Alzheimer’s drug: another take on Solanezumab

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The Alzheimer’s drug Solanezumab turned out to be a disappointment when clinical trials showed patients with long-established Alzheimer’s did not benefit from it. But a new study aims to find out if Solanezumab will help people who have high levels of amyloid in their brains but have not yet developed symptoms of Alzheimer’s.

Some people develop amyloid plaques in their brains years before Alzheimer’s disease symptoms appear. Amyloid plaques are a sticky buildup which accumulates outside nerve cells. These plaque formations can interfere with how the brain works, causing problems with memory and thinking. Research has shown that people with high levels of amyloid in their brains are more likely to develop Alzheimer’s disease, though some do not. The drug Solanezumab provides an antibody that binds to the amyloid proteins, and may slow the progression of the disease.

Dr. Brian Ott of Rhode Island Hospital is leading a study on the antibody drug. The vaccine is supposed to attach to the protein that makes neurofibrillary tangles in the brain, and block it from causing degeneration of other cells. This is the first study to find out whether Solanezumab can help prevent Alzheimer’s disease through early intervention.

The trial will examine healthy people ages 65 to 85, with normal memory. The subjects will undergo a Positron Emission Tomography (PET) scan to measure the amyloid in their brains. Participants must pass a general health screening and have normal brain function and memory, but an elevated amyloid level. The participants will be randomly assigned to get either the investigative antibody drug or a placebo by intravenous infusion every month. Three out of four participants will receive the drug, and the rest will get the placebo.

The study will last three years, and the results will show whether the drug can change the course of Alzheimer’s disease when given before symptoms start.

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Alzheimer’s is the sixth leading cause of death in America. It is the leading reason that people need long term care. For information on Alzheimer’s and long term care insurance, see the Guide To Long Term Care.

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Blood test coming to diagnose Alzheimer’s disease?

A research team has found a method to detect biomarkers of Alzheimer’s disease in blood platelets. The test uses a ratio between normal and abnormal brain tau proteins to identify those with Alzheimer’s disease and other neurodegenerative conditions.

The researchers found that the presence of abnormal tau proteins corresponds with decreased brain volume in parts of the brain where characteristics of Alzheimer’s appear.
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A non-invasive test for Alzheimer’s disease would help detect people at risk before symptoms develop, and make prevention and early treatment possible.

A study published in the Journal of Alzheimer’s Disease in 2016 described using levels of the protein clusterin to ascertain which dementia patients are at risk of Alzheimer’s. Also, a 2015 study focused on using metabolites in saliva to detect cognitive impairment.

In 2016, 5.4 million Americans were affected by Alzheimer’s disease. For more information, consult the Alzheimer’s @Guide To Long Term Care.


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How your nose can expose your risk of Alzheimer’s disease

Alzheimer’s researchers found that a person’s sense of smell declines strongly in the early stages of Alzheimer’s disease, suggesting a noninvasive “sniff test” for diagnosis.

The test can help identify the pre-dementia condition called mild cognitive impairment (MCI), which often progresses to Alzheimer’s dementia in a few years.

David Roalf, Assistant Professor at the Perelman School of Medicine, University of Pennsylvania, led a study in which scientists used a simple, commercially available test called the Sniffin’ Sticks Odour Identification Test. Subjects have 16 different odours to identify.

Along with the sniff test, researchers administered a standard cognitive test (the Montreal Cognitive Assessment) to 728 elderly people who had already been diagnosed by doctors as healthy, having mild cognitive impairment, or having Alzheimer’s disease.

The research team found that the sniff test, when combined with the cognitive test, increased diagnostic accuracy. The cognitive test alone identified 75% of people with mild cognitive impairment; after adding the sniff test, 87% of cases were identified.

Using the two tests together also helped the researchers to detect subjects with Alzheimer’s and those who were healthy, and to determine the degree of cognitive impairment.

Doctors believe it is more possible to help people with Alzheimer’s disease if they begin treatment before dementia symptoms appear.
Genworth 2015 Cost of Long-Term Care Survey Chart

Many people get Long Term Care Insurance to protect themselves and their families against the debilitating effects of Alzheimer’s and other dementias.


 

 

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Parkinson’s disease connected to bacteria in the gut

Some researchers have found a link between Parkinson’s disease and the bacteria in the digestive tract. The discovery may lead to a new way of treating Parkinson’s, through the digestive tract, rather than the brain. Finely targeted probiotics may be the answer. The scientists published their findings in the journal Cell.

Parkinson’s disease causes brain cells to accumulate excessive amounts of the protein alpha-synuclein and then die. Physical and mental effects include loss of motor function, tremors, shaking, and more. It seems to be caused by environmental factors rather than heredity.

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The researchers performed three different experiments that showed the link between bacteria in the gut and Parkinson’s disease. The experiments were performed on two sets of mice that were genetically modified so they overproduced the protein alpha-synuclein. One set of mice had bacteria in the gastrointestinal tract; the other set had none. Read more about the experiments at Cell.

So Parkinson’s patients may have bacteria in their guts that contribute to the disease, or lack beneficial bacteria that could prevent the disease. These patients have some kinds of bacteria in their digestive tracts that are not found in healthy people, and they lack some kinds of bacteria found in healthy people.

Parkinson’s disease is a debilitating neurodegenerative disorder. One million people in the United States and up to 10 million worldwide have Parkinson’s, making it the world’s second most common neurodegenerative disease after Alzheimer’s.

Past research indicates bacteria in the gut may also be connected with other diseases, such as multiple sclerosis. There has been found a type of bacteria that is a major cause of stomach (gastric) and upper small intestine (duodenal) ulcers.

To find out about insuring for the risk of these disabilities visit the Guide to Long Term Care


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Groundbreaking ideas tested in high-tech Alzheimer’s facilities

A new concept is revolutionizing the care of patients with dementia and Alzheimer’s disease.

The idea is an assisted living facility that is like a time capsule for residents. The home’s interior is designed to look like a small town in the 1940s. Each resident’s room is a small house, with a front porch light that turns on by timer every night. The carpet outside the rooms looks like grass, with “sidewalks” leading from one room to another. In the ceiling, fiber optics change from sunlight to stars for day and night. Chirping bird sounds make the space feel like outdoors. There is a movie theater, a barbershop, a saloon and salon and supermarket.

The idea is to set up an environment that nurtures memories, promotes functional independence, and stimulates new learning. This charming environment can trigger fond nostalgic memories that will help the residents relax. It also creates the feeling of living in a community rather than an institution.

The innovative environments are created by Jean Makesh, an occupational therapist who is CEO of The Lantern Group. The Lantern Group has Ohio facilities in Chagrin Falls, Ashtabula, and Madison, with plans to expand: website.

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For more information see “Alzheimer’s on GuideToLongTermCare.com

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New rule protects nursing home residents’ right to sue

For the first time in 25 years the federal government has completed a comprehensive revision of the way it regulates nursing homes, where 1 million older adults and younger people with disabilities reside.

The Centers for Medicare and Medicaid Services, a federal agency within the Health and Human Services Department, recently released a new rule for nursing homes, banning contracts that require arbitration. The rule applies to nursing homes and assisted living facilities that receive federal funding.

Many nursing homes have required new residents to sign mandatory arbitration agreements, giving up their right to sue for wrongdoing.

Though mandatory arbitration can reduce costs, it also hinders the ability of patients and families to be compensated in cases of elder abuse, patient neglect, sexual harrassment, and even wrongful death. Arbitration also enables the facility to hide these cases from the public.

The rule will affect 15,000 nursing homes, which house 1.5 million residents.

Unless challenged in court, the new rule goes into effect on November 28. It will only apply to residents admitted in the future. Nursing homes will still be able to offer arbitration as a voluntary option to solve disputes.
Genworth 2015 Cost of Long-Term Care Survey Chart
Long term care insurance gives families the ability to choose an excellent nursing home or to provide home care.

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Why are some long term care insurance rates going up so much?

Group rates for long term care insurance will rise steeply in November.

  • Federal LTCI premiums will rise an average of 83%
  • CNA recently raised premiums nearly 100% for some group policies for employers, unions, and associations.
  • John Hancock Financial raised premiums as much as 126% on group policies for federal employees and retirees.

Policy holders, many of them angry, are wanting to know the reason for the sudden rise in rates.

Some blame the Office of Personnel Management. OPM oversees government insurance programs and must approve any rise in premiums.

Some say that the government keeping oil prices down produced the shortfall.

Others blame John Hancock, the only insurance company to bid on the federal program this year. John Hancock pays about $13 million a month in federal long term care insurance claims. Since 2002 the federal program has paid out more than $700 million for long term care.

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Part of the reason for the rise in premiums is that insurers originally set prices too low, underestimating how long people would live and need care. Insurance companies must balance the need for affordable rates with the responsibility to pay claims when they come in. Fourteen years ago, 102 companies offered long term care insurance. In 2016, only 12 to 14 companies are still in the business.

Insurance companies earn some of their money in interest on premiums; they make investments that help pay for claims. The recession unexpectedly brought interest rates down below 8%. Around the world, interest rates are near zero, and in some places have even become negative. The low interest rates are one of the main reasons insurance companies must raise premiums.

Because of the low earnings, some insurers have struggled to pay dividends to their shareholders. The Federal Reserve Board held down interest rates on Treasury bonds to prevent another recession.

A law passed in 2012 was supposed to protect consumers from steep increases in insurance rates. Insurers need permission from regulators in most states before premiums can be increased. However, since state insurance regulators still have not issued the final rules, insurance companies can raise rates on some policies without regulatory approval. Group coverage, while it offers discount rates, does not have the same regulatory protections as individual coverage. New regulations are being discussed.

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The National Active and Retired Federal Employees Association and some members of Congress are calling for hearings on the premium increases. But Congress will have little time for action before September 30 when enrollees must decide whether to keep their policies; so hearings will probably take place after the premiums have already gone up.

For those who enrolled in a policy before August 2015, premium increases will begin on November 1.

Policy holders must choose to either keep their policy and pay higher premiums, scale back coverage, or discontinue the policy and consider getting a different policy. Some enrollees can switch to an option in which they pay no more premiums but have a much lower benefit.

For some people, it may be possible to find a better policy in the private market. If the policy holder is in good health and bought the policy within the last few years, it may be possible to get a new policy with better rates. However, if the original policy was bought many years ago, a new policy will probably not cost less – and may have no guarantee that its premium will not rise.

Premiums are based on the insured’s age at the time of purchase. Each year the purchaser waits to buy a policy, premiums can rise 5% to 12%. The risk of being denied coverage for medical reasons also increases with age. And newer policies are regulated more strictly, which makes them more expensive than those issued years ago. Genworth 2015 Cost of Long-Term Care Survey ChartWays to lower the cost of a policy include reducing the benefit period, reducing the daily or monthly benefit, extending the waiting period before benefits apply, or changing the inflation protection. People who have policies with lifetime coverage could save a lot by reducing the benefit period to three or five years. Most long term care claims are for three years or less.

Policy holders should not wait until the last minute to look at the alternatives. If you decide to switch to another company, make sure your application has been approved before ending your existing coverage.

Many policy owners bought their policy before their state had approved the Partnership asset protection program. Some policyholders may choose to buy a smaller second policy just to get the Partnership.

Despite the proposed rate hike, long term care insurance is still the most cost effective way to protect yourself from the high risk that you will need expensive long term care.

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