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Trend: With 25% of US physicians aged 65+, hospitals test older doctors on mental and physical acuity

When Are Doc­tors Too Old to Prac­tice? (The Wall Street Jour­nal):

In Feb­ru­ary, Robert Brown received an email that left him trou­bled. The New Jer­sey hos­pi­tal where the 71-year-old pedi­a­tri­cian was prac­tic­ing informed him that doc­tors age 72 and old­er would have to take a test to assess their phys­i­cal and men­tal health—or risk los­ing their priv­i­leges Read the rest of this entry »

Study: Families’ Perspectives on ADHD and its Treatment

In 2005 the Amer­i­can Acad­e­my of Pedi­atrics (AAP) began an ini­tia­tive to pro­mote an approach to care among its mem­bers in which “…the pedi­atric team works in part­ner­ship with a child and a child’s fam­i­ly to assure that all of the med­ical and non-med­ical needs of the patient are met.” A crit­i­cal­ly impor­tant focus of this approach is the role of the fam­i­ly and child — as devel­op­men­tal­ly appro­pri­ate — in the devel­op­ment of an over­all plan of care.

This shared deci­sion-mak­ing approach is espe­cial­ly impor­tant for con­di­tions like ADHD where there is not a sin­gle treat­ment that is the most appro­pri­ate and pre­ferred option for all patients. How­ev­er, Read the rest of this entry »

Cognitive screenings and Alzheimer’s Disease

The Alzheimer’s Foun­da­tion of Amer­i­ca just released a thought­ful report advo­cat­ing for wide­spread cog­ni­tive screen­ings after the age of 65 (55 giv­en the right con­di­tions).

Accord­ing to the press release,

- “The report shat­ters unsub­stan­ti­at­ed crit­i­cism and instead empha­sizes the safe­ty and cost-effec­tive­ness of these tools and calls on Con­gress to devel­op a nation­al demen­tia screen­ing pol­i­cy.”

- “Lift­ing the bar­ri­ers to ear­ly detec­tion is long over­due, Hall said. “Con­ver­sa­tions about brain health are not tak­ing place. We must edu­cate and empow­er con­sumers to talk open­ly about mem­o­ry con­cerns, par­tic­u­lar­ly with pri­ma­ry care providers, so they get the atten­tion and qual­i­ty of life they deserve.

- “Demand for screen­ings is evi­denced by the suc­cess of AFA’s recent sixth annu­al Nation­al Mem­o­ry Screen­ing Day held on Novem­ber 18, dur­ing which an esti­mat­ed 50,000 peo­ple were giv­en free con­fi­den­tial mem­o­ry screen­ings at near­ly 2,200 com­mu­ni­ty sites nation­wide. Dur­ing last year’s event, approx­i­mate­ly 16 per­cent of indi­vid­u­als who had a face-to-face screen­ing scored pos­i­tive and were referred to their pri­ma­ry care providers for fol­low-up. An AFA sur­vey of par­tic­i­pants revealed that few­er than one in four with self-report­ed mem­o­ry com­plaints had pre­vi­ous­ly dis­cussed them with their physi­cians despite recent vis­its.”

Excel­lent report avail­able: here

Please note that the Alzheimer’s Asso­ci­a­tion recent­ly argued in the oppo­site direc­tion (no screen­ings) — which prob­a­bly trig­gered this response.

We see emerg­ing trends that sug­gest the posi­tion in favor of cog­ni­tive assess­ments may in fact gath­er momen­tum over the next few years: wide­spread com­put­er­ized cog­ni­tive screen­ings in the US Army, insur­ance com­pa­nies like OptumHealth adding such tools to its clin­i­cal deci­sion-mak­ing sys­tems, polls such as the Amer­i­can Soci­ety of Aging’s a cou­ple of years ago indi­cat­ing a very strong demand for an “annu­al men­tal check-up”, the avail­abil­i­ty of use­ful assess­ment tools and research-based pre­ven­tive advice.

The start­ing point is to under­stand what those assess­ments are NOT: they are not diag­nos­tic tools. When used prop­er­ly, they can be used as a base­line to track per­for­mance in a vari­ety of cog­ni­tive domains over time, so that both the indi­vid­ual AND the physi­cian are not blind­ed by a one-time assess­ment, com­par­ing an indi­vid­ual with his or her peers (instead of his or her past per­for­mance) when seri­ous symp­toms have fre­quent­ly already been going on for a while.

Our con­trib­u­tor  Dr. Joshua Sil­ver­man, from Albert Ein­stein Col­lege of Med­i­cine, recent­ly gen­er­at­ed a nice debate on the top­ic by ask­ing our read­ers their reac­tion to these 3 ques­tions: Read the rest of this entry »

Grand Rounds 5:12 — Healthcare Reform Q&A

If Dr. Rob can inter­view San­ta, why can’t I inter­view a select group of health & med­ical blog­gers? They will have some good ideas to share”.

So did Pres­i­dent-elect Oba­ma came to real­ize a few days ago. After his peo­ple kind­ly con­tact­ed our peo­ple, we felt com­pelled to grant him open access to our col­lec­tive wis­dom. With­out fur­ther ado, below you have Grand Rounds 5:12 — a Q&A ses­sion led by the incom­ing Pres­i­dent on how to reform (for the bet­ter, we hope) health­care.

On Health Insur­ance

Q:  How does the blo­gos­phere per­ceive the prob­lem of hav­ing a sig­nif­i­cant group of peo­ple unin­sured?

Health Insur­ance Col­orado: a grow­ing eco­nom­ic bur­den, which may lead to emer­gency rooms turn­ing peo­ple away if they are unable to pro­vide proof of health insur­ance.

Dr Rich: well, a recent arti­cle in the Jour­nal of the Amer­i­can Med­ical Asso­ci­a­tion showed how over­crowd­ing in Amer­i­can emer­gency rooms is NOT due to the unin­sured. Rather, it is due to insured Amer­i­cans who can­not get in to see their pri­ma­ry care physi­cians. We may need improved care both for the insured and unin­sured groups.

Insure­Blog: I’d sec­ond that. Lack of health insur­ance is a major prob­lem but is it real­ly our Biggest Prob­lem?

It’s All about Atti­tude

Q: You may have heard my cam­paign mantra, “Yes We Can”. Can I count on your sup­port?

ButY­ouDont­Look­Sick: Yes. If Leslie Hunt can talk so open­ly about her chron­ic ill­ness (Lupus) yet ful­fill her Amer­i­can Idol dreams, we can ful­fill our dreams too.

Notes of an Anes­the­sioboist: you are talk­ing to the group of pro­fes­sion­als will­ing to self-exper­i­ment with our own body for the ben­e­fit of sci­ence and our patients.

Med­views: My wife, son, and I signed up to work as med­ical vol­un­teers for your upcom­ing inau­gu­ra­tion.

Emergi­Blog: I am on board too. But, please, remem­ber that car­ing is the essence of nurs­ing. And that is why my patients will always be my patients and nev­er my  clients.

Neu­roan­thro­pol­o­gy: Mr. Pres­i­dent-elect, it seems to me that, despite all our good inten­tions, bal­anc­ing the bud­get and mul­ti­ple com­pet­ing pri­or­i­ties will be a chal­lenge. May I sug­gest you start prac­tic­ing some capoeira for equi­lib­ri­um train­ing?

Shrink Rap: Hap­py to help. Now, we will need to pro­tect some time for qual­i­ty sleep time.

Train­ing

Q: I am encour­aged by your words. How can my team and I bet­ter sup­port you in your dai­ly activ­i­ties?

Aequa­nim­i­tas: we need more role mod­els for us to “learn to think, observe, and com­pare” and that the patient is our “first, last, and only teacher”.

Mud­phud­der: Couldn’t agree more. We need Read the rest of this entry »

Towards a Healthy Living & Cognitive Health Agenda

Here you have the Novem­ber edi­tion of our month­ly newslet­ter cov­er­ing cog­ni­tive health and brain fit­ness top­ics. Please remem­ber that you can sub­scribe to receive this Newslet­ter by email, sim­ply by brain fitness and health newslettersub­mit­ting your email at the top of this page.

Thank you for your inter­est, atten­tion and par­tic­i­pa­tion in our Sharp­Brains com­mu­ni­ty. As always, we appre­ci­ate your com­ments and sug­ges­tions.

Sum­mit of the Glob­al Agen­da

How can we per­suade busi­ness lead­ers, pol­i­cy-mak­ers and researchers of the urgency to devel­op and pro­mote an inte­grat­ed “Healthy Liv­ing” agen­da focused on main­tain­ing life­long phys­i­cal and cog­ni­tive health, vs. the usu­al mind­set focused on deal­ing with spe­cif­ic dis­eases and prob­lems once they arise?

In The Future of the Aging Soci­ety: Bur­den or Human Cap­i­tal?, I sum­ma­rize some of the key themes dis­cussed at the World Eco­nom­ic Forum event in Dubai on Novem­ber 7–9th. The world is aging — and in health­i­er ways. But our health­care and retire­ment sys­tems are on track to go bank­rupt — their premis­es are out­dat­ed. The cur­rent dis­ease-based research agen­da com­pounds the prob­lem. Solu­tions? 1) Pro­mote Healthy Lifestyles that help Main­tain Phys­i­cal and Cog­ni­tive Func­tion­al Abil­i­ties, 2) Redesign Envi­ron­ments to Fos­ter Health, Engage­ment and Finan­cial Secu­ri­ty, 3) Devel­op an Inte­grat­ed Healthy Liv­ing & Aging Research Agen­da. Specif­i­cal­ly, we could work with the UN and Glob­al 2000 com­pa­nies to move for­ward a new agen­da.

Plan­et Earth 2.0: A New Oper­at­ing Sys­tem: Imag­ine see­ing a top sheik in Dubai, wrapped in tra­di­tion­al Arab cloth­ing, exclaim “Yes We Can (a la Oba­ma) in front of the 800 glob­al experts, adding that “we build the future with our own hands. Some of the atten­dants of the World Eco­nom­ic Forum’s Sum­mit of the Glob­al Agen­da urged us to “reboot” the sys­tem. More than a “reboot”, we may have to upgrade to a new glob­al “Yes We Can” oper­at­ing sys­tem.

Brain Fit­ness Research

Train­ing Atten­tion and Emo­tion­al Self-Reg­u­la­tion: Dr. Michael Pos­ner, a promi­nent  cog­ni­tive neu­ro­sci­en­tist and first recip­i­ent of the Dogan Prize, grants us a fas­ci­nat­ing inter­view on what atten­tion, self-reg­u­la­tion, and effort­ful con­trol are, and how to improve them using soft­ware, med­i­ta­tion, and par­ent­ing. In his words, “we have found no ceil­ing for abil­i­ties such as atten­tion, includ­ing among adults. The more train­ing (…) the high­er the results.”

Neu­ro­plas­tic­i­ty and the Brain That Changes Itself: Lau­rie Bar­tels reviews the excel­lent book by Nor­man Doidge, explain­ing that “the neu­ro­science behind Doidge’s book involves neu­ro­plas­tic­i­ty, which is the brain’s abil­i­ty to rewire itself. This means that the brain  is our intel­li­gence,  is not some­thing fixed in con­crete but rather a chang­ing, learn­ing enti­ty.”

Can We Pick Your Brain re: Cog­ni­tive Assess­ments?: In our view, a crit­i­cal com­po­nent in the matu­ri­ty of the brain fit­ness mar­ket will be the avail­abil­i­ty of inex­pen­sive, valid and reli­able objec­tive cog­ni­tive assess­ments,  to help mea­sure how our brain func­tions change over time and iden­ti­fy pri­or­i­ties for tar­get­ed improve­ments. Dr. Joshua Stein­er­man asks if you would be up for them?

Use It (Prop­er­ly) or Lose It

Mem­o­ry Prob­lems? Per­haps you are Mul­ti-task­ing: Dr. Bill Klemm tells us that “Mul­ti-task­ing vio­lates every­thing we know about how mem­o­ry works.” He explains that “(mul­ti-task­ing) prob­a­bly does make learn­ing less tedious, but it clear­ly makes learn­ing less effi­cient and less effec­tive.”

Phys­i­cal and men­tal exer­cise to pre­vent cog­ni­tive decline: The Amer­i­can Med­ical News, a week­ly news­pa­per for physi­cians pub­lished by the Amer­i­can Med­ical Asso­ci­a­tion, just pub­lished an excel­lent arti­cle on the impor­tance of phys­i­cal and men­tal exer­cise. We are very hap­py to see efforts like these to train physi­cians and health pro­fes­sion­als in gen­er­al,  giv­en that most of them were trained under a very dif­fer­ent under­stand­ing of the brain than the one we have today.

Brain Fit­ness 2: Sight & Sound: PBS recent­ly announced the sec­ond install­ment of their pop­u­lar Brain Fit­ness Pro­gram show, to start air­ing soon.

MetaCar­ni­val #1: a con­ver­sa­tion across the blo­gos­phere: We often insist on “Nov­el­ty, Vari­ety and Chal­lenge” as key ingre­di­ents for good “brain exer­cise”. There are many ways to mix those ingre­di­ents — you may enjoy this one, the first inter­dis­ci­pli­nary gath­er­ing of blogs and blog car­ni­vals cov­er­ing health, sci­ence, anthro­pol­o­gy, gen­er­al advice and more.

Brain Teasers

Top 15 Brain Teasers and Games for Men­tal Exer­cise: Over the last 2 years we have pub­lished close to 100 puz­zles, teasers, rid­dles, and every kind of men­tal exer­cise (with­out count­ing our in-depth inter­views with top neu­ro­sci­en­tists). Which ones have proven most stim­u­lat­ing for you. Let us know. Here is a selec­tion of our Top 15 teasers.

Final Details

That’s all for now. Next month, we will be offer­ing anoth­er great selec­tion of arti­cles: Dr. Andrew New­berg will dis­cuss the brain val­ue of med­i­ta­tion,  Dr. David Rabin­er will review a recent study on how neu­ro­feed­back may assist in the diag­nos­tic of atten­tion deficits, and much more.

Please share this newslet­ter with your friends and col­leagues if you haven’t done so already.

Have a Hap­py Thanks­giv­ing!

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters and more, SharpBrains is an independent market research firm tracking health and performance applications of brain science.

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