Health
Alzheimer’s and other dementia diagnoses can vary by zip code, new study finds
Your home address could determine the likelihood of getting a dementia diagnosis, a new study suggests.
Researchers from University of Michigan Medical School analyzed Medicare claims for nearly five million older adults in regional health care markets across the country — focusing on the areas that had higher rates of diagnoses of Alzheimer’s disease and other dementias.
They found that in areas with a higher rate of diagnosis — known as “diagnosis intensity” — residents were twice as likely to find out they had the condition, especially among those ages 66 to 74, along with Black and Hispanic subgroups.
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“The number of people who obtain a formal diagnosis is different across regions,” lead study author Dr. Julie Bynum, a researcher and professor in the Department of Internal Medicine at University of Michigan Medical School, told Fox News Digital.
“Those differences are related to how many people actually have dementia, which is driven by risk factors like age, race and cardiovascular risks — but we cannot explain all the differences in the percentage of people who get diagnosed on these population characteristics.”
Where you live could determine the likelihood of getting a dementia diagnosis, a study by researchers from University of Michigan Medical School found. (iStock)
Certain health system factors may come into play, Bynum said – such as the accessibility of health care and the availability of clinicians who have experience in diagnosing and caring for people with dementia.
Some of the health care markets with the highest dementia diagnosis rates include Texas (McAllen, Wichita Falls, Harlingen); Miami, Florida; Lake Charles, Louisiana; Alabama (Tuscaloosa and Montgomery); Michigan (Detroit, Dearborn, Royal Oak); Oxford, Mississippi; and New York (Bronx, Manhattan).
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Bynum wasn’t entirely surprised by the findings, she said.
She expected to find differences in the rate of formal diagnosis, she said, based on how practices and individual doctors typically respond to patients with cognitive concerns.
The accessibility of health care and the availability of clinicians who have experience with diagnosing and caring for people with dementia could impact the diagnosis rates, the new study found. (iStock)
“What was less expected is that the location of high and low diagnosis intensity areas does not follow a pattern of where there is a higher burden of disease in the population,” she said.
“I had expected that in places where dementia was a bigger problem, we might see a greater effort to get those people into care.”
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Lycia Neumann, PhD, senior director of health services research at the Alzheimer’s Association, was not involved in the study but commented on how it highlights regional disparities in the diagnosis of Alzheimer’s and other dementias.
“This suggests that unless there is intentional effort from health systems, payers and governments to promote equitable access to diagnosis, these disparity gaps will continue growing,” she told Fox News Digital.
Overcoming barriers to diagnosis
Based on the findings, people who are concerned about cognitive decline among their family members may need to “put in some extra effort” in communicating their concerns with their primary doctors, Bynum said.
“One of the problems is that the concern can get lost among all the other things older adults and their doctors address, and sorting out cognitive complaints is challenging for doctors,” she told Fox News Digital.
People who are concerned about cognitive decline in regard to their family members may need to “put in some extra effort” in communicating their concerns with their primary doctors, a researcher said. (iStock)
“In addition, we should all be encouraging our local health systems to develop the capacity to address the needs of this burgeoning population through clinical and supportive programming.”
Neumann said younger individuals and those from “historically underrepresented ethnic and racialized groups” have a greater risk of being underdiagnosed.
“We know that barriers to an early and precise dementia diagnosis exist at all levels,” she said.
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“They go from stigma and lack of awareness of signs and symptoms to barriers to health care access related to health insurance coverage, distance to clinical settings, and lack of transportation and companionship.”
It is Neumann’s hope, she said, that studies like this one spark efforts to raise awareness of early warning signs and encourage individuals to discuss any concerns with their health care providers.
“Barriers to an early and precise dementia diagnosis exist at all levels.”
Educational programs and interventions can also facilitate access to timely dementia diagnoses, she added.
“After all, an accurate diagnosis is the first step to appropriate treatment and care.”
Potential limitations
One of the study’s limitations is that the researchers were not able to determine whether the rate of diagnosis is “too high or too low” based only on their data, Bynum noted.
“We can only say that it is higher or lower than the national average rate,” she said.
“We would need to know the actual number of people living with dementia in each community, which would be incredibly costly to measure.”
This approach, however, can help researchers understand whether getting a formal diagnosis is more or less difficult across geographical areas, according to Bynum.
“We should all be encouraging our local health systems to develop the capacity to address the needs of this burgeoning population through clinical and supportive programming,” a dementia expert said. (iStock)
“There are always limitations regarding studies based on claims data,” Neumann noted.
“Claims data are only about individuals who received care, in this case a diagnosis — so it excludes people who might be living with the disease but haven’t been able to access the health care system or haven’t received an accurate diagnosis.”
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Additionally, the information collected in medical claims is for payment and reimbursement purposes, not for research — so it doesn’t allow for the understanding of the factors that might be driving the disparities, she added.
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The study population is also only composed of older adults enrolled in Medicare fee-for-service, or traditional Medicare, Neumann noted.
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A highly contagious digestive virus is surging across the U.S., experts warn.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain.
The virus primarily affects infants and young children, but there have also been outbreaks in elderly populations, such as nursing homes.
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Data from the Centers for Disease Control and Prevention shows that in the week ending April 4, out of 2,329 rotavirus tests, 7.3% were positive for the infection. Last year’s highest infection rate was 6.77% as of the week ending April 19.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain. (iStock)
“We’re seeing a lot of rotavirus in the wastewater right now,” Dr. Marc Siegel, Fox News senior medical analyst, confirmed to Fox News Digital. “Testing for rotavirus is way down, but the percentage of positive tests is up.”
While the virus typically peaks in the spring, it is not currently slowing down, he noted.
Why cases may be rising
Patricia Pinto-Garcia, M.D., a medical editor at GoodRx who is based in California, said there are several possible reasons for the rotavirus spike.
“Vaccine rates are down overall among young children, as they decreased during COVID,” she told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.”
The rotavirus vaccine series must be completed by the time a child is 8 months old, she noted.
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As a result of the declining vaccinations, herd immunity isn’t protecting vulnerable children, according to Pinto-Garcia. “Children who haven’t finished the vaccine series yet, are too young to get vaccinated, or can’t get the vaccine due to medical illness are more likely to get exposed to the illness because other children aren’t vaccinated,” she said.
Siegel noted that before the vaccine became available, rotavirus resulted in 55,000 to 70,000 in the U.S. per year.
“Vaccine rates are down overall among young children, as they decreased during COVID,” a doctor told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.” (iStock)
“I am concerned that the vaccination rate has been declining over the past seven years and is continuing to decline in the current climate of vaccine skepticism,” he said.
Surveillance methods are also much better than they used to be, Pinto-Garcia noted, which means public health experts are able to pick up and track cases better than ever before.
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“But we see that rotavirus-related healthcare visits are also up, so improved detection is not the only reason we are seeing this spike,” she said.
The COVID pandemic also disrupted the pattern of infections, according to Pinto-Garcia, so it’s “tricky” to compare the current levels against older cycles.
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor,” she added.
Transmission and risk
Dr. Zachary Hoy, a pediatric infectious disease specialist at Pediatrix Medical Group based in Nashville, Tennessee, often sees young patients with rotavirus.
“Rotavirus is spread via the fecal-oral route, meaning that a person comes into contact with virus droplets from contact with other children or adults, or from contact with objects such as toys that have been contaminated with the virus from someone who is sick,” he told Fox News Digital. “This can lead to outbreaks, especially at schools where many young children share the same toys.”
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor.”
Rotavirus is associated with many dehydration cases in the hospital due to the degree of diarrhea, according to Hoy.
In some severe cases, the virus can lead to seizures due to electrolyte imbalances from dehydration and loss of electrolytes in the stool.
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“Younger children do not have the reserves that older children and adults have, so they can become more dehydrated quicker and develop more severe electrolyte imbalances, leading to more severe infections,” Hoy said.
“Patients with problems with their immune systems or on medications that can decrease their immune systems can have more severe and prolonged infections, too.”
Treatment and care
Because rotavirus is a viral infection, antibiotics are not effective against it. There is no specific antiviral treatment for the condition, with doctors typically recommending supportive care.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” Hoy told Fox News Digital. “Sometimes it can take up to two to three days of IV fluids to help get patients rehydrated.”
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Blood draws are often necessary to evaluate patients’ electrolyte levels, such as sodium, potassium, calcium and magnesium, according to the doctor.
“If these electrolyte levels are significantly low, sometimes patients need special IV solutions or individual electrolyte medications,” he added.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” a doctor told Fox News Digital. (iStock)
Dr. Daniel Park, medical director of the Pediatric Emergency Department at UNC Health in Chapel Hill, North Carolina, noted that most children recover with supportive care, but parents should seek medical attention if a child shows signs of dehydration. Those include decreased urination, lethargy or inability to keep fluids down.
“While rare, rotavirus can be life-threatening in vulnerable populations, especially very young infants or children with underlying medical conditions,” Park told Fox News Digital.
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Prevention strategies
Given the lack of antiviral medications for rotavirus, doctors emphasize the importance of prevention, primarily the vaccine.
There are two rotavirus vaccines – Rotateq (a three-dose series) and Rotarix (a two-dose series). They are given starting at age 2 months as oral drops, not injections, according to Hoy.
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“It’s important to get the rotavirus vaccines on schedule, because these younger infants are at greatest risk if they get rotavirus,” he advised.
Other recommended prevention methods include handwashing with soap and water.
Every day we’re faced with a zillion small choices: Go to sleep early, or watch one more episode of that Netflix drama. Call an old friend to catch up, or cruise social media. Of course, no single action will guarantee a long, healthy life or doom you to an early grave. But those little daily decisions do add up, and over the long term they can make a difference when it comes to both your longevity and your health span, the amount of life spent in relatively good health.
Scroll through this theoretical “day in the life” and select the option that best fits your typical day. Not every situation will apply perfectly, but think about which choice you’d be most likely to make. This isn’t a formal scientific assessment. The goal here isn’t to assign you a “good” or “bad” score, but to help you understand the central factors that shape the way we age and how long we live.
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A study from Harvard Medical School indicates natural selection has favored the red hair gene, resulting in a potential increase in the number of redheaded people as humanity continues to evolve.
By analyzing nearly 16,000 ancient genomes spanning 10,000 years, researchers identified a list of traits that nature is actively pushing forward. Among the most prominent were the genetic variants for red hair.
“Perhaps having red hair was beneficial 4,000 years ago, or perhaps it came along for the ride with a more important trait,” the authors noted.
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The study, published in the journal Nature, relied on a large database of ancient DNA from West Eurasia. Using new computing methods, the team was able to filter out random fluctuations in DNA to identify what it called “directional selection.”
Directional selection happens when a particular version of a gene gives an organism a strong survival or reproductive advantage, causing it to become more common in a population faster than it would by chance, according to experts.
Directional selection is when a specific gene provides such significant benefits that it rises in frequency across a population much faster than random chance. (iStock)
Prior to this study, scientists only knew of about 21 such instances in human history, one of which was lactose tolerance. This new research uncovered hundreds more.
“With these new techniques and a large amount of ancient genomic data, we can now watch how selection shaped biology in real time,” Ali Akbari, first author of the study and senior staff scientist in the lab of Harvard geneticist David Reich, said in a press release.
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The data showed that genetic markers for red hair are among 479 gene variants that have been strongly favored over the past 10,000 years. One likely explanation, the researchers said, is a major shift in human history: the transition to farming.
Scientists have long pointed to vitamin D synthesis as a likely driver for the rise of traits like fair skin and light hair. (iStock)
As humans moved away from hunting and gathering and settled into agricultural societies, their environment and behavior changed radically, triggering an evolutionary “acceleration.”
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While the Harvard study provides the first definitive statistical proof that red hair was actively selected during the rise of farming, the researchers noted that the exact prehistoric benefit still requires more study.
However, scientists have long pointed to vitamin D synthesis as a likely driver for the rise of these light-pigmented traits in northern climates.
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While redheads remain a minority of the global population today, the Harvard study’s analysis suggests that they may not be an evolutionary accident.
While redheads remain a minority of the global population today, the Harvard study’s analysis suggests they may not be an evolutionary accident. (iStock)
Instead, the red hair trait was “boosted” by natural selection as humans adapted to the challenges of a modern world, according to the researchers.
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The researchers urged caution in how these findings are interpreted.
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“What a variant is associated with now is not necessarily why an allele propagated,” the authors noted.
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