…more hip fractures occurring in older women. After years of steady decline, the rate of hip fractures among older women in the United States is rising, according to a new study.
Researchers analyzed Medicare claims for two million women, ages 65 to 74, from 2002 to 2015. Fracture rates declined steadily until 2012, then began climbing again. Between 2013 and 2015, hip fracture rates jumped 2.5 percent in the 65- to 69-year-old group and 3.8 percent in the 70- to 74-year-old group. That is equivalent to about 11,000 more fractures among these age groups.
While the researchers did not look specifically at why the hip-fracture rate has risen, they speculated that decreased bone density testing and fewer prescriptions for osteoporosis drugs are contributing to this alarming trend. There is concern about some of the drugs used to prevent loss of bone mass, specifically bisphosphonates. Though they have been successful in treating osteoporosis for a decade, the Food and Drug Administration has issued a warning that people who take these drugs may be at risk for a rare type of thigh-bone fracture and for certain cancers, as well as serious side effects like joint pain and abnormal heart rhythms.
But if you have already had an osteoporosis-related fracture, you are at high risk of another one, experts say. Despite possible side effects, treatment with osteoporosis drugs has been shown to significantly reduce the chance of more fractures.
Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip, according to the American Academy of Orthopedic Surgeons. Medical conditions such as osteoporosis or cancer, or previous stress injuries, can weaken the bone and make it more susceptible to breaking. Hip fractures can significantly affect a person’s mobility and ability to live independently and are a major reason for nursing home placement. About 50 percent of those who break their hips fail to regain the levels of function they had before the fracture, and 20 to 30 percent die within the year.
Each year more than 300,000 people 65 and older are hospitalized for hip fractures, reports the Centers for Disease Control and Prevention. About 75 percent are women, who fall more often than men and are more likely to have osteoporosis. By 2025, it’s projected that osteoporosis will cause three million fractures and cost $25.3 billion annually.
… how a ‘brain pacemaker’ may help prevent cognitive decline. Scientists are hoping that a tiny device similar to one that helps heart patients may also help older adults with Alzheimer’s disease. Researchers at Ohio State University tested a “brain pacemaker” in a small group of Alzheimer’s patients to see how safe and effective deep brain stimulation (DBS) is at slowing the decline of problem-solving and decision-making skills.
Thin electrical wires were surgically implanted into the frontal lobes of three patients with mild or early stage Alzheimer’s disease to test whether the pacemaker could improve cognition, behavior and function. Over 18 months, cognition and ability to perform daily tasks declined more slowly among those who had the pacemaker, compared with a group of similar patients who were not treated with DBS. Study findings were published online in the Journal of Alzheimer’s Disease.
Your brain’s frontal lobe controls many functions affected by Alzheimer’s disease, including problem solving, judgment, planning, concentration and mental flexibility. While current therapies and medications can help with memory loss, few tools exist to help Alzheimer’s patients with judgment, concentration or attention. These skills are necessary to perform tasks such as choosing what to eat, making the bed or having meaningful conversations with others, according to the study’s authors.
DBS has been used successfully for people with Parkinson’s disease. The researchers say the approach looks promising for Alzheimer’s too. The next step will be exploring nonsurgical, less intrusive methods of frontal lobe stimulation.
… why older women do more poorly than men after stroke. Each year 55,000 more American women than men have a stroke. It is the third leading cause of death for women in the United States and is a leading cause of disability.
Women tend to live longer than men, and the risk of stroke increases with age. Women also generally experience a stroke at a later age and it’s frequently more severe; they tend to die more often or have a worse recovery. They are more likely to move to a nursing home and have poorer function and quality of life, compared with men.
To find out why, researchers conducted an in-depth examination of recent studies that looked at how gender influences women’s risk factors, treatment and outcomes for stroke.
Ischemic strokes, the most common type, are caused by narrowing or blockages in the arteries leading to the brain. Certain health conditions like diabetes, some types of heart problems, or migraines increase the risk of stroke. However, the risk in women is also affected by fluctuating hormone levels, hormone replacement therapy, hormonal birth control, pregnancy, and reaching menarche or menopause early.
Additionally, treatment may be delayed for female stroke victims because they have some symptoms that men don’t have, which may not be as easily recognized. Common symptoms include sudden weakness or numbness of the face, arms or legs, blurry vision, confusion or difficulty speaking. However, some women experience loss of consciousness or fainting, difficulty breathing or shortness of breath, sudden behavioral change, agitation, hallucination, nausea or vomiting, pain or seizures. The most effective stroke treatments work only if the condition is diagnosed within the first three hours of showing symptoms.
Better understanding of gender differences in stroke risk, of the urgency of appropriate treatment and of post-stroke care may pinpoint ways to narrow the gender gap, the researchers concluded.
… why you should think twice about dietary supplements. If you’re one of the 80 percent of adults over 55 who takes dietary supplements, you may be unwittingly putting your health at risk in your quest for wellness.
Supplement use is increasing (for this population, it’s up from 74 percent in 2016), but some herbal or dietary supplements can interact with certain prescription drugs in a harmful way. Generally, the more prescriptions you take—and older adults commonly take multiple medications—the greater the risk for negative reactions between drugs, or between supplements and drugs.
Supplements are not regulated by the Food and Drug Administration and do not undergo the same rigorous, lengthy clinical trials as do prescription medications. For some products, there just isn’t enough proof that they work as advertised.
Many doctors don’t question patients about their use of herbal or mineral supplements, and patients may not think to mention it. This can cause problems. For example, fish oil has been touted as good for heart health, but if you’re also on the blood thinner warfarin, it can actually increase your risk for heart disease and may cause major bleeding. Glucosamine, marketed to help with joint pain, can interfere with insulin-regulating medications and anticoagulants. Echinacea, an immune system enhancer, can cause problems for those taking immunosuppressants.
And while sales of memory-booster supplements have nearly doubled in the past decade, they also should be used with caution. Numerous, large, clinical trials have been unable to determine that they actually do what they claim. One of the most popular herbs for memory improvement, ginkgo biloba, interferes with medications like warfarin and can cause spontaneous bleeding in people who also take aspirin or other pain relievers.
Of course, many supplements can be beneficial, even when used along with prescription medications. Vitamin D and calcium have long been recommended for better bone health. Vitamin B12 may be necessary for those who can’t get enough from food. Before taking any supplement, over-the-counter drug or herbal remedy, check with your doctor to make sure it won’t negatively interact with any other medications you’re already using.
Freelance journalist Liz Seegert has been writing about health for nearly 30 years. Her work has appeared in Consumer Reports and Kaiser Health News, on the AARP and New America Media websites and on WBAI-FM/Pacifica Radio. She covers aging for the Association of Health Care Journalists. A native of Queens, NY, she loves to walk with her rescue dog, Duke. You can follow Liz on Twitter: @lseegert.