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NIA Study Reveals Key Findings on Aging

By Michael A. Piekarz
Staff Writer

The National Institute of Aging (NIA) “Health and Retirement Study” (HRS) has revealed that cognitive impairment among older Americans is on the decline and that better healthcare may be the reason.

“These data suggest that we may be experiencing a shift in the cognitive health of older Americans,” said Richard J. Hodes, M.D., director of the NIA.

“Continuing to track trends will be critically important both for chronicling changes in brain health and for achieving a better understanding of factors that may play a role.”

The HRS is a national examination of health, retirement and economic conditions of more than 20,000 men and women over age-50. It was conducted by researchers from the University of Michigan, University of Pennsylvania, and Group Health Cooperative of Puget Sound in Seattle. The National Institute of Mental Health provided additional support.

“Although the trend of improving cognitive health is consistent with chronic disability reductions since 1984 in those aged 65 and older, replication in other studies is essential,” said Richard Suzman, Ph.D., director of NIA’s Social and Behavioral Research Program, which oversees the HRS.

“I’d like to see further analysis of how education, exercise, medications, cardiovascular health and lifestyle affect cognitive functioning.”

The HRS is the first long-term study on the health impact of an aging America. In addition to tracking the health of older people, the study accumulated data on factors such as wealth, education and access to healthcare as indicators of overall senior health.

The researchers suggest that improved treatment for stroke, heart disease and vascular conditions between 1993 and 2002 might have been factors in the improvement. A recent study by Harvard University Medical School in conjunction with HRS found a correlation between health coverage, improved health and improved cardiovascular health.

The Harvard study also found that individuals who lacked insurance experienced a steeper decline in health as compared to their insured counterparts prior to age-65. But after five years of Medicare coverage, this health gap closed by 50 percent. The impact of coverage was greatest for those with a history of heart disease, stroke, high blood pressure or diabetes.

“While it may seem self-evident that gaining health insurance should improve health, some experts have questioned this assumption,” said Dr. J. Michael McWilliams, a research associate in Harvard Medical School’s Department of Health Care Policy.

“By comparing the health trends of insured and uninsured adults as they became eligible for Medicare, we were able to measure the impact of coverage on health in a more rigorous way.”

An earlier Harvard study showed that uninsured adults transitioning to Medicare end up costing the system more in annual medical spending after age-65 when compared with continuously-insured individuals. The most recent study and others based on accumulated HRS data support health coverage as a way of lowering long-term care costs as people age.

A University of Michigan study based on HRS showed that those with cognitive impairments such as dementia received substantially more informal help than those with normal cognitive function.


This help includes assistance with basic daily activities such as bathing, dressing, eating and fixing meals, and with less frequent activities including grocery shopping and managing money.

“Helping those with dementia places a significant burden on both families and society, and this burden increases sharply as the level of cognitive impairment progresses from mild to severe,” said Dr. Kenneth Langa, assistant professor of internal medicine at the University of Michigan Medical School and faculty associate at the University of Michigan Institute for Social Research.

“Both physicians and policymakers will be confronted with difficult choices regarding the allocation of healthcare resources as the U.S. population ages and the prevalence of dementia increases,” says A. Mark Fendrick, M.D., study co-author and University of Michigan associate professor of internal medicine.

Researchers said the findings will need to be explored further to see if they can be observed in other studies and to pinpoint factors influencing cognition or the ability to think, learn and remember.

 


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