Author Archives: HIA Guest Blog

AGS Releases New Action Steps to Guide Care for Older Adults with Multiple Chronic Illnesses

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Journal of the American Geriatrics Society Research Summary

Caring for older adults with multiple chronic conditions can create challenging situations. For example, some treatments may be harmful to older adults who live with and manage several chronic conditions. In some cases, several treatments might be available but healthcare providers may not know which are best for a particular individual. In other cases, older adults and caregivers could even receive different treatment recommendations depending on the healthcare providers who offer guidance. Most important of all, managing care for multiple chronic conditions can make it difficult to focus on what matters most to us as individuals—a key priority when we think about the high-quality, person-centered care we all want and need as we age.

In 2010, the American Geriatrics Society (AGS) convened a panel of medical experts to address how to provide the best care for older adults living with multiple chronic conditions. The panel reviewed a host of clinical studies and developed the AGS Guiding Principles for the Care of Older Adults with Multimorbidity as a result.

The expert panel identified five “key principles” that healthcare providers should follow to support the best care for older adults with multiple chronic conditions:

  1. Include personal preferences in care decision-making. Older adults who have multiple chronic health conditions should be asked how they wish to make medical decisions affecting their care. Whenever appropriate, caregivers and family members should also be involved in these discussions.
  2. Understand the limits of evidence on treatment options. Clinicians must understand that specific, evidence-backed answers to questions about the best medical choices for individual older adults may not exist. That’s because every older adult and every health situation is unique.
  3. Weigh benefits versus harms. When addressing multiple chronic conditions for an older individual, clinicians must consider how a person might be burdened by one medical plan or treatment versus others. They also must weigh the benefits of treatment options, as well as information on the person’s functional status (their ability to perform daily activities such as bathing and eating), life expectancy (how long they are likely to live), and quality of life.
  4. Consider if treatment is manageable. When sharing recommendations, clinicians must account for the complexity of a treatment and whether it suits an older adult’s particular situation.
  5. Make the best informed choice possible. Ultimately, healthcare professionals also must try to choose therapies that have the most benefit, pose the least harm, and will work to enhance an older person’s quality of life.

Now, an expert group of geriatricians, cardiologists, and general physicians have identified a set of action steps based on those guiding principles to help healthcare providers work with older adults and caregivers to make the best treatment choices possible when addressing multiple chronic conditions.

These steps include: Continue reading →

Depression Increases Risk of Death in Older Adults

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Journal of the American Geriatrics Society Research Summary

As we age, we become more likely to experience symptoms of depression. Research shows that depression’s symptoms can be linked to a higher risk for death. Yet often, older adults’ symptoms of depression may be missed by healthcare professionals.

What’s more, symptoms of depression have been linked to heart disease and stroke in middle-aged and older adults. Researchers suggest that the depression-heart disease link could play a role in the increased risk of death among older adults who have symptoms of depression. There’s also a known link between depression and deaths from cancer and falls in older adults. These connections might contribute to an increased risk of death for older adults, researchers suggest.

Since depression symptoms change over time, it’s possible that studying those symptoms during an older adult’s doctor visits could provide more information. To learn more, a research team designed a study to investigate the role depression symptoms play in an increased risk of death over time. The team also examined the role heart disease and stroke play in the link between depression symptoms and increased risk of death. Their study was published in the Journal of the American Geriatrics Society. Continue reading →

New Wisdom about High Cholesterol Treatment for Adults Aged 80 and Older

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Journal of the American Geriatrics Society Research Summary

Experts know that in adults younger than 65, having high cholesterol levels in your blood can raise your risk for heart attacks and strokes. However, in adults 80 years old and older, researchers have not—until now—thoroughly studied high cholesterol’s impact on heart disease, your ability to function well, or your risk for death.

In fact, some research shows that a higher level of total cholesterol and a lower level of so-called “bad” cholesterol (also known as “low-density lipoprotein” or LDL cholesterol) might be helpful in protecting your ability to perform daily activities and preserving your life for longer.

What’s more, it appears that having low cholesterol is linked to a higher risk of death from cancer, respiratory disease, and accidents in adults aged 80 and older. It also appears that the benefits of taking medications known as statins, which lower cholesterol, may lessen as people age. Researchers even have a phrase for this phenomenon. They call it the “risk factor paradox.” This describes the fact that for adults aged 80 and older, having some conditions that are considered health risks in younger adults predicts better survival. These conditions include having higher total cholesterol, higher blood pressure, and higher body mass index (BMI, a ratio of body weight to height that helps determine whether you are overweight or obese). Continue reading →

Learning about the Impact of Multiple Symptoms in Older Adults

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Journal of the American Geriatrics Society Research Summary

“Symptoms” is the medical term for any sign of a health problem, even if that sign doesn’t help your healthcare provider diagnose a specific illness. Symptoms, such as feeling tired or rundown (also called fatigue), are among the leading causes of disability for older adults.

Sometimes symptoms are directly caused by illness—for example, an aching chest can be a symptom associated with a heart attack. But often, symptoms have multiple causes. For example, fatigue can be a common symptom when you have conditions such as knee osteoarthritis, depression, and heart failure.

What’s more, older adults often experience more than one symptom at a time, which can make each symptom feel worse.

Up until now, we haven’t had much information about how symptoms that occur at the same time affect an older adult’s ability to function. To learn more, a team of researchers recently examined information from a large study of older adults, the National Health and Aging Trends Study (NHATS), which included more than 7,500 participants aged 65 and older. The study was published in the Journal of the American Geriatrics Society. Continue reading →

For Older Women, Taking High Blood Pressure Medication May Not Raise Risk for Falls

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Journal of the American Geriatrics Society Research Summary

High blood pressure (also known as hypertension) is the medical term for when the force of blood against your blood vessel walls is too high. We know that using medication to lower high blood pressure can prevent heart attacks and strokes. But healthcare professionals often worry that prescriptions for lowering high blood pressure can sometimes lower it too much. This can put you at risk for becoming dizzy and falling.

Falls are a serious problem in older adults. In 2014, falls caused 2.8 million emergency room visits, 800,000 hospitalizations, and 27,000 deaths, and cost Medicare an estimated $31.3 billion.

Although some healthcare experts suspect that taking high blood pressure medication over time is linked to falls and fractures, very little research supports that belief. In fact, at least two major studies examining blood pressure reduction did not find an increased risk for falls among people taking medication to reduce high blood pressure. Other studies have not shown an increase in fracture risk for people taking medication for high blood pressure—in fact, some studies suggest that high blood pressure medicines may actually reduce the risk for fractures.

Researchers decided to learn more about the links between falls, high blood pressure, and high blood pressure medication in older women. They published their study in the Journal of the American Geriatrics Society. Continue reading →