An experimental blood test was highly accurate in detecting Alzheimer’s disease, scientists have reported. A promising breakthrough that could make diagnosis simple, affordable and widely available.

The test was able to determine whether people with dementia had Alzheimer’s instead of another condition, the New York Times reported. It also identified signs of Alzheimer’s 20 years before memory and thinking problems were expected in people with a genetic mutation that causes the degenerative, deadly disease, the outlet said.

“This blood test very, very accurately predicts who’s got Alzheimer’s disease in their brain, including people who seem to be normal,” Dr. Michael Weiner, an Alzheimer’s disease researcher at the University of California, San Francisco, told The Times.

The research was published in JAMA Network Open and presented at the Alzheimer’s Association International Conference.

The blood test — which performed as accurately as more invasive methods such as MRI brain scans, PET scans and spinal taps — provides a much simpler and more affordable way to diagnose whether people with cognitive problems were experiencing Alzheimer’s, as opposed to another type of dementia.

Such a blood test also may eventually be used to predict whether someone without symptoms would develop the disease, according to The Times.

“It’s not a cure, it’s not a treatment, but you can’t treat the disease without being able to diagnose it. And accurate, low-cost diagnosis is really exciting, so it’s a breakthrough,” said Weiner, who was not involved in the study.

The test could be available for clinical use in as little as two to three years, experts said.

by Matt Sutterer Health Specialist, Division of Neuroscience (DN)

The ability to stand or sit without falling seems simple enough, but it actually involves a complex orchestration behind the scenes of our visual, positional, and vestibular systems. Aging can affect all three of these sensory systems, resulting in balance disorders such as dizziness or vertigo and increased risk for falls. According to the Centers for Disease Control and Prevention, one in four Americans aged 65 or older reports falling each year, and 20% to 30% of those who fall suffer moderate to severe injuries.

Robust research has helped us understand how vision contributes to balance in older adults. However, there has been significantly less research conducted on how balance is affected by the aging vestibular system — the organs of the inner ear that help us sense movement and orientation in space. How these systems interact in the brain, both in healthy aging and in older adults with neurodegenerative diseases and conditions such as Alzheimer’s disease and related dementias and Parkinson’s disease, is not well understood.

Seeking a steadier research landscape

In April 2019, NIA, in partnership with the National Institute on Deafness and Other Communication Disorders (NIDCD), hosted a two-day workshop, “Central and Peripheral Control of Balance in Older Adults.” Workshop co-chairs Coryse St. Hillaire-Clarke (Program Director, Division of Neuroscience) and Lyndon Joseph (Program Director, Division of Geriatrics and Clinical Gerontology) led the effort that featured presentations from an array of researchers and clinicians across diverse fields, including gerontology, geriatrics, neurology, neuroscience, movement science, and rehabilitation. A white paper was recently published highlighting the workshop’s outcomes.

The discussion focused on three key questions:

How does aging impact vestibular function?

We lack a good understanding of aging’s impact on vestibular organs and the brain areas to which they connect and how these changes relate to clinical symptoms.

How do we tease apart the different contributions of age-related sensory and motor changes in an older adult with balance problems?

Common symptoms like dizziness, disequilibrium, unsteady walking, and increased falls can result from age-related changes in the vestibular system, other sensory systems, and even musculature or cognition. Determining the effects of each is vital for identifying treatments for balance disorders.

How can we develop a better classification system of balance problems in older adults?

The field currently lacks a widely accepted model of balance that reflects its multimodal nature. This is needed to guide the development of clinical outcome measures and to translate balance interventions into clinical or community settings.

NIA is interested in helping to answer the question of how aging affects the vestibular system and how these changes interact with other factors that lead to balance impairment. Given the multidisciplinary and multisystem nature of balance, a team science approach will be critical to this effort.

Funding available — let’s hear your ideas!

If you are interested in tackling these and other questions about the vestibular system and balance in aging, please apply for the funding opportunity announcement released earlier this year in collaboration with NIDCD by October 2, 2020. Contact Dr. Joseph or Dr. St. Hillaire-Clarke for more details. We would love to hear your questions or comments!

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by Jayson Cohen American Legacy Solutions

In June We celebrated World Elder Abuse Awareness Day. There can be many ways the elderly are abused by family or those close to them. Let’s look at abuse from a financial aspect.

Financial abuse can be a complicated subject, but at its most basic level it involves taking advantage of an older adult through manipulation or intimidation to steal their money or property.

Elderly adults are some of the most vulnerable to financial abuse. Some of the biggest risk factors for older adults include:

Isolation – Isolation can cause extreme loneliness in seniors, leaving them desperate for any sort of social connection. Many abusers target elder adults for this reason.

Lack of knowledge of financial matters – Elder adults who don’t pay much attention to or don’t understand financial issues can be tricked into giving over secure information.

Disability – Whether the older adult has a physical or mental disability, they are dependent on others to take care of themselves. This leaves them vulnerable to manipulation and intimidation by caregivers. Disability can also make an elder adult seem less likely to take action against the abuser.

Who is most likely to abuse?

Unfortunately, abusers are rarely unknown to the abused. In fact, those who are most likely to abuse are the ones who are closest to the elder individual or someone that he or she trusts. The most common financial abusers include:

Family members – Family members can have different motivations for committing financial abuse. They may feel entitled to their relative’s money or property, especially if they are due to inherit from the elder or are in a caretaking position.

Caretakers – A caretaker can be a family member or someone who is paid to provide care to an older adult in the elder’s own home. As such, a caretaker is the person who has the most access to the elder.

Professionals in whom the elder trusts – Professionals are people in whom the elder adult depends on to take care of the things he or she is not capable of handling alone anymore. These services can range from attorneys to someone your relative hires to take care of the lawn. Abusers can take advantage of older adults by overcharging for services or manipulating them into signing documents that they don’t understand.

Scammers and con artists – Some predators prey specifically on elder adults, counting on their social isolation and lack of knowledge about financial matters to be able to gain access to their victim and their financial assets.

What types of financial abuse exist?

Financial abuse can take different forms, depending on the relation of the abuser to the elder adult. Common tactics include (but are not limited to):

Theft of money or property

Using manipulation or intimidation to force him or her to sign legal/financial documents

Forging his or her signature

Fraud

Telemarketing and email scams

How can you prevent financial abuse of elders?

The best thing that you can do to prevent elder financial abuse is to keep your older relative or friend from being isolated. Check in regularly, make sure you know who has access to him or her, and know the signs of financial abuse. Keep an eye out for suspicious signatures on checks, suddenly unpaid bills, and new and unexplained “friends.” By knowing the signs, you can help prevent the financial abuse of your loved one.

Millions of America’s seniors could face disruptions to audiology and speech-language pathology therapy services vital to their health and quality of life unless Congress and the Centers for Medicare & Medicaid Services (CMS) act to protect them, the American Speech-Language-Hearing Association (ASHA) have warned

At issue is CMS’s 2021 proposed Medicare Physician Fee Schedule rule, released on August 3, in which the agency recommends significant payment reductions to more than three dozen health care provider groups, including audiologists and speech-language pathologists. This is an effort to offset increasing payments for office/outpatient evaluation and management (E/M) codes typically used by primary care physicians.

Audiologists are facing a 7% cut to Medicare reimbursement, and speech-language pathologists are facing a 9% cut—which would translate into significant reductions in therapy services for a range of communication, cognition, and swallowing problems common in seniors. These problems are often a result of conditions including stroke, brain injury, Alzheimer’s disease, Parkinson’s disease, and head and neck cancers, along with hearing loss—one of the most common health conditions that seniors experience.

“The services provided by audiologists and speech-language pathologists are absolutely essential to our seniors as they recover from serious medical events and live with chronic conditions such as neurological disorders and hearing loss,” said Theresa H. Rodgers, MA, CCC-SLP, ASHA 2020 President. “Medicare cuts are most unfortunate, and especially ill-advised, given the treatable nature of many of these conditions—and the tremendous improvements that our members witness every day when patients have appropriate access to needed diagnostic and rehabilitative services. Our seniors deserve better.”

The proposed cuts are the product of a Medicare statutory requirement known as budget neutrality, which requires that any increase in costs to the Medicare program (in 2021, higher spending on E/M codes) must result in decreased spending elsewhere under Medicare. The cuts will go into effect in 2021, unless Congress and CMS act to waive the budget neutrality requirement.

ASHA, along with the American Occupational Therapy Association (AOTA), the American Physical Therapy Association (APTA), and many other physician and nonphysician provider groups, has engaged in vigorous advocacy efforts over the past several months aimed at Congress, CMS, the Department of Health and Human Services, and the Office of Management and Budget to curtail these cuts and stress the serious impact that such cuts would have on seniors.

While recognizing the importance of funding the services provided by primary care physicians, ASHA notes the equally important value of its members’ diagnostic and rehabilitative services—calling for a holistic reimbursement approach. In a joint statement issued August 4, ASHA, AOTA, and APTA noted: “Our organizations call on Congress and CMS to advance well-reasoned fee schedule payment policies and waive budget neutrality.”

Further reinforcing this approach, ASHA joined with a broad coalition of organizations representing more than 330,000 physicians and 884,000 nonphysician providers. In a collective statement, those groups specified: “Our groups are calling on Congress and CMS to collaborate on developing a solution that will allow the changes to the E/M services to proceed, while at the same time preventing cuts to our health care professionals.”

For more information, visit www.asha.org.