The Alzheimer's Foundation of America (AFA) last month expressed its concerns to the United States Senate Special Committee on Aging about the inappropriate use of antipsychotic medications among nursing home residents, and outlined alternative non-pharmacological strategies to deal with behavior issues.

   AFA submitted its testimony in mid-December for inclusion in the record, following the committee's hearing on November 30 on the overutilization of atypical antipsychotics in long-term care settings, particularly when used as a behavioral intervention among people with dementia.  

     AFA "is committed to ensuring that people with Alzheimer's disease and related dementias are not treated with inappropriate or harmful medications," stated Eric J. Hall, AFA's president and CEO.

   "Yet," he continued, "AFA recognizes a limited role for the appropriate use of antipsychotics in the treatment of nursing home residents with Alzheimer's disease."

     AFA noted there are some instances where behavioral and psychotic symptoms, such as violence, pose a greater risk to the resident, staff and family than the use of the medication. It also recognizes that curbing usage could lead nursing homes to restrict or deny admission if the facility perceives behavioral difficulties and lacks effective safety tools.

    AFA's recommendations include funding for nursing homes for staff training and to ensure proper staffing levels; promotion of early detection of Alzheimer's disease and related dementias through memory screenings, since early recognition and appropriate treatment seem to be associated with a decrease in the development of problematic behaviors that could lead to antipsychotic treatment; and enforcement of requirements by the Centers for Medicare and Medicaid Services that a nursing home facility avoid use of antipsychotics in most circumstances.

   Two recent government studies found that more than 14 percent of all nursing home residents had Medicare claims for atypical antipsychotic drugs, half of which were not used for medically accepted indications.

Obesity may increase the risk of falls in older adults, while those who are the most severely obese may be somewhat protected from the effects of a fall, according to researchers at Syracuse University, Syracuse, NY.

     Obese older adults were 12 percent to 50 percent more likely to suffer a fall than their normal-weight peers, factoring in other conditions such as arthritis, pain in the legs, diabetes and stroke.  The risk rose in line with a person's increased body mass index (BMI), a measure of height against weight. For example, the most severely obese people with a BMI of 40 or higher or approximately 100 pounds overweight for a man and 80 pounds for a woman faced a 50 percent higher risk.

    However, noting a buffering effect, those who were severely obese were one-third less likely to be injured from a fall than those with a normal weight. In contrast, older adults with a BMI of 30 to 34.9 were 17 more likely and those with a BMI of 35 to 39.9 were 39 percent more likely to suffer a disability with activities of daily living compared to normal weight participants.

   The study, which appeared in the Journal of the American Geriatrics Society, examined nearly 11,000 people aged 65 and older from 1998 to 2006. During that time, the participants experienced 9,621 falls during two-year intervals, with 3,100 resulting in injuries that merited medical attention. Of those who fell, 23 percent were obese.

News to Use:

• A new iPhone app might literally be a lifesaver. Azavea, a Philadelphia-based software development company, recently released an Emergency Medical Center Locator app that enables users to quickly locate state-of-the-art medical centers in 101 countries. The app determines a user's location and then uploads the names and addresses of the 50 closest centers. It also recommends facilities with the best patient outcomes in six key areas: trauma, stroke, eyes, pediatrics, cardiac and burns. It is available for free download through iTunes. 
• Why is more research needed to find cures for brain disorders? It's not too late to voice your opinion by submitting your story to the 2012 Neuro Film Festival, an annual contest sponsored by the American Academy of Neurology Foundation. Applicants, including individuals with neurological disorders, caregivers and others, will compete for a chance to win up to $1,000 and a trip to New Orleans. The deadline is January 31.

• Certain vitamins linked to brain health...Higher blood levels of omega-3 fatty acids and vitamins B, C, D and E correlated to healthier brain vessels and brain volume and better cognitive functioning, according to a recent study of 104 older adults (average age 87). In contrast, higher levels of trans fats in the blood was associated with impaired mental ability and smaller brain volume. Read More...   
• Changes in cerebrospinal fluid may precede Alzheimer's disease...Researchers found that a majority of people with mild cognitive impairment (MCI) whose medical condition progressed to Alzheimer's disease had a decrease in specific components of cerebrospinal fluid in the brain and spinal cord. In the study, approximately 90 percent of individuals with MCI who experienced the shifts in cerebrospinal fluid developed Alzheimer's disease within nine to 10 years. Read More... 
• Scientists link silent strokes to memory loss...In comparing brain scans and cognitive performance of people with and without silent strokes--characterized by small spots of dead brain cells--researchers found a link between silent strokes and poor performance on tests that evaluated memory, language, speed of processing information and visual perception. The study observed 658 people aged 65 and older who were free of dementia, including 174 who had silent strokes. Read More...        

Call into Care Connection, a telephone support network, on January 12 at 1 p.m. (ET) to hear Carole Larkin, MAG, CMC, CDP, EICS, geriatric care manager, ThirdAge Services, Dallas, speak about "The Biology of Dementia."

     The free teleconference is designed for family caregivers and healthcare professionals; members of AFA's Dementia Care Professionals of America (DCPA) can earn training credits toward renewal of their DCPA status. Call (toll-free) 877-232-2992 and enter the guest identification number 271004#.

AFA recently announced the formation of a Legacy Society, which offers special recognition to individuals who have included AFA in their wills or estate plans. Information about AFA's new Legacy Society is available at

www.alzfdn.org or by contacting AFA at 866.232.8484 

To obtain more information about AFA, visit us at www.alzfdn.org or call us toll-free at     866-AFA-8484.