Senior Achievement Program Detail 2012
 

Race Impacting Hospice Enrollment?

(American Health Newswire) -- If you were given 6 months or less to live, would you want to spend it in hospice care? Approximately 1.58 million patients are in hospice today. A new study is researching racial differences in enrollment.

Non-white Medicare patients with heart failure are 20-percent less likely to enroll in hospice than their white counterparts. Why? Ivanhoe spoke with Dr. Kathleen T. Unroe, M.D., MHA, assistant research professor of medicine at the Indiana University School of Medicine to find out.

"African Americans prefer more aggressive treatment to the end of life. When you look at broad groups they tend to be less likely to use hospice. So we wanted to use this national Medicare data set of heart failure patients to look a little bit more closely at this issue," Dr. Unroe told American Health.

The researchers studied a national sample of 219,275 Medicare beneficiaries with heart failure. Among those who elected for hospice care, non-white patients were more likely to have an emergency department visit, to be hospitalized and to have an intensive care unit stay. Among patients who remained in hospice until death, nonwhite patients had higher rates of acute care resource use and higher overall costs than white patients in hospice.  

"Often people disenroll because they want something that hospice doesn't provide. They want more aggressive care and treatment," Unroe said.

"What I thought was interesting is, when you choose to enroll in hospice, your making a decision that you are not going to be perusing curative care, that you are going to be pursing supportive and palliative care. I would think that once you decided to enroll in hospice, no matter what race you are, your patterns of use would look pretty similar, but that wasn't what we found," Unroe told Ivanhoe.

Source: Interview with Dr. Kathleen T. Unroe, M.D., MHA, July 3, 2012

Fruit Fly Research Gives an Answer to Aging?

(American Health Newswire) - New fruit fly research sheds light on fatty acid metabolism in muscle, which could ultimately have implications for people who restrict calories in the hopes of gaining a longer life.

Fruit flies on dietary restriction need to be physically active in order to reap the lifespan extending benefits that come from their simple diet. If this same principle holds true in humans, those who restrict calories in their diets need to make sure that they eat enough to avoid fatigue.

Research from the Buck Institute shows that flies on dietary restriction shift their metabolism towards increasing fatty acid synthesis and breakdown, specifically in muscle tissue. "Dietary restriction is known to enhance spontaneous movement in a variety of species including primates, however this is the first examination of whether enhanced physical activity is necessary for its beneficial effects," Buck faculty Pankaj Kapahi, PhD, who runs the lab where the research took place, was quoted as saying. "This study establishes a link between DR-mediated metabolic activity in muscle, increased movement and the benefits derived from restricting nutrients." Flies on DR who could not move or had inhibited fat metabolism in their muscle did not demonstrate an extended lifespan. "Our work argues that simply restricting nutrients without physical activity may not be beneficial in humans," Kapahi was quoted as saying.

Additionally, the research points towards a potential target that could produce a drug that mimics the good effects of dietary restriction. Flies that are genetically engineered to over express the circulating peptide AKH (the fly equivalent of glucagon in mammals) showed increased fat metabolism, spontaneous activity and extended lifespan even though their diet was unrestricted. AKH plays an important role in glucose and lipid metabolism. "Our data suggests that DR may induce changes in muscle similar to those observed under endurance exercise and that molecules like AKH could serve as potential mimetics for DR that enhance activity and healthspan," lead author, Subhash D. Katewa, PhD, Buck Institute staff scientist, was quoted as saying.

"A better understanding of the dynamics of fat metabolism is needed in order to clarify its role in aging and disease," Katewa was quoted as saying. "These current results suggest that enhanced fat metabolism could help slow aging and the onset of age-related disease."

Source: Cell Metabolism, July 2012

Gene Variant That Lowers Cholesterol?

(American Health Newswire) It is known that high levels of low-density lipoprotein (LDL) cholesterol increase the risk for coronary heart disease. Now, researchers have discovered further insights about how a certain gene variant uses two mechanisms to reduce cholesterol.

A variant in the human gene that encodes the protein sortilin is linked with reduced plasma LDL levels and a decreased risk of heart attack. This variant results in noticeably higher sortilin protein expression in liver. 

Both effects were reliant on a cellular process called lysosomal targeting. Their data provide useful evidence that genetically-increased hepatic sortilin in humans reduces LDL by increasing LDL degradation, which removes LDL from circulation and decreases APOB.

Source: Journal of Clinical Investigation