FYI Daily

From the Department of Tell Me Something I Didn't Already Know: Caring for a loved one with Alzheimer's disease can be stupendously expensive, says a new report in The New England Journal of Medicine. That's not news for the millions of caregiving families emptying their pocketbooks over the long haul of Alzheimer's care.

But the scale of the costs may be: Alzheimer's is the most expensive disease to treat, more expensive than cancer or heart disease, according to the research. How expensive? Try to the tune of $157 billion to $215 billion -- a year. That breaks down to roughly $41,000 to $56,000 per case, exclusive of costs for other chronic illnesses the person may have.

The research comes from Rand Corporation economists and was sponsored by the National Institute on Aging.

Where does the money go...  Read more

By the time Abigail Van Buren -- a.k.a. "Dear Abby" -- died with Alzheimer's disease last week at 94, she hadn't written her famous advice column for years. (Her daughter, Jeanne Phillips, took over advice-dispensing duties back in 1987.) But in addition to her legacy of snappy wisdom penned over the 30-plus years she wrote her syndicated column, Abby leaves us with some parting insights about Alzheimer's:

Plan for the long haul, because you can't know how long someone with the disease will live.

The former Pauline Phillips was diagnosed with Alzheimer's in 1996, although her family says she had symptoms of the disease for years before. So she may have lived with Alzheimer's for 20 years.

Certain factors help roughly estimate life expectancy with Alzheimer's, such as the severity of symptoms and age at diagnosis. But predictions are very hard to make, as the rate of progression is different for everyone...  Read more

The words "caregiver" and "unsung hero" go together in countless ways -- not least, their role in healthcare. A new report from the Family Caregiver Alliance calls caregivers "essential" in helping their loved ones transition from one care setting to another, such as from hospital to home or rehab facility.

One of the biggest problems, says the report, is how undervalued caregivers are in smoothing transitions and improving communications. Many transitional-care programs don't actively engage family members, for example. Yet there's growing evidence that people have better outcomes when a hands-on caregiver is involved.

Hospital discharge can be a fraught time. Among the risks to frail older adults during these transitions, according to the report:

• Medication errors

• Unnecessary duplicative tests

• Lack of coordination between services and providers

• Poor communication among professionals...  Read more

Include music in your holiday plans with ailing older relatives and you'll all feel a bit better for it. A growing body of research indicates that music really does have healing powers.

Music's good effects are not only psychological. Music seems to have the power to affect the body's metabolic responses, finds a review in the journal Nutrition. The researchers at Massachusetts General Hospital in Boston reviewed many previous studies on music's health benefits.

Research in this review and elsewhere show that music can, for example:

• Boost the metabolic function, including the immune system. Hearing music reduces serum cortisol in the blood. This can have a wide-ranging impact on chemical reactions in the body, say the Mass General authors. Specifically, they single out music's effect on the function of the hypothalamic-pituitary axis, the sympathetic nervous system, and the immune system...  Read more

Many families have had this experience: An older loved one comes home from the hospital seeming mentally different from before he or she went in. Is it just normal aging? Or dementia that was happening anyway? In fact, the hospitalization itself -- particularly if the stay involved an intensive care unit -- may have added to the dementia risk.

Surviving a critical illness can put certain high-risk populations at risk for dementia, independently of the illness itself, research shows.

Three situations in particular might up the risk of later dementia for older, hospitalized patients, found a study of 25,000 Medicare patients ages 66 and older in the journal Critical Care, reported by ScienceDaily.com. They are:

1. Infection or severe sepsis.

   These patients had a critical illness that featured an infection that led to a more severe infection.

2. Neurological dysfunction, such as delirium.

   ...  Read more

If exercising to reduce stress or ward off diseases feels a little abstract to you, how about this incentive: Exercise can make you live longer.

Adults who do some moderate to vigorous physical exercise for at least 150 minutes a week live longer than couch potatoes, says a study in the American Journal of Preventative Medicine.

That's just half an hour a day, five days a week.

The researchers, at Queens University in Ontario, Canada, say this finding adds to other research showing that people are more likely to make behavior changes when they hear about the positive benefits. That apparently beats just hearing about the negative consequences if they don't exercise or eat right.

To that end, here are a few more exercise benefits that caregivers will appreciate:

• An I-can-cope mood.
  
  Dieting can make you cranky. But physical movement releases feel-good hormones and gives you more energy...  Read more

If your holidays include some movie-going, consider seeing a little picture with a big name, "The Man Who Shook the Hand of Vicente Fernandez". It's interesting even aside from the remarkable fact that it stars a lively Ernest Borgnine, in his final role before he died in July, 2012, at 95.

Early reviews have been middling (though with applause for Borgnine). But "The Man Who Shook the Hand of Vincente Fernandez" is noteworthy because of its setting: A nursing home that Borgnine's character moves into following an accident.

This nursing home backdrop isn't used to explore the tragedy of a disease, like Julie Christie's early-onset Alzheimer's, which led to her move to a dementia-care facility in "Away From Her." It's not about a family exploring assisted living options for a loved one. (See: "The Savages".)

"The Man Who Shook the Hand . . ." is a comedy about a former would-be actor who loves Westerns and once had a brush with fame with "the Mexican Frank Sinatra" (the title character)...  Read more

President George H.W. Bush, 88, copes daily with effects of mild Parkinson's disease -- but it was a garden-variety bug that sent him to a Houston hospital. Bronchitis, inflammation of the tubes that lead to the lungs, can produce difficulty breathing, shortness of breath, and a painful lingering cough. Most dangerously, it can lead to pneumonia, which is often deadly. Bronchitis is usually caused by a virus, typically influenza (flu).

Don't let such common illnesses wreck your holidays:

• Consider a flu shot a kind of "gift."
  
  We're all busy with shopping lists this time of year. But getting an older loved one immunized -- and doing the same for family members in close contact or the same household -- can help preserve the most precious gift of all, life. Flu kills 3,000 to 49,000 people in a typical year, says the CDC. Nine in 10 flu deaths, and 60 percent of flu-related hospitalizations are in those 65 or older, says the National Council on Aging...  Read more

Two tough conditions often lurk behind the lights and tinsel of the holiday season: grief and depression. They often share many of the same symptoms. But are they the same thing? After much debate in the psychiatric world, the ruling is yes: The new DSM-5 mental-health diagnostic guide no longer supports a "grief exclusion" for depression.

That means that someone suffering a loss who shows the signs of depression can be treated as being clinically depressed. Health workers in the past excluded grief as being depression until the severe symptoms persisted longer than two months or made the person functionally impaired.

There are arguments for and against this distinction. For example, some clinicians say that many kinds of stressors can lead to depression, so why not mourning? Some people do experience an extreme form of mourning known as "complicated grief". But other experts worry that wthout the exception, the grief process will be rushed along, swept under a rug as unnatural, or overmedicated...  Read more

Where will your parents live when they can no longer set up house independently? Though multiple generations have long lived together under one roof, that hasn't been the American way in recent history. But as more of the oldest live longer, some innovative new "granny flat" options are expanding the possibilities:

• A built-in apartment
  
  Close -- but not too close. That's the idea behind new construction that incorporates a separate apartment space complete with kitchen and bath. They often have both a private entrance and an entrance connecting the apartment to the main dwelling. The recession is also fueling a boom in these "Next Gen" houses, reports The New York Times.

  Builders' other configurations include over-the-garage apartments (where stairs may be a problem for seniors) and large "flex rooms," with separate entrances and bathrooms, that can be used in multiple ways (such as for a relative or a home business)...  Read more