AWS.

Chlordiazepoxide and diazepam are first metabolized by hepatic oxidation, then glucuronidation.

Lorazepam and oxazepam undergo only hepatic glucuronidation.

Benzodiazepine oxidation is decreased in persons with liver disease and the elderly.

Accumulation with resultant excessive sedation and respiratory depression may be significant when administering chlordiazepoxide or diazepam to patients with impaired oxidative metabolism.

Lorazepam and oxazepam metabolism is minimally affected by age and liver disease. Chlordiazepoxide and diazepam are erratically absorbed by the intramuscular route. Lorazepam is predictably absorbed by the intramuscular route. Oxazepam is not available in parenteral form. Lorazepam appears to be the safest empiric choice among the various benzodiazepines for treating AWS in the elderly and in patients with liver disease, or those who require therapy by the intramuscular route.

https://www.ncbi.nlm.nih.gov/pubmed/8700792


Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication.[2] It is used to treat anxiety disorders, trouble sleeping, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy induced nausea and vomiting, as well as for surgery to interfere with memory formation and to sedate those who are being mechanically ventilated.[2][6] While it can be used for severe agitation, midazolam is usually preferred. It is also used, along with other treatments, for acute coronary syndrome due to cocaine use. It can be given by mouth or as an injection into a muscle or vein. When given by injection onset of effects is between one and thirty minutes and effects last for up to a day.[2]

Common side effects include weakness, sleepiness, low blood pressure, and a decreased effort to breathe. When given intravenously the person should be closely monitored. Among those who are depressed there may be an increased risk of suicide. With long-term use larger doses may be required for the same effect. Physical dependence and psychological dependence may also occur.

If stopped suddenly after long-term use, benzodiazepine withdrawal syndrome may occur. Older people more often develop adverse effects. In this age group lorazepam is associated with falls and hip fractures.

Due to these concerns, lorazepam use is generally only recommended for up to two to four weeks.[9]

Lorazepam was initially patented in 1963 and went on sale in the United States in 1977.[10] It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system.[11] It is available as a generic medication.[2] The wholesale cost in the developing world of a typical dose by mouth is between US$0.02 and US$0.16 as of 2014.[12] In the United States as of 2015 a typical month supply is less than US$25.[13] In the United States in 2011, 28 million prescriptions for lorazepam were filled making it the second most prescribed benzodiazepine after alprazolam.

https://en.wikipedia.org/wiki/Lorazepam


Connie’s comments: Benzodiazepine should not be given to seniors who might have dementia and Alzheimer’s disease.