Diabetes drug doing double duty as Alzheimer’s therapy

A drug developed for treating diabetes now shows promise for Alzheimer’s patients, according to scientists at England’s Lancaster University. The drug is described as a triple receptor agonist, or TA. It combines hormones glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and Glucagon, activating these three receptors at the same time. The new study is published in the journal Brain Research.

A group of mice with Alzheimer’s-related symptoms were tested in a spatial water maze. The TA drug was injected once a day for two months. The mice who were treated with the drug remembered their path better than the control group.

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In addition to the memory improvement, other symptoms were improved: the accumulation of plaque in the brain was reduced; brain nerve cells were protected from deterioration and loss; and chronic nerve inflammation was reduced, as well as oxidative stress in the cortex and hippocampus. Increased levels of synaptophysin indicated protection from synaptic loss that occurs in Alzheimer’s. An increase of doublecortin positive cells showed improved neurogenesis.

Other diabetes drugs have shown promise for Alzheimer’s patients. The two diseases are known to be related, and type 2 diabetes increases the risk of Alzheimer’s disease. Clinical trials are proceeding to investigate the neuroprotective effects of extendin-4 and liraglutide.

Alzheimer’s cases are expected to triple in the next forty years, requiring more long term care. The increase in patients will bring financial challenges as well as medical ones. For more information on supporting Alzheimer’s and dementia patients, see the Alzheimer’s Section on Guide To Long Term Care.

 

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Insomnia increases Alzheimer’s risk

Just one night without enough sleep can cause harmful proteins to build up in the brain, increasing the risk of Alzheimer’s disease, according to a new study.

Past studies already linked insufficient sleep to increased risk of Alzheimer’s and other chronic diseases — but this recent study from Washington University,published in the Annals of Neurology, discovered what insomnia actually does to the brain.

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One of the functions of sleep is to clear the brain of waste, including amyloid beta proteins which can bond with each other and form plaques on nerve cells. These plaques build up in the brains of people with Alzheimer’s disease.

People with a genetic tendency for Alzheimer’s disease have higher than normal levels of beta amyloid proteins, even before they develop symptoms. After a night without sleep, these higher levels appeared in the healthy study participants.

Inadequate sleep has been linked to a 1.5 fold increase in the odds of developing Alzheimer’s. It’s not surprising, therefore, that research shows that sleep disorders such as sleep apnea increase the risk.

In the study, eight participants with no previous sleep or memory problems were instructed to either stay awake all night, get a normal night’s rest, or use the drug sodium oxybate to help them sleep. The sleep aid is supposed to increase the period of deep, dreamless sleep when the brain is thought to restore itself.

The scientists tested the cerebrospinal fluid surrounding each participant’s brain for amyloid proteins. Measurements were taken before the night of the test, and then every 2 hours the next day, to show how the night of sleep or no sleep affected the accumulation of these proteins in the brain.

Study participants who went without sleep for just one night had a 25-30% increase in the beta-amyloid proteins in their cerebrospinal fluid, bringing the levels to what researchers would expect to see in people who have genes for Alzheimer’s disease. Before the test, the participants all had normal levels. The pills designed to promote the deep sleep did not affect the levels of amyloid protein.

In a healthy person, normal sleep eliminates waste and restores the brain each night. But repeated nights of insufficient rest may overwhelm the brain’s recovery system, allowing amyloid proteins to build up and form plaques which interfere with the brain’s functioning.

For information on Alzheimer’s and also long term care insurance, see Alzheimer’s Section on the Guide To Long Term Care.

 

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Nurses laugh as a 89-year-old veteran dies in nursing home

An 89-year-old World War II veteran in a nursing home bed called for help, saying he couldn’t breathe.

A hidden camera recorded nurses failing to take life-saving measures for the patient and laughing as he struggled to breathe, and eventually died. The man’s family had secretly recorded a video, which was kept from the public for 3 years until a television station, WXIA-TV, persuaded courts to unseal it.

The family of James Dempsey of Woodstock, Georgia, sued the Northeast Atlanta Health and Rehabilitation Center in 2014. Two nurses lost their licenses after the video was made public in September, with a link sent to the Georgia Board of Nursing. The nurses did not start CPR immediately and did not follow emergency procedures; then they laughed while trying to start his oxygen machine.

The nursing home issued a statement claiming that care has improved since the incident, under different leadership. But records show continued problems at the home, including $813,000 in Medicare fines since 2015.

Watch the video here: https://youtu.be/lU6NlK3OQDc

The video will probably cause families to think seriously about care options for their loved ones, including home care in some cases. A long term care insurance policy can support care either at home or in a facility. Find out more and get insurance quotes at Guide To Long Term Care.

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Millennials are most aware about long term care insurance

Only 20% of Americans have taken steps towards financing long term care, including even researching the costs. Millennials, who have long known that Social Security may not exist by the time they retire, are the generation most likely to have taken action on long term care insurance, according to Genworth Life Insurance Company, a long term care insurer since 1974.

Of people age 65 and older, 70% will need long term care at some point. However, only 52% of baby boomers believe they will need care. Millennials and members of Generation X are more realistic; 64% of Millennials (age 34 and younger) and 65% of Generation X (age 35-50) expect they may need long term care in the future.

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Most Americans (66%) mistakenly believe government programs will cover the costs of long term care. But Medicare only pays for skilled services or rehabilitative care, not for non-skilled assistance with activities of daily living, which is the bulk of long term care services.

Here are the 2016 national average costs for long term care in the United States (costs vary by state): $225/day or $6,844/month for a semi-private room in a nursing home; $253/day or $7,698/month for a private room in a nursing home; $119/day or $3,628/month for a one-bedroom space in an assisted living facility; $20.50/hour for a health aide; $20/hour for homemaker services; $68/day in an adult day health care center.

For those who are not prepared financially to handle their care costs, the burden will fall on their families and communities. It’s important for people who are growing older to talk with their families about their possible future needs and develop a plan — including how they will pay for care if needed.

Other facts the Genworth study showed Americans were uninformed about: 52% did not know that long term care insurance can cover help in their homes; 61% did not know that long term care can be personalized and that the insurer can help them find good care providers.

Insurers say people are never too young to begin planning for long term care costs, which can be a major expense and quickly use up retirement savings. To find out about long term care insurance, see the Guide To Long Term Care

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More insights on Alzheimer’s disease – how some brains are protected

A feature of the brain’s neurons called dendritic spines may protect against dementia, according to new findings.

Neurofibrillary tangles and amyloid plaques appear in the brains of people with Alzheimer’s, but not everyone who has these formations goes on to develop the disease. Between 30 and 50 percent of patients with the plaques and tangles do not develop Alzheimer’s disease. Why not? Scientists have been looking for the reasons.

Researchers at the University of Alabama at Birmingham found the answer may lie in dendritic spines. The dendritic spines of a neuron help it make connections with other neurons and send information. These parts of the neuron may protect against Alzheimer’s disease.

Dendrites, the branched projections of a neuron that transfer electrochemical stimulation from other neural cells to the cell body, have small membranous protrustions called dendritic spines. Each dendritic spine receives input from a single axon at the synapse. The loss of dendritic spines results in the loss of synapses, which can impair cognition. Logically, subects with normal brains would have healthy dendritic spines, and those with dementia would not. The researchers tested the structures and published the results in the journal Annals of Neurology.

The scientists compared dendritic spines in 21 patients with Alzheimer’s, 8 patients who had Alzheimer’s brain changes but no symptoms, and 12 healthy patients. Using bright-field microscopy, Professor Jeremy Herskowitz and the team took images of the dendritic spines, then used the images to create a 3-D digital reconstruction.

The healthy control subjects had more dendritic spines than the subjects with Alzheimer’s. The subjects with Alzheimer’s brain changes but no symptoms also had more spines than the Alzheimer’s subjects — and almost the same dendritic spine density as the healthy subjects. The group with pathology but no symptoms group had very long dendritic spines, longer than both the other groups.

Longer dendritic spines might indicate greater neuroplasticity — the capacity to change and form new neural connections. Increased neuroplasticity could enable the neurons to bypass plaques and tangles, and still communicate with other neurons. If so, this phenomenon could explain why some people who have Alzheimer’s pathology do not show cognitive impairment.

The research suggests that it may be possible for the brain to rebuild neurons. The information gained in the study may help scientists to develop new therapies, especially when brain changes are detected before symptoms appear.

In 2014, a study at NYU Langone Medical Center in New York, published in the journal Science, showed that getting sleep after learning helps neurons form connections, through dendritic branches, that may help brain cells pass information to each other and facilitate long-term memory.

The scientists observed mice that were genetically modified so a particular protein in their brain cells would fluoresce when viewed with a laser scanning microscope. The fluorescence allowed the team to track the growth of new spines along each branch of a dendrite. The mice sprouted new dendritic spines within 6 hours of learning a new task. Different structural changes occurred for different types of learning.

Healthier and more numerous dendritic spines may be a genetic trait, but the brain also may respond to healthy diet and lifestyle. According to Medical News Today, research suggests that as many as a third of dementia cases can be prevented by regular exercise and an active social life.

For more information on Alzheimer’s and dementia, and care choices, see the Guide To Long Term Care.

 

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After Disaster: New Emergency Requirements for Nursing Homes

During Hurricane Irma, 14 people died at The Rehabilitation Center at Hollywood Hills, Florida, due to a power outage that left residents in extreme heat. Lack of air conditioning made the building heat up like an oven. One of the victims died with a body temperature of 109.9 degrees. The nursing home’s owners now face criminal investigation and civil lawsuits.

In response to the tragedy, Florida Governor Rick Scott issued an emergency order requiring nursing homes to have generators that can run air conditioners.

The nursing home industry has brought court cases to challenge the emergency order. But in the meantime, state senators Lauren Book and Rene Garcia have filed bills to make the generator requirement a state law. Also, state senator Gary Farmer is preparing a more comprehensive Florida nursing home reform bill.

On the Federal level, U.S. Representative Debbie Wasserman Schultz is sponsoring a bill that will require nursing homes to have generators that can run air conditioning for at least 96 hours in the event of an emergency power outage. The bill will also put nursing homes on the top priority list, along with hospitals, for restoring power after a hurricane.

The Federal bill provides for loans to help small facilities comply with the new regulation. Homes that have fewer than 50 beds, or a private room monthly rate of $6,000 or less could qualify for a loan to get the generators and other required equipment. This bill also sets up higher fines for facilities that break the rules and adds nursing homes to the critical infrastructure list so power will be restored there first.

Nursing homes are among the most important resources for long term care. For more information about long term care insurance see the Guide To Long Term Care.

 

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Most Americans Incorrectly Believe Health Insurance or Medicare Pays For Long Term Care

More than half of Americans, 55%, incorrectly believe health insurance or Medicare will pay for long term care, the assistance with daily living that some people need because of illness or injury.

People who are sick or injured may need help with activities of daily living such as bathing, dressing, preparing food, and so forth that they would normally do for themselves.

A recent online survey asked adults how they would pay for assistance with activities of daily living if they are unable to take care of themselves for an extended period of time. More than half, 55%, said they would use Medicare or health insurance. But Medicare and health insurance, although they cover some of the medical costs, do not pay for long term assistance with daily living. See “Who Pays for Care”

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Medicare covers these costs for a maximum of 100 days (or until you stop improving). Medicaid will pay for these costs only when the individual’s assets are down to around $2,000 or $3,000 – depending on the state of residence – and Medicaid will recover the costs from the estate after death. This is often done with a lien on the Medicaid recipient’s primary residence.  How long will your savings/investments last if paying $75,000 a year per person for care?

The survey involved 2,065 U.S. adults age 18 and older. People over age 55 were more likely to say they would pay for long term care needs with health insurance and/or Medicare. People ages 18-54 were more likely to say they would borrow money from family and friends or use a credit card or loan. Long term care costs are estimated to be $70,000 a year or more, most of which will not be covered by health insurance or Medicare.

The U.S. Government Accounting Office and The Wall St. Journal report that 72% of Americans will need long term care at some time, either part-time assistance at home or full-time care in a facility. But people need to be educated about the costs of care and how to pay for it. Long term care insurance will relieve some of the burden. Many states now have available a Partnership insurance policy that protects assets by exempting the policyowner from Medicaid spend-down. Read more about The Partnership.

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