Baroness Nueberger heads Government review of controversial “euthanasia pathway”

Following the nationwide controversy over the so-called “euthanansia pathway” when food and medication are withdrawn from dying elderly patients in hospital, the government has announced it is to conduct an independent review.
Members of the public are now being invited to share their experiences of the Liverpool Care Pathway for Dying Patients (LCP), both good and bad, as part of the review being chaired by Senior Rabbi and Crossbench Peer, Baroness Julia Neuberger.
Their views will feed into the independent review of the pathway, which was announced in November 2012 by Care and Support Minister Norman Lamb to investigate concerns about the pathway, particularly accounts of the withdrawal of foods and fluids from dying patients and the use of financial incentives.
Julia NeubergerSpeaking today, Baroness Neuberger said:
“I am honoured to have been asked to lead this review. It will tackle a really important area of concern and, I hope, be able to make recommendations that will improve how dying people are treated within our health and social care system.
The review will examine various elements of the LCP, including:
  • the experience and opinions of patients and families;
  • the experience and opinions of health professionals;
  • hospital complaints;
  • the role of financial incentives in respect of the LCP;
  • the literature about benefits and limitations of the Liverpool Care Pathway.

Care and Support Minister Norman Lamb added:

“Experts agree the Liverpool Care Pathway, if applied properly, can help patients die a dignified and pain free death, but, as we have seen, there have been too many unacceptable cases where patients or their families were ignored or not properly involved in decisions. There have also been reports of food and fluids being denied to people inappropriately.
“It is vital for relatives to have complete confidence in the care that their loved ones are receiving. This is why we want to hear from people with experience of the Liverpool Care Pathway, where it met the high standards expected and where things went wrong.
“I urge people to get in touch to share their experiences, so we can ensure that lessons are learned and things put right.”
As part of the review, Baroness Neuberger will be holding meetings with families who have had experience of the LCP.
Today, Baroness Neuberger also announced full details of the panel of independent experts she has appointed to run the review:
Denise Charlesworth-Smith – Has experience of the Liverpool Care Pathway when her father was placed on it
Tony Bonser – fund-raiser for Macmillan Cancer Support; North Western Champion for the Dying Matters Consortium
The Rt Revd Richard Harries – Former Bishop of Oxford
Lord Charles Guthrie – Chancellor of Liverpool Hope University; Chairman of both the Hospital of St John and St Elizabeth and St Johns Hospice.
Professor Emily Jackson – Dean of Law at the London School of Economics
Dr Dennis Cox – Royal College of General Practitioners
David Aaronovitch – Columnist for The Times
Lord Khalid Hameed – Chairman of the Alpha Hospital Group; Chairman & CEO of the London International Hospital,
Sarah Waller – A former trust chief nurse and director of human resources: currently leads The King’s Fund’s Enhancing the Healing Environment Programme.
The review will report to ministers and to the NHS Commissioning Board in the summer.
For further information about the review and to submit evidence, please visit: http://www.dh.gov.uk/health/category/policy-areas/social-care/end-of-life/

Loneliness threatens life of elderly as Government mobilises to tackle problem

Esther.jpeg

Ester Ranzen, chair of Silver Line
A co-ordinated effort, bringing together care agencies and local authorities, to tackle loneliness amongst the elderly has been launched by the Government.
 For the first time local authorities will identify areas where older people suffer most acutely from loneliness to allow them to tackle the growing problem of social isolation and its harmful effects, announced Health Secretary, Jeremy Hunt.
By mapping areas where loneliness is high, better care can be targeted at those who need it most – including older people.
Research clearly shows us that loneliness can affect health – it increases the risk of heart disease, puts people at greater risk of blood clots and dementia, and makes them more likely to exercise less and drink more. Socially isolated and lonely adults are also more likely to undergo early admission into residential or nursing care.
The new measure of social isolation, launched as part of the updated Adult Social Care Outcomes Framework for 2013/14, is part of a package of plans to address the challenges of caring for an ageing population – including £20m announced today to help thousands of older people stay warm and healthy over the winter.
Health Secretary, Jeremy Hunt said:
“Tackling loneliness, by giving people better care and improved services, is another step towards making the UK one of the best places to live in Europe for older people.
 
“I want the highest standards of treatment and care in our hospitals, in our care homes and in the community – and that means looking at whatever is needed to drive improvements.
 
“We need a measure of loneliness to shine a light on this problem and to know what we are dealing with.  Once we have this solid evidence, local communities will have new tools to come up with the right, targeted solutions to the problem.”
Further research shows that:
  •  more than half of those over the age of 75 live alone – with about one in ten suffers ‘intense’ loneliness;
  • half of older people – more than five million – say that the television is their main company;
  • 17 per cent of older people are in contact with family, friends and neighbours less than once a week, and 11% are in contact less than once a month;
As a result of this new measure, local authorities will be able to compare data about how lonely or isolated the people in their area report to be. This information will help them identify how serious the problem is in their communities and what action is needed to tackle it.
Laura Ferguson, Director of the Campaign to End Loneliness said:
“Loneliness is a major health issue. An effective measure of isolation and loneliness is an important step to improving the lives of the hundreds of thousands of older people who are chronically lonely. This national measure can only help those making local health and care decisions to prioritise loneliness as a health issue, and one that they will tackle.”
Chair of The Silver Line, Esther Rantzen CBE said:”Loneliness creates a loss of confidence, an erosion of self-esteem, so that the front door becomes as solid as a brick wall and as impossible to break through. Some older people told me that they have nobody to speak to at all for weeks on end.  
“And yet there are many varied projects and organisations all over the UK, often staffed by volunteers, who could break through this life-threatening isolation, if older people knew whom to contact.   That is why we are in the process of creating a special helpline for older people, The Silver Line, which pilots from the end of November for three months and will launch nationally next year, and which will offer advice, information and friendship. We will have an important role in linking callers to the existing services in their local areas and we hope that our high profile will enable us to reach people who are at the moment totally isolated. Our slogan will be, “No question too big, no problem too small, no need to be alone.”  
Paul Najsarek, ADASS and Corporate Director for Adult Services at London’s Harrow Council said:
“The development of the Adult Social Care Outcomes Framework for 2013/14 has been a genuinely collaborative process between the Department of Health and local government. We strongly support the emphasis on the greater alignment of the framework with the Public Health and NHS Outcomes Frameworks – shared outcomes will drive the more efficient use of resources, and more seamless, joined-up care pathways. 
“The framework’s focus on people’s experiences of care and support is welcome – in particular, a new measure of social isolation among users of care and carers will bring a renewed focus to efforts to support people to maintain the connections to their communities which are so vital to their wellbeing. This year’s framework marks a significant step forward, and we look forward to continuing to work with the Department to build on the framework in future years”.
This announcement comes as Jeremy Hunt revealed that thousands of people across the country will benefit from a share of £20 million of Government money to help them stay safe and well during the cold winter months.
Council projects will receive a total of £20 million from the Warm Homes, Health People fund. This will help them run innovative schemes to help vulnerable people keep warm and safe and prevent people needing to go to hospital during the winter months.
The new measure forms part of the new Adult Social Care Outcomes Framework and updated Public Health Outcomes Framework for 2013/14. The Adult Social Care Outcomes Framework measures the quality of our care and support, and how well that care helps people to stay well and independent, and able to play an active role in their communities.   As the problems of  loneliness and social isolation can affect everyone, not just users of care services and carers, the Department of Health is working to develop a population based measure of loneliness.
The updated framework includes:
  •  Social isolation – a new measure of social isolation for users of care and support and carers, in response to the key White Paper commitment to address loneliness and social isolation (shared with PHOF)
  • Dementia care – a new measure to promote joined up working across adult social care and the NHS, to improve the quality of life and sustain the independence of people with dementia (shared with NHSOF)
  • Integrated care – a new measure on people’s experience of seamless, integrated care (shared with NHSOF)
  • Reablement – a new measure of the effectiveness of reablement care in supporting people to maintain their independence
 
Enhanced by Zemanta

One in six aged over 50 lives in isolation, says new report

One in six people in England aged over 50 are ‘socially isolated’, according to a new report.
olderpeople.jpg
They have few friends and little other social engagement, says the latest report by the English Longitudinal Study of Ageing (ELSA), a project that aims to understand the economic, social, psychological and health concerns of an ageing society. 
The ELSA report revealed that the least wealthy over-fifties suffer the most social isolation, with the wealthier among the same age group half as likely to become socially isolated, compared to the least wealthy.
The report suggests that much of the problem is caused by dwindling financial resources and that focussing public health intervention efforts on less wealthy, less healthy older people and on improving access to public and private transport for the over-50’s is likely to have the greatest impact in alleviating social isolation.
The ELSA project is an extensive research study that follows the lives of more than 10,000 English people throughout their older age and which reveals the complex inter-relationships between personal finances, social detachment and overall health and well-being.
 
Previous reports from the project have shown how social engagement is closely linked with long life and healthy ageing. The current findings come from the fifth report of ELSA, which is led by researchers at University College London (UCL) and which is carried out in partnership with researchers at the Institute for Fiscal Studies, the University of Manchester and NatCen Social Research.
One of ELSA’s goals was to determine whether measuring psychological well-being at a younger age could predict a person’s risk of later developing poor health and suffering an earlier death. Subjects were first visited in 2002/03 (wave one) and again most recently in 2010/11 (wave five).
 Inadequate transportation for those over-50 leave them feeling lonely
Those who were recorded as having a greater enjoyment of life in wave one were more likely to still be alive nine to 10 years later than were other participants. The difference between those who enjoyed life the most and those who enjoyed life the least was marked, with nearly three times more people dying in the lower than greater enjoyment group. 
Researchers also found that measures of psychological well-being that were taken in 2004/05 (wave two) could be used to predict which previously unaffected individuals would go on to suffer disability, reduced walking speed, impaired self-rated health, and to develop coronary heart disease by the time they were visited again in 2010/11.
ELSA coordinator Professor Andrew Steptoe, British Heart Foundation Professor of Psychology and director of the Institute of Epidemiology and Health Care at UCL, said: ‘These remarkable findings became even more astonishing when it became clear that the link between psychological well-being and long term health and survival was independent of other factors such as age, gender, ethnicity, wealth, education and baseline health.’
Women are more likely to become detached from leisure activities than men 
The report also found evidence that a significant number of people over recent years have been retiring gradually, rather than abruptly ceasing work. Almost half of men and a third of women aged 60 to 64 years who are in receipt of private pension income are still in work; and these people on average work fewer hours than those who have yet to start drawing their private pensions.
Among those who have retired over the last decade, average post-retirement family net income fell to 72 per cent of average pre-retirement income. Those in the top quarter of pre-retirement income experience the biggest post-retirement percentage decrease (down 40 per cent).
Prof Steptoe added: ‘We also found social detachment is more common among individuals who never married or have been separated/divorced or widowed than members of couples.
‘Men, those living alone and those living in rural areas are less likely to remain in regular contact with friends and family.
‘Mobility problems are associated with a withdrawal from leisure activities and cultural engagement, as is losing access to transport.
‘Women are more likely to become detached from leisure activities than men, but less likely to become detached from social networks; while widowed individuals are less likely to withdraw from leisure activities, cultural engagement and, in particular, social networks than those in a couple.’
ELSA began in 2002 and visits volunteer participants every two years. This is the fifth biennial report.
 
 
 
Enhanced by Zemanta

Selenium deficiency link to diseases of ageing

 

sel.jpeg

Elderly people in care homes are more likely to be deficient in the anti-inflammatory mineral selenium, according to a report in The Journal of Nutrition, Health & Aging.
Researchers in Taiwan studied 336 men and women between the ages of 65 and 101 years who were residents of long-term health facilitie.
Blood samples were analysed for the inflammatory cytokine interleukin-6 (IL-6), selenium and other factors.
MR W Y Lin, who led the research team said: “The ageing process has been demonstrated to be associated with oxidative damage and increased production of inflammatory cytokines.
“The inappropriate presentation of inflammatory cytokines, including tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6, characterizes a chronic inflammatory state in the elderly. Meanwhile, it has been reported that the increase in serum inflammatory cytokines, especially IL-6, is related to the development of sarcopenia, functional disability, frailty, and increased morbidity and mortality.”
Selenium deficiency, defined as having a serum selenium level of less than 80 micrograms per liter (mcg/L), was detected in 35.6 of the men and 43.2 percent of the women participating in the study. An increased risk of deficiency was associated with rising levels of IL-6. Among those whose IL-6 levels were among the top 25 percent of participants, the risk of deficiency was more than double that of subjects whose IL-6 levels were among the lowest quarter.
The authors attribute the finding to selenium’s antioxidant and anti-inflammatory properties, and note that decreases in serum selenium as well as increases in interleukin-6 have been linked with chronic diseases involving inflammation, including cardiovascular disease and high blood pressure. They remark that chronic inflammatory diseases could be a consequence rather than a cause of the relationship between selenium and IL-6; however, the design of the study prohibited exploration of causality. “Future studies should aim to further clarify the linkage between selenium and IL-6, and possible benefits and disadvantages of intervention,” they conclude.
Enhanced by Zemanta

New laser treatment for age-related sight loss launches

image

London: A new laser treatment to correct the need for reading glasses in ageing adults has been launched in the UK.

Ultralase has launched the new laser-based procedure, UltraRenew, which will be available for the first time in the UK to treat presbyopia, the age-related condition resulting in the need to wear reading glasses. The treatment, available to men and women, corrects the problem in just 15-20 seconds.

Staggeringly, this common condition affects everyone during their 40’s. Symptoms, including eye fatigue, increase the need for reading glasses as the eye’s natural lens starts to harden and the focusing mechanisms naturally decrease.

With reading glasses voted amongst the top five premature ageing factors, approximately 4.5 million Britons* could soon be binning their ‘readers’ in a bid to turn back the years as a result of this breakthrough.

Mark Korolkiewicz, Clinical Services Director, commented: “This truly is a revolutionary treatment which will make a huge difference to many individuals lives. It will appeal to people’s vanity, as well as to those involved in reading or detailed work as part of their professional life.

“It’s a real first to be able to offer this laser treatment to men and women in the UK who are generally in their 40’s. The procedure brings a host of advantages over existing treatments, essentially offering a solution to presbyopia without affecting distance vision.

“The advanced technology, linked with the fact that the treatment is carried out by surgeons certified by the Royal College of Ophthalmologists, the very highest industry accreditation, means patients should be able to throw away their reading glasses within 24 hours of surgery.”

As part of the development into the treatment, Ultralase questioned over 1,000 individuals into their feelings around wearing reading glasses to reveal that almost half of short-sighted Brits feel self conscious wearing them in public. Reading glasses were highlighted as one of the top five ageing factors alongside hairstyle, posture and dress sense.

Many stressed vanity as the reason for not wanting to wear their ‘readers’, with one in ten stating it makes them look old and an unlucky 13% highlighting they feel unfashionable. Interestingly, when broken down by gender, it is actually men who feel more conscious about reading glasses aging their looks than women.

Hassle was stated to be the key annoyance helping to drive the requirement for the treatment, with one in five fed up with constantly having to take reading glasses on and off during the day.

With prices starting from £2,195 per eye, free consultations for UltraRenew are available at all 31Ultralase clinics throughout the UK and Ireland.

Treatment is available from the Ultralase Hammersmith clinic with plans to expand UK wide by 2010. For more information about Ultralase and to book a free consultation visit www.ultralase.comor call 0800 9888 237.

*4.5 Million, based on total number of people needing reading glasses, approximately 42% of 45-62 year olds.

Over 60s warned to check drug cocktail with pharmacist – new survey

image

Older people may be taking a potentially dangerous cocktail of drugs, according to new research from the Royal Pharmaceutical Society of Great Britain.

The Society said is urging older people to review the medication they are taking. Millions of over 65s in Britain, said the Society, are taking a cocktail of medicines without fully understanding what they are, or the side effects they may be suffering from.

The research shows how nearly half (43%) of over 65s in Britain are currently taking over five medicines at any one time. However, one in five admit to not always taking the medicine as prescribed, and a staggering six out of 10 (61%) over 65s believe they either definitely or possibly have had a side effect from a medicine – yet one in five said that they did not get it checked out.

Other findings of the research revealed that almost one in 10 (9%) admit to not fully understanding what their medications do or how they treat their condition, and one in seven (14%) say they sometimes forget to take a pill at the recommended time.

Older people take more medicines than any other age group and account for about 50% of the NHS Drug Bill (Over £4Billion), mainly via repeat prescriptions (80%). Statistics show that the over 65s are three times more likely to be admitted to hospital because of adverse drug reaction (such as falls, confusion, delirium, gastrointestinal bleeds and other reactions) with up to 17% of hospital admission being due to these conditions – and it’s estimated that 80% of hospital admissions due to adverse reaction to medicines are predictable and preventable.

Watch the Society video on this subject:

US elderly have better mental function than those in UK

image

US elder have better cognitive function compared to their counterparts of the same age in the UK, according to a joint UK-US study.

The researchers said that mental function of the US elder was better despite the greater incidence of cardiovascular disease risk factors, which was managed better in the US with drugs.

They said: “Cognitive function is a key determinant of independence and quality of life among older adults. Compared to adults in England, US adults have a greater prevalence of cardiovascular risk factors and disease that may lead to poorer cognitive function.

“We compared cognitive performance of older adults in the US and England, and sought to identify sociodemographic and medical factors associated with differences in cognitive function between the two countries.”

The esearcher was carried out at Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA, Department of Public Health and Primary Care, University of Cambridge, Cambridge,UK; Epidemiology and Public Health, Peninsula Medical School, Exeter, UK; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA Department of Epidemiology, University of Iowa, Iowa City, IA, USA and the Department of Psychiatry, University of Cambridge, Cambridge, UK.

They studied 13,566 ethnic white individuals over the age of 60, beginning in 2002.

They found that adults in the UK were economically poorer and suffered more from depression than the US adults, where more money is spent on healthcare and also managing symptoms associated with impaired cognitive function, such as high-blood pressure, with drugs. US adults were also better educated.

The researchers concluded: “We found that despite a higher prevalence of cardiovascular risks and cardiovascular disease among older US adults, they performed significantly better than their English counterparts on tests of memory, suggesting an advantage in cognitive health in the United States.

“While we were unable to confidently identify thecause or causes of this US advantage, higher levels of education and wealth, lower levels of depressive symptoms, and more aggressive treatment of cardiovascular risks
such as hypertension, may be important contributing factors. Given the growing number of older adults worldwide, future cross-national studies aimed at identifying the medical and social factors that might prevent or delay cognitive decline in older adultswould make important and valuable contributions to public health.

Read the full study at Full Paper

UK MPs highlight abuse of elderly with dementia

image

London: An influential group of MPs is calling on the Government to stop the dangerous over-prescribing of antipsychotic drugs to people with dementia. Up to 105,000 people with dementia are given the drugs inappropriately, according to expert predictions in the new All-Party Parliamentary Group (APPG) on Dementia report, ‘A Last Resort’, published today.

Antipsychotics continue to be a first resort for dealing with challenging behaviour in people with dementia, such as aggression or agitation, despite causing devastating side effects, doubling risk of death and costing the UK over £60 million a year.

‘A Last Resort’ identifies 5 vital steps to reduce antipsychotic use and reveals there is currently no audit or regulation of the issue. It urges the Government to use its new National Dementia Strategy to address the problem and the National Institute for Health and Clinical Excellence to conduct a thorough review.

Jeremy Wright, Chairman of the APPG on Dementia, says:
‘A Last Resort shines a light on one of the darkest areas of dementia care. Antipsychotics can double risk of death and triple risk of stroke in people with dementia, heavily sedate them and accelerate cognitive decline.

‘The Government must end this needless abuse and make the 5 point plan a key element of the National Dementia Strategy. Best practice guidelines are not enough – safeguards must be put in place to ensure antipsychotics are always a last resort. We need to include families in decisions, give people with dementia regular reviews and equip care staff with specialist training.’

Neil Hunt, Chief Executive of the Alzheimer’s Society, says
‘It is absolutely disgraceful that widespread the abuse of people with dementia has been allowed to continue despite safety warnings on antipsychotics. Urgent action is needed.

‘Safe, effective alternatives to antipsychotics are available. New Alzheimer’s Society research shows specialist dementia training vastly increases quality of life and could save the UK £35 million a year if it was mandatory.’

‘Over 70% of people with dementia experience challenging behavior at some point during illness. More often than not this is an expression of unmet need, not a symptom of dementia, and there is no excuse for reaching for the medicine cabinet.

Lynn Ramsey, whose husband David was prescribed antipsychotics, says
‘My husband David was given antipsychotics without my knowledge. He was unable to make the decision himself because of his dementia. At first it was extremely painful for him and the drugs impacted on his ability to eat and dress. David’s chin became slumped onto his chest and he could only look at the floor for the rest of his life. He died aged 63. These drugs have a major adverse affect on people’s lives, both patients and families.’

The 5-point plan recommended in the report:

1. Specialist dementia training for all care staff
2. Families must be involved in all decisions around antipsychotics.
3. More pro-active support for care home staff from GPs, community psychiatric nurses and psychiatrists.
4. Compulsory medical reviews of people with dementia every 12 weeks
5. A cost effectiveness review by The National Institute of Health and Clinical Excellence and a national audit by the Care Quality Commission

References

• Up to 150,000 people with dementia in the UK in care facilities are prescribed antipsychotics according to best estimates.’ (Prof C Ballard, APPG inquiry oral evidence). Experts in Old Age Psychiatry predict 70% of prescriptions are inappropriate, therefore up to 105,000 people with dementia are inappropriately prescribed antipsychotic drugs (A Last Resort).
• Alzheimer’s Society funded research estimates antipsychotics cost the UK £60, 792, 263 per annum and specialist dementia training would save the UK £35 million a year if it was mandatory.
• Antipsychotics can treble risk of stroke in people with dementia (Committee on Standards for Medicine, 2004), and double a person’s risk of mortality (FDA 2005).
• Alzheimer’s Society research published in the BMJ found that specialist dementia training reduces disruptive behaviour and the use of antipsychotics by 50%.

More information
• ‘A Last Resort’ collates evidence from stakeholders, experts and people with personal experience, received as part of an All Party Parliamentary Group on Dementia investigation, including the Royal College of Nursing, Royal College of Psychiatrists, Alzheimer’s Society and the Commission for Social Care Inspection.
• 244,185 people (two thirds of care home residents) have a form of dementia.
• If we live to over 65, 1 in 3 of us will end ourlives with a form of dementia
• 700,000 people in the UK have a form of dementia. In less than 20 years nearly a million people will be living with dementia and by 2051 there will be 1.7 million
• For support or advice contact Alzheimer’s Society Dementia Helpline number is 0845 300 0336 or visit www.alzheimers.org.uk

Men with low-testosterone suffer increase in bone fractures

image

Sydney: Elderly men with low levels of testosterone are more than twice as likely to suffer bone fractures as those with higher amounts of the sex hormone, researchers in Australia found.

A study of men at least 60 years old found a quarter had testosterone deficiency linked to a two-fold increase in the risk of bone fractures caused by osteoporosis, according to researchers at Sydney’s Garvan Institute of Medical Research. The finding may enable doctors to identify susceptible elderly men and devise strategies to prevent bone fractures.

Osteoporosis, when bones thin and break easily, affects 10 million Americans and is generally considered a women’s disease. While women’s bones become fragile after menopause when they stop producing estrogen, men’s weaken at a later age and can cause just as much damage. In Australia, 30 percent of the 110,000 osteoporosis-induced fractures that occur each year are in men.

John Eisman, Professor Medicine at the University of New South Wales and director of Garvan’s bone and mineral programme said: “Osteoporosis in men is basically ignored. This is something that gives us more insight into why they might have problems, why they might be likely to fracture.”

In the US, for example, two million men have the disease and another 12 million are at risk for it, the National Osteoporosis Foundation estimates. Treating patients with osteoporosis medicines including Eli Lilly & Co.’s Evista and Forteo, Merck & Co.’s Fosamax and Procter & Gamble Co.’s Actonel may prevent fragility fractures if the disease is diagnosed early, previous studies have shown.

Each year, about 329,000 hip fractures occur in the U.S. About 20 percent of the people die within six to 12 months after breaking hips, according to a study published in November in the Journal of the American Medical Association.

Men’s testosterone levels are usually about 300 to 1,000 nanograms per deciliter of blood, according to the U.S. National Institutes of Health. A quarter of men over 60 had levels of 294 nanograms or less in the Garvan study, which followed 609 men aged over 60 years between January 1989 and December 2005.

Even after adjusting for factors known to alter fracture risk, including age, weight, fracture history, smoking status and calcium intake, the risk of fracture was more than doubled in men with low testosterone compared with men with high levels of the hormone, according to the study. The results were published yesterday in the Archives of Internal Medicines.

“Men with lower testosterone might be getting a double whammy,” Eisman said. “Their bones are worse and their muscles are a bit weaker, both of which are likely then to contribute to their risk of fractures.”

While testosterone supplements may assist those deficient in the hormone, other treatments may also help, he said.

“Importantly, reducing alcohol consumption, avoiding smoking, maintaining an active lifestyle, getting sunlight exposure and eating a diet rich in calcium will also help to minimize risk,” Eisman said.

The research is part of the Dubbo Osteoporosis Epidemiology Study, which started in 1989 and recruited all men and women 60 years or older living in Dubbo, a regional city of 32,000 predominantly white people in Australia’s New South Wales state.

Half a million elderly abused in UK, says Help the Aged

London Half a million elderly people in the UK are suffering some form of abuse or neglect, according to Help the Aged.

A major survey by the charity claims they face physical, emotional, sexual or financial mistreatment.

But campaigners say that, despite the size of the problem, more than one-third of people have never heard of elder abuse.

And a quarter of those questioned admitted they would not know how to spot if an older person was suffering.

Help the Aged is launching a national campaign – Enough is Enough – to draw attention to the problem.

Supported by TV presenter Esther Rantzen, it aims to raise awareness of the warning signs and give advice on how to help.

Ms Rantzen told BBC News 24: “As a nation we’re not very good at valuing older people. They’re sort of detritus, they’re a bit of sort of rubbish.

“It’s all about younger people these days and when you start getting white hairs and wrinkles on your face you’ve had your time… why don’t you push off to a care home.

“If we treat older people with respect, if we value them and treat them as precious the way we regard children now, that would do a great deal to provide the comfort and protection that vulnerable old people need.”

Help the Aged says many people in Britain wrongly believe elder abuse is most likely to be carried out in care homes by professional staff.

In fact, it claims the largest proportion of abusers are related to their victim and that 64% of abuse occurs in the older person’s own home.

Paul Cann, director of policy at Help the Aged, said: “These figures signal a frightening ‘Not in my back yard’ public attitude, fuelling existing myths that abuse of older people is largely carried out in professional settings, or by primary carers and never close to home.

“We know this simply isn’t the case. Elder abuse can happen anywhere and by anyone, and is more likely to occur within the family home, by someone in a position of trust.

“If more people understood what elder abuse is and its impact on those affected, instead of treating it as a taboo, we’d be one step closer to tackling this national scandal.”

Elder abuse in the UK

46% of abusers are related to their victims
25% of abusers are sons and daughters
80-89 year olds are most at risk

A new booklet produced by Help the Aged lists tell-tale signs which concerned friends and relatives should look out for.

These include the person becoming withdrawn or depressed, changes to their appearance such as weight loss or an over-emphasis on insisting everything is fine.

Ms Rantzen added: “Elder abuse not only has a devastating effect on older people, it shocks and appals their loved ones and indeed the whole nation.

“What kind of country allows older people to suffer and looks away?”

Help the Aged is also calling for:

* a zero-tolerance approach to all forms of elder abuse

* compulsory training in the prevention and recognition of abuse for anyone working with the elderly

* elder abuse to be given the same priority as child abuse

* greater awareness among the legal profession to ensure abusers are brought to justice

To support the campaign, Help the Aged has also produced a moving documentary in which an actor tells the story of an abuse victim in her own words.

Story fromBBC News

Discrimination against older workers grows in UK

London: Britain has the second highest number of unemployed older people in Europe, according to a recent report from the main trade union body.

The Trades Union Congress (TUC) which carried out the report also demands that UK companies must ditch sterotypes of older people.

In the report the TUC reveals that more than a million job hunters in the UK in their 50s and 60s are being forced on to state aid because businesses believe they are past their prime.

According to the survey, many businesses simply refuse to hire older workers or
pay to train middle-aged staff.

Frances O’Grady, the TUC’s deputy general secretary, said: ‘ Companies need to
ditch stereotypes of 50 and 60-somethings and capitalise on the value of
experienced staff by offering retraining and flexible working.’

Euopean Union rules aimed at ending age discrimination at work will come into force in October giving those who want to keep on working beyond 65 the right to ask to stay on. But companies can turn them down without giving a reason.

By 2046, the Government wants the state pension age – currently 60 for women and 65 for men – to have gone up to 68 for everybody. But the TUC says any savings will be swallowed up by state handouts to the unemployed

Britain has one of the highest rate of older people who want to work but cannot
find a job, says the report Ready Willing and Able. Only Austria has a greater percentage among the main European economies.

Elderly poor of Europe more at risk of illness

London: Elderly poor in Europe at greater risk of ill-health, according to a new report that highlights the inequalities in health care.

Called, “The State of Ageing and Health in Europe” which was compiled by the International Longevity Centre in the UK and the Merck Company Foundation, found that although most Europeans are living longer, ethnic minorities and the poor are at greater risk of ill-health.

The report, found that elderly Europeans who are poor have a 30% to 65% higher risk of almost all chronic diseases, including stroke, cardiovascular disease and cancer, the report said.

It also found older women have a greater risk of depression and disability than their male counterparts.

Demographic trends have brought a major shift toward chronic illness in the region, particularly stroke, heart disease, cancer, cataracts, risk of falls and incontinence.

In those over 65, cancer and cardiovascular diseases account for around three-quarters of all deaths in Europe.

However, the report noted that disease and disability do not have to be synonymous with growing old.

It urged European societies to address the issues of ageing in a positive and constructive manner.

Sally Greengross, executive director of the International Longevity Centre-UK, said: “The ageing of the population in Europe is to be celebrated. But if we want this trend to continue, policy makers must factor the needs of an ageing society into the planning, organisation and delivery of services. Equity of access to services is critical.

“From a policy perspective age needs to be considered as part of the health inequalities debate. The impact of socio-economic factors, gender and age must be viewed together as they affect individuals’ chances of achieving the best possible health outcomes into advanced age.”

The report made a number of recommendations to governments including further investment in community services and working closely with voluntary and private sectors.

It argues for better information to be given to the elderly and their families so they are able to negotiate the complexities of health care systems.

The charities also want to see a move away from the “catastrophic and short-sighted view” that older people are a drain on health care resources.

Healthcare for UK elderly still patchy, says new report

London: Good, respectful care for older people is still too patchy in Briton’s National Health Service, argue senior members of the British Geriatrics Society in this week’s British Medical Journal.

Last month’s government report A New Ambition for Old Age examined how the national service framework (NSF) for older people is being implemented and announced new aims and targets under three themes: dignity in care, joined up care, and healthy ageing.

So what has improved since the framework was launched five years ago, ask the authors?

A third of older people needing intensive daily help in England now receive this in their own homes rather than in residential care; delayed discharge from acute hospitals has been reduced by more than two thirds; and specialist services for people with stroke and for those prone to falls continue to improve.

But such health gains now need to be built on, say the authors. Despite older people being the prime users of health care and social services, investments have not been made in more specific services, such as general hospital care for older people.

Care for older people is still not sufficiently integrated, they add. The increasing emphasis in the NHS on moving patients rapidly through the emergency system towards discharge may benefit younger people at the expense of effective planning and specialist assessment of the frail and old.

The separation in the NHS of medical specialties from psychiatry is also hampering the provision of effective, humane, and responsive services for older people with mental health problems, such as dementia and depression.

They suggest that better coordination of care for people with complex needs will be achieved by strengthening commissioning arrangements between the NHS and local authorities, to ensure that social care is not provided without medical problems being treated.

The dignity of older frail patients is also infringed every day in many different ways, they warn. The establishment of a seven point plan to improve dignity in care is to be welcomed.

“This report contains much that is praiseworthy,” they conclude. “We hope that the levers set out in this report really convince providers of health and social care to reorganise their priorities.”

Eyesight deterioration in elderly may be linked to diet

Boston: The leading cause of blindness in the elderly, age-related macular degeneration (AMD), may be accelerated by regular diet of “high glycemic index” foods.

People with AMD are also likely to suffer from other health problems such as cognitive impairment, or problems with thinking, learning and memory, according to a new study in the April issue of the Archives of Ophthalmology.

The study was led by Chung-Jung Chiu and Allen Taylor at the Jean Mayer USDA Human Nutrition Research Center on Aging in Boston, Mass., and is part of the Nutrition and Vision Project, a substudy of the federally funded Nurses’ Health Study.

A high glycemic-index diet is a diet high in the type of carbohydrates that are quickly digested and absorbed, resulting in a rapid rise in blood glucose levels. The macula is a yellow pigmented spot, one-eighth-inch wide, in the center of the retina toward the back of the eye. AMD is one of the leading causes of irreversible vision loss among those aged 40 or older in the United States.

Study participants were 526 women aged 53 to 73 years who did not have a history of age-related maculopathy, the early form of AMD. The scientists assessed the participants for macular disease and classified the results. They then compared the results with long-term dietary information that had been collected using questionnaires over a 10-year period prior to the macular disease assessment.

When ranked into three groups from highest to lowest in terms of dietary glycemic index, the participants who were ranked highest were well over two times more likely to have macular pigment abnormalities as those ranked lowest.

An abnormal level of macular pigment is an early indicator of macular degeneration. The macula is responsible for the maximum ability to receive light and distinguish images.

Although the data do not establish a causal relationship, they do indicate a new direction for further studies that may help prevent or delay the onset of macular disease.