AGEC

Food Insecurity Among Seniors In Arkansas

By Jacquie Rainey, DrPH, MCHES
Department of Health Sciences, University of Central Arkansas

Students from the Nutritional Services Administration class in the Department of Family and Consumer Sciences at the University of Central Arkansas are learning how to plan and serve a meal for clients at the Faulkner County Senior Center. The Faulkner County Senior Center is part of the Faulkner County council on Aging, Inc. Its mission is to meet the social, nutrition and transportation needs of seniors. The partnership between the senior center and UCA students is a win for both groups. The students get real world practice in meal preparation and delivery, the seniors are fed a nutritious meal, and everyone has a good time. Any food that is not eaten the night of the theme meal is portioned for use the next day to serve to home delivered meal participants throughout Faulkner County. The event in April was centered on the theme of a 1950’s diner and included bingo and ‘50’s attire.

The Faulkner County Senior Center is one of the many organizations in the state that is working to combat food insecurity among older adults. Food insecurity is when someone is unable to acquire nutritionally adequate food in sufficient quantities and in socially-acceptable ways.¹ Arkansas ranks in the top tier nationally in the proportion of older adults (currently about 20% of all Arkansans over the age of 60) who are living with food insecurity.² Food insecurity is associated with many negative health effects, including nutritional inadequacy, poor overall health, extended hospital stays, cardiovascular disease, and worsening of chronic conditions. These health consequences have significant costs in terms of quality of life and financial impact.¹

For older adults, food insecurity is primarily an issue of access. Many areas of Arkansas, especially rural areas, are considered ‘food deserts’ where a large portion of the population does not live near a grocery store. Financial hardship is another common cause of food insecurity among seniors. People on fixed incomes have a difficult time purchasing the amount of healthful food that they need. Reduced mobility may produce barriers to older adults shopping for food or leaving home to secure a meal. In Arkansas, 21% of older adults have a health problem that requires the use of specialized equipment such as a wheelchair or walker. ¹ Additionally, lack of access to transportation or the inability to drive due to physical limitations can significantly contribute to food insecurity.

Food insecurity is more common among women, minorities, individuals without a spouse, those who use alcohol or tobacco, have high blood pressure, diabetes or depression, those who have been hospitalized or visited an emergency room in the previous year, and grandparents caring for grandchildren. ^3,1 Efforts should be made to recognize the risk factors for food insecurity and to connect older adults with resources within the community. Resources include but are not limited to: the Older American Act Meal Program that provides meals at sites administered by the Area Agencies on Aging (AAA), local nonprofit organizations such as the Arkansas Hunger Relief Alliance, the Arkansas Foodbank Network, and the Arkansas Rice Depot, and the federally-funded Supplemental Nutrition Assistance Program (SNAP). One example of how Arkansans can make a difference is letting seniors in Northwest Arkansas know about the Double Your Dollars (DYD) Programs at Farmers’ Markets. Senior Farmers’ Market Nutrition Program participants may receive a ‘match’ for purchases made at participating NWA farmers’ markets with their vouchers. Participants receive market coupons that are to be used like cash to purchase fruits, vegetables, meats, eggs, dairy, jam/jelly, honey and food-producing plants. If the market is participating in the DYD project, participants can receive a 1:1 match in market coupons.

The Supplemental Nutrition Assistance Program benefits are reported to be underutilized by older adults.¹ The recommendation from the Senior Hunger in Arkansas report was to increase the number of seniors who participate in the SNAP program thus providing access to sufficient amounts of healthful foods for Arkansas seniors.¹ The Arkansas Hunger Relief Alliance quoted Tomiko Townly, SNAP outreach director as saying, “We often see eligible seniors who don’t know they can receive food assistance or believe they will be taking food from those who are worse off than they are, so they are opting instead to cut back on medications to afford food.” ²

The threat of hunger among seniors in Arkansas is a continuing challenge. Food insecurity is associated with numerous poor health outcomes that can lead to additional challenges for the individual and the healthcare system. An avenue to potentially reduce the burden of disease on these individuals and the healthcare system is to ameliorate the problem of food insecurity in America.⁴UCA is happy to have a small part in helping to do this.

Division of Aging and Adult Services, Arkansas Department of Human Services. Senior Hunger in Arkansas. https://arhungeralliance.org/wp-content/uploads/2014/12/Senior-Hunger-in-Arkansas-2014-FINAL.pdf. Accessed June 5, 2018.
Arkansas Hunger Relief Alliance. (2018). Senior Hunger. https://www.arhungeralliance.org/programs/senior-hunger/. Published 2018. Accessed June 5, 2018.
American Geriatrics Society (2018) How common is food insecurity among older adults? https://www.eurekalert.org/pub_releases/2018-03/ags-hci030818.php. Published March 8, 2018. Accessed June 5, 2018.
Ziliak J, Gunderson G. The state of senior hunger in America 2015: An Annual report. Feeding America and the National Foundation to End Senior Hunger. http://www.feedingamerica.org/research/senior-hunger-research/state-of-senior-hunger-2015.pdf. Published August 16, 2017. Accessed June 5, 2018.

The Importance of Socialization As We Age

By Kathy Packard, MS, M.Ed., LPC, and Valerie Claar, MSN, RN, CNE
Oaklawn Center on Aging

Loneliness is defined as a feeling of sadness or distress about being by yourself or without friends. Loneliness can be either a response to or an effect of isolation. Loneliness can lead to isolation, which is defined as being separated from other people and your environment. Loneliness can also lead to depression and numerous health issues. As we grow older we experience losses. Family and friends may become ill and or die. We might find it easier to look for companionship through social media, or to order our groceries, clothing, etc. online, avoiding any and all human contact. As health care professionals who focus on best practices for the older adult population, we are capable of taking care of the medical, physical, and mental health needs but find we are at a loss as to how to get our consumers to get out and participate in social events with their peers. We know loneliness and social isolation are health hazards.

According to Brigham Young University study in 2010, loneliness isn’t just bad for the individual and communities; it is a legitimate public health threat. The Brigham Young study found that weak social connections can shorten a person’s life by 15 years, which is the same health impact as smoking 15 cigarettes a day.

Without the benefit of socialization, older adults who are facing medical issues do not have the support of their peers and may tend toward health decline. Research presented at the American Psychological Association’s annual convention in 2017 showed that greater social connection corresponds with a 50 percent decrease in the risk of early death.

It can be beneficial to know how to help and where to start. The answer may lie within our own reach by really working with the consumer/patient and having an honest conversation about the health benefits of socialization. It can also help to make a consumer driven plan that is achievable and enhances quality of life by decreasing loneliness.

More and more older adults are living longer and alone. Including socialization as part of the treatment plan may be one way to attack the problem. Getting the psychosocial history and writing a prescription for social activities our consumers are “willing and able to fill” may be a good first step toward increasing human contact and decreasing their loneliness. Encouraging older adults to include social activities, along with healthy eating and physical activity may help foster a healthy way of living for quality, enrichment and social engagement. Promoting local community programs such as Senior Centers, congregate meals, YWCA, YMCA, art classes, exercises classes such as Tai Chi, music programs (local orchestras, bands, etc.), and volunteering to help others are just a few of the resources at the local level.

As with any prescription, start low and go slow, it will take time for someone who has suffered from loneliness and isolation to “get back out there”. Having the consumer/patient actively participate in the development of the treatment plan and goals will be a step in the direction of self worth and motivation to achieve the desired outcome.

Understanding Shingles Vaccination and Other Adult Vaccinations

IMPORTANT: All CE Documents are accessible online and will be posted in approximately 10 days. Both CE and Live Channel information will be updated on this event page.

FREE VIDEO TELECONFERENCE/LIVE STREAMING CE EVENT

Please join the UAMS Arkansas Geriatric Education Collaborative (AGEC), a Geriatric Workforce Enhancement Program (GWEP) and the UAMS Donald W. Reynolds Institute on Aging for a FREE video teleconference for healthcare professionals, non-healthcare professionals, and other interested persons, regarding:

“Understanding the New Shingles Vaccination and Other Adult Vaccinations”

Our speaker is Robert H Hopkins, MD and Kara Jones, PharmD

Date: Tuesday, May 8

Time: 11:00 am to 1:00 pm

NEW Location: 4301 W. Markham Street, Rahn Building, Room G225, Little Rock, Arkansas 72205

Three viewing options are available:
1) Attend the event in Little Rock at the address above
2) Watch from a computer via UAMS Blackboard Collaborate CLICK HERE TO LIVE STREAM

3) The Centers on Aging will host live stream/webinar rooms at their locations and IVN (VTC) Networks available.

TIP: For best viewing quality, Blackboard Collaborate operates a higher quality signal with hardline computers (as opposed to a wireless laptop connection)

If you experience technical difficulties:

STEP 1: First please verify you are using Google Chrome.

STEP 2: If that doesn’t correct the issue, email blackboardhelp@uams.edu with your contact phone number and indicate you are attempting to join Arkansas Geriatric Education Collaborative Network

Location: Participants may view the conference on the UAMS Campus in the Jo Ellen Ford Auditorium at the Donald W. Reynolds Institute on Aging at 625 Jack Stephens Drive in Little Rock, Arkansas, via webinar on http://www.agec.org and at the Centers on Aging (COAs) located in: Hot Springs, Jonesboro, Springdale, Pine Bluff, Texarkana, Fort Smith and El Dorado.

For reminders and updates, pre-register on On EventBrite – click here

MATERIALS and CE information:

Program Flyer
Program Agenda
Powerpoint – Coming Soon

Parking is available in Parking Deck 3, at the corner of 4th and Cedar Streets. Unfortunately, tickets are not validated.

Do I have to bring my ticket to the program?
No. Pre-registration is recommended but not required

Have questions?
Email us at agec@uams.edu.

Caregiver Stress and Burnout

by Kathy Packard, MS, M.Ed., LPC, Director of Education, Oaklawn Center on Aging

Caregivers, are you experiencing caregiver stress or burnout? According to the Alzheimer’s Association, 15 million Americans provide unpaid care for people with dementia. Approximately 35% of those 15 million caregivers report that their health has gotten worse due to caring for their loved one. Obviously, caregiver stress is common among family caregivers.

Caregiver Stress: If you are a caregiver and are experiencing a loss of interest in activities you previously enjoyed, have feelings of helplessness, hopelessness, sadness, anger, rage, anxiety, agitation, irritability, are experiencing a change in sleep patterns, appetite, weight, feel exhausted, or feel sick more often; you may be experiencing caregiver stress. It may be time to take a break from full time caregiving and get some help. You can reach out to a family member, trusted friend, church family, or a healthcare professional.

Caregiver Burnout: If you are experiencing the same symptoms of caregiver stress with the added burden of feelings of wanting to hurt yourself or the person you are caring for, emotional and physical exhaustion, excessive use of alcohol and or sleep medications, you are experiencing caregiver burnout. Caregiver burnout can happen before you realize it. Other symptoms that are associated with caregiver burnout are:

role confusion; it can be difficult to delineate your roles of spouse and caregiver. How do you care for a spouse who no longer remembers that he/she is married?
lack of resources; limited community resources, limited or no finances to use for care;
lack of control; limited ability to manage and plan for the needs of your loved one or yourself;
unreasonable demands; “no one else can take care of my loved one like I can”, placing a heavy burden on yourself to always be there;
illness; as a caregiver you do not recognize caregiver burnout until you become so ill that you can no longer give the care that is required.As a caregivers we forget to tend our own garden, the weeds of stress take over and you neglect your own emotional, physical and spiritual health. Give yourself permission to tend your garden; take time to refresh and renew your soul by giving yourself permission to take 5 minutes a day to do some deep breathing without interruption, go for a walk in the fresh air, hire a caregiver so you can leave the demands of caregiving for a little while, do something you enjoy and reap the benefit of feeling happy.Make your own tool box for coping with stress, use what works for you and keep it handy when you feel the symptoms of stress:
Deep breathing
Talk to a trusted friend
Set time aside daily (5 minutes) just for you
Research and know your community resources
Know your limitations
Educate yourself on caregiving skills
Use humor
Exercise
Sleep
Good nutrition
By giving yourself permission to take time off, you remain healthy and happy. You can look at the situation with a realistic view. Before you became a full time caregiver, you may have been employed and may have raised a family, your employer placed value on your time, talent and expertise by allowing you two days a week to rest and a vacation so that you could recharge and come back to work refreshed and renewed with a positive purpose. So I challenge the 15 million caregivers to place as much value on your time, talent and expertise as your employer did, and give yourself a much needed break. For more information on caregiver stress access these websites:
www.uamscaregiving.org
www.alz.org
www.agec.org

Speech Entrainment: A Promising Approach for Aphasia

by Richelle Weese, M.S. CCC-SLP, University of Central Arkansas, Department of Communication Sciences and Disorders

Conversational partners naturally adapt their verbal and nonverbal communicative actions to mimic, or more closely resemble each other. This is called speech, or rhythmic, entrainment (Borrie & Liss, 2014). Speech entrainment (SE) is important for understanding normal speech production, but can also be used as a rehabilitative technique for those individuals who need help with their communicative functions. Speech Entrainment (SE), is a therapeutic technique being utilized to improve communication with patients suffering from aphasia and is showing promise in other neurologic conditions.

The premise of SE is an audiovisual speech model, in which patients are exposed to audio-visual speech stimuli and instructed to mimic the stimuli, enabling them to produce fluent speech in real time (Fridriksson, J., Hubbard, H. I., Hudspeth, S. G., Holland, A. L., Bonilha, L., Fromm, D., & Rorden, C., 2012). Entrainment is evident in various aspects of speech, including speaking rate, utterance durations, pitch properties, voice intensity, voice quality, and dialectal features (Borrie & Liss, 2014).

With entrainment being a natural feature of human communication, the question is being raised regarding the likelihood that SE would be successful if used as a therapeutic tool in other neurologic communicative disorders. UCA Speech-Language Hearing Center is conducting a study in SE. Currently four clients have undergone therapy sessions utilizing SE. Although results are in the early stages of analyzation for specifics, preliminary findings are promising. Two patients with both expressive aphasia and verbal apraxia have increased their overall phrase length, reduced “robotic” prosody features, and improved articulatory precision. Two clients completed SE that focused on improving cognitive-linguistic skills for memory, targeting recall of family and friend names, with one client showing an improved ability to now recall all five children, their spouses, and grandchildren names.

The applications for SE are encouraging. Socializing and independence are deeply rooted in successful communication. We are seeing some of those results in our participants as they engage in group activities with other participants, play games with their grandchildren, or independently order a meal at a restaurant. SE tasks have been personally chosen to target goals chosen by each participant. Speech entrainment, regardless of the precipitating event leading to the communication issue, is a promising tool that is leading to communication effectiveness and improved quality of life.

References:
Borrie, S.A., Liss, J.M. (2014). Rhythm as a Coordinating Device: Entrainment With Disordered Speech Journal of Speech, Language, and Hearing Research, June 2014, Vol. 57, 815-824. doi:10.1044/2014_JSLHR-S-13-0149

Fridriksson, J., Hubbard, H.I., Hudspeth, S.G., Holland, A.L., Bonilha, L., Fromm, D., & Rorden, C. (2012). Speech entrainment enables patients with Broca’s aphasia to produce fluent speech. Brain, 135 (12), 3815-2829.

Creating a Gerontology-focused Health Fair

New CNHP ASU Logo

by Jessica E. Camp, MSN, APRN, AGCNS; Addie N. Fleming, MNSc, RN, CCRN; Valerie Fielder, BS, CDP, and Samantha M. Hollis, BSN, RN, CDP
Edited by Dr. Susan Hanrahan and Dr. Linda Tate
Arkansas State University, UAMS Center on Aging Northeast & Schmieding Home Caregvier Training Program, St. Bernards Medical Center

The committee designed a health screening event for older adults, their caregivers, and professionals that provide care to older adults. Northeast Arkansas has a large number of elderly, care givers, and a large variety of professional services. The event was designed to bring everyone together. It was planned for November to increase attendance by avoiding other area events and in conjunction with National Family Caregiver Month. The Fair gathered more than 200 patients and 90 vendors from the community. This article shares the successes of the event and the opportunities for next year.

Advisory Panel
The Center on Aging had a vision for the event. The mission and vision were shared with the team during recruitment and revisited at the initial meeting. An advisory panel consisted of the many health professionals, community members, university faculty and leaders from services for older adults in the area was invited to participate.

Health Screenings
The local university, ASU, provided a great foundation for creating a health screening event.

The physical therapy department provided “timed up and go” (TUG) screenings aimed at identifying balance issues and risk for falling. Social work faculty provided anxiety and depression screenings. Communication Disorders students provided hearing screens in a private room. Nursing students provided blood pressure checks, height, and weight and body mass index screenings. Dietary Approaches to Stop Hypertension (DASH) diet education was given verbally and in writing to persons at risk for or currently experiencing hypertension. Exercise, weight loss and the DASH diet can help control chronic illnesses, such as heart disease and diabetes, making it important information to share with older adults and their caregivers (Cash & Glass, 2015, p. 1047).

The Arkansas Department of Health provided vaccinations based on the Center for Disease Control and Prevention (CDC) recommendations for adults and older adults (Cash & Glass, 2015, pp.18-21). Hilltop Eye Care and Southern Eye Associates provided vision screenings and education on cataracts and glaucoma. St. Bernard’s Imaging Center conducted bone density screenings as well as total cholesterol, anemia, and glucose laboratory screenings. Higginbotham Family Dental provided dental screenings. Additional professionals were invited and provided services or information about services.

Transportation
Transportation for the public was not available to the event. This was noted by some persons unable to attend as a barrier. Requests to public transportation and local churches to enlist transportation assistance were not met. For the 2018 event, negotiations are in process.

Communication
Some screening groups left before the event ended which participants complained about. Critical conversations with the voluntary service professional groups will need to take place early in the planning of the 2018 event to ensure the professionals stay for the whole event, which could include shortening the event.

A secondary communication issue was not being able to hear announcements made at the event stage. With exciting activities such as the mayor’s appearance and a physician’s panel, it was difficult for the audience to hear anywhere past the first row of vendors. This is an opportunity that can be corrected for the 2018 Senior Expo (Larsen, 2018).

Professionals
Health professionals, caregivers, and patients were targeted to receive education during the event. Several vendors voiced a desire to attend the planned educational sessions, but were unable because they were also manning a booth at the event. In post-event discussions, it was decided that a separate educational event targeting health professionals could be a solution.

Vendors
While the volume of local vendors involved in the first annual event surpassed the goal, there were still challenges. Discussions with leaders of another local annual health fair shared tactics that prevented vendors from leaving their event early, such as imposing fines or not inviting them to future events.

In summary, these services met the needs of many older adults. Senior Health Fairs bring value to the intended audience. Targeted health fairs, such as this one, provide more opportunities for older adults to interact with health professionals in the community. With the success of the first event, the 2^nd Annual UAMS Center on Aging Northeast’s Senior Expo is scheduled for November 9, 2018.

References:

Cash, J. C. & Glass, C. A. (2016). Adult-gerontology practice guidelines. New York: Springer Publishing Company.

Larsen, P. (2018). Lubkin’s chronic illness: Impact and illness. Burlington, MA: Jones & Bartlett Publishing.

Rhoads, J. & Peterson, P. S. (2018). Advanced health assessment and diagnostic reasoning (3^rd ed.). Burlington, MA: Jones & Bartlett Publishers.

From the Director’s Desk

by Robin McAtee, PhD, RN, FACHE, Director, Arkansas Geriatric Education Collaborative at UAMS

Hello from the Arkansas Geriatric Education Collaborative (AGEC), the Geriatric Workforce Enhancement Program for Arkansas. As we enter into the winter of 2018, there is snow on the ground and temps are single digits, but the sun is shining! It is exciting to start a new year as we enter the last six months of this grant. We are anxiously awaiting the release of a request for proposal from HRSA so we can apply for another grant, but delays are inevitable it seems as the US government struggles to approve a fiscal year budget!

Fall was a busy time as we continued our programming in education with our partners. We had two video-teleconferences/webinars with over 150 attendees at each program. Being able to broadcast our programs on-line/webinar is really helping us to reach more individuals, especially those in rural areas and those who can’t leave work to attend in person. Our academic partners, ASU and UCA, were also busy reaching thousands of students with geriatric content during the fall semester! We continue to seek new ways to reach and teach these audiences and if you have any suggestions, please let us know.

During November, National Family Caregiver Month, we partnered with the UAMS Schmieding Home Caregiving Training Program to host a panel discussion regarding family caregiving. Donna Terrell (a former caregiver for her daughter) from FOX 16 was the moderator, Les Warren (a legislator from Hot Springs), Beth Coulson (a former judge who serves on the board of several community organizations), and Dr. Sybil Hampton (a former educator and former President of the Winthrop Rockefeller Foundation) who all had extensive experience caring for elderly parents, served as panelists. It was a well-attended and engaging event that culminated in presenting awards to 6 deserving family caregivers from all across the state!

As spring approaches, our community programs will blossom! Tai Chi, diabetic empowerment education programs, healthy cooking, dementia experiences, and many others are all planned and scheduled. We also have exciting events scheduled for professionals and direct care workers such as certified dementia training and new webinars! Please keep close tabs on our website for upcoming events! See you in the spring!!!

Statins: When Do the Benefits Outweigh the Risks in the very Elderly?

by Taylor J Neeley and Lisa C Hutchison, PharmD, MPH, UAMS

High quality studies show that statins significantly reduce all-cause mortality in older patients with established cardiovascular disease (CVD). One meta-analysis included approximately 20,000 patients between ages 65 and 82 with coronary heart disease who received either placebo or statin. There was a 22% decrease in all-cause mortality over 5 years in the statin group vs. placebo. The meta-analysis also revealed significant risk reductions in cardiovascular mortality, nonfatal myocardial infarction, and strokes of around 30% each. ¹

However, the benefits for patients 75 years and older without CVD are less clear because major statin trials have excluded patients greater than 75. Very few trials have included patients over 70 years of age, and evidence for patients >80 is largely limited and conflicting.² For example, in the Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial (ALLHAT-LLT), initiation of pravastatin 40 mg for primary prevention in patients 65 years and older showed no risk reduction in cardiovascular events.⁴ However, in the Prospective Study of Pravastatin in Elderly at Risk (PROSPER) trial, patients of ages 70-82 with at least one cardiovascular risk factor (hypertension, smoking, and/or diabetes) were randomized to either pravastatin 40 mg or placebo. There was a significant reduction in major vascular events (stroke, fatal or non-fatal MI) in pravastatin group vs. placebo. ⁵

So, guidelines provide no specific recommendations for statin therapy in the middle and oldest old without CVD. Despite the lack of information, approximately 39% of patients 79 and older are on statin therapy for primary prevention of cardiovascular events. ³

Because this population is known to be more vulnerable to adverse drug effects, we see hospitalizations due to statin-induced rhabdomyolysis is 5 times more likely in patients 65 and older versus younger patients.²Even moderate muscle pain, a common side effect of statins, could cause already frail patients to increase their fall risk and/or immobility. And in rare cases, statins cause confusion and memory loss, especially with atorvastatin, lovastatin, simvastatin. Fortunately, these effects are reversible upon discontinuation.^{6, 7}

More research of statin benefits vs. risks, specifically in patients 75 and older at risk for CVD, are needed. So for now, patient-centered decision-making is key when the evidence is unclear.

Current ACC/AHA guidelines recommend that in patients >75 with established CVD

Begin statin therapy, but at a moderate intensity. There is strong evidence of statin cardiovascular benefit in this population.
In patients already well established on a high intensity statin with no complications, this may be continued. ⁸

In patients > 75 without established cardiovascular disease:

The decision to initiate a statin should be individualized and should weigh in heavily on patient concerns and goals. ²
- Factors that may support initiation of a statin:
  - Few comorbidities,
  - > 1 cardiovascular risk present
  - Patient priority to minimize cardiovascular risk
- Factors that may support avoiding statin initiation:
  - High comorbidities
  - Only 1 cardiovascular risk present
  - History of myopathy
  - Severe dementia
  - Frailty
  - High risk of drug-drug interactions
  - Patient priority to avoid pill burden
  - Patient priority to avoid adverse drug effects
  - Life expectancy < 1 year
In patients already well established on a statin with no complications, this may be continued.

Finally, in all elderly patients initiated on a statin, monitoring for adverse side effects should be a priority due to increased risks. Reassessment of factors such as development of dementia, frailty, and life expectancy should be made after starting therapy as these may change overtime and affect the decision to continue.

References:

Ross SD, Allen IE, Connelly JE, Korenblat BM, Smith ME, Bishop D, Luo D. Clinical Outcomes in Statin Treatment TrialsA Meta-analysis. Arch Intern Med.1999;159(15):1793–1802. doi:10.1001/archinte.159.15.1793
Pletcher, M. J., Coxson, P. G., Thekkethala, D., Guzman, D., Heller, D., Goldman, L., & Bibbins-Domingo, K. Statins for Primary Prevention in Older Adults.
Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129(25 Suppl 2):S1-45.
ALLHAT Officers and Coordinators for the ALLHAT Col- laborative Research Group. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs. usual care: the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALL- HAT-LLT). JAMA 2002; 288: 2998–3007.
Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in eld- erly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002; 360: 1623–1630.
Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet2010;376:1670-81.
Haag MD, Hofman A, Koudstaal PJ, et al. Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study. J Neurol Neurosurg Psychiatry 2009;80:13-7.
Lambert, M. (2014). ACC/AHA Release Updated Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD Risk. American family physician, 90(4), 260.

From the Director’s Desk

By Ronni Chenoff, PhD, FAND, FASPEN

UAMS Arkansas Geriatric Education Collaborative

The Arkansas Geriatric Education Collaborative (AGEC), a Geriatric Workforce Enhancement Program, is working on goals and objectives for the second year of this program to educate health professionals, students, caregivers, first responders and the general public about issues and topics that affect our older population. We are proud of our achievements during the first year and are coming up to midway through year 02.

We will continue to offer video teleconferences four times/year; the first conference, broadcast in September addressed strategies to prevent and manage falls in both in-patient and outpatient settings. An upcoming video teleconference, scheduled for October 26, will be on trauma in the geriatric patient and anti-coagulant reversal strategies. Previous programs that you may have missed will be available as DVDs or on-line (unedited). Coming programs may be seen at UAMS or a site near where you or work by the interactive television network, but programs are now available through Blackboard Collaborative, a web-streaming option; this means you can stay at your computer and receive the program in real time and ask questions through the chat option. This is always true for some live programming; on November 2, we are sponsoring a Geriatric Grand Rounds to be broadcast live and video streamed. The grand rounds speaker will be Dr. Richard Zraick, professor and chairman of Speech Pathology/Audiology at the University of Central Florida, formerly professor in the College of Health Professions at UAMS and UALR. He will be addressing “Communication Impairment in Persons with Alzheimer’s disease”. We are delighted to offer you the opportunity to access AGEC programming more conveniently.

Opportunities for more education in geriatrics include the Arkansas Geriatric Education Mentors and Scholars (ARGEMS) program, a self-study for health professionals that can be completed on line and the Summer Institute, a program for faculty in the health professions. ARGEMS can be started at the participants’ convenience; more information may be obtained at our website, www.agec.org, for interested readers. Invitations for Summer Institute for Faculty will be sent out after the New Year. If you are interested, read more about it on our website. Both programs are tuition-free.

As we plan ahead, we would love to hear from you about what you would like to know more about. We will be conducting a statewide needs assessment in the spring, 2017 and hope you will take the time to answer the questions on line or using a mailed survey. In the meantime, feel free to e-mail your suggestions for topics and programs to agec@uams.edu or post a note on our website page.

We all wish you a great fall and holiday season and hope to see you soon!

10 Interesting Facts about Senior Citizens

By Regina V. Gibson, MALS, RN, CHES

UAMS Arkansas Geriatric Education Collaborative

1. Senior Citizens are Still Active in the Workforce

There are currently over 5 million senior citizens who are active in the work force. That means that 5 million older people are still sharing their skills and expertise to help make the world and their industry a better place.

2. Senior Citizens Are More Likely to Vote

Senior citizens make up the majority of registered voters. That means that they are also good citizens with a strong sense of civic pride and commitment to their country.

3. Senior Citizens Have a Day of Recognition

May is the designated month for appreciating and recognizing senior citizens. August 21st, however, is official Senior Citizens Day. Its purpose is to bring awareness about social and economic issues regarding the well-being of seniors, as well as to honor them for their contributions.

4. Senior Citizens are More Likely to Commit Suicide

The media may lead us to believe that younger people are more inclined to take their own lives. However, the truth is that people 65 and older are more likely to commit suicide than any other age group.

Men are more likely to commit suicide than women. According to the CDC, the suicide probability for women levels off in the 60’s, but continues to climb for men. Contributing factors can include depression (which is often missed, ignored or misdiagnosed in the elderly), loneliness, isolation, physical limitations (feelings of low self-worth), poverty, illness, and being recently divorced or widowed.

Suicide goes up in individuals with access to hand guns. Lethal weapons, but especially guns, are the main method for suicide among the elderly.

Montana has the highest suicide rate among seniors.

5. Poverty Is Still a Serious Issue for Senior Citizens

Over 16% of seniors live in poverty.

“9.4 percent of seniors had incomes in 2006 below the poverty threshold of $9,669 for an individual, and $12,186 for a couple, nearly a quarter of older Americans (22.4 percent) had family incomes below 150 percent of the poverty line.” — Center for American Progress. This is not always due to mismanagement of funds. As the economy fluctuates, seniors often find that the value of their assets and savings may not match or exceed the rising cost of health care, medications, assisted living and other needs of aging.

6. Senior Citizens Still Have Sex

At least 73% of all senior citizens are still sexually active and not always with their spouses and partners. The elderly are also just as likely to engage in experimental sexual practices as any other age group.

The numbers don’t change much over the age groups either. Men and women in their 60’s, 70’s and beyond reported to be just as satisfied and sometimes more satisfied than when they were younger.

Elders who are single or widowed are highly likely to seek out one or more sexual partners. Rather than being appalled at the sexual preferences and practices of the aging population, more education and health screenings need to be available, since those over 60 are the least willing to implement safe-sex practices.

7. Senior Citizens are Tech Savvy

More than 40% of seniors have computer access and are active online. About 15 million Facebook users are 65 and older.

Along with social media sites where they can connect with friends and family, older computer users play online games, read news sites, sign up for dating sites, and contribute to sites related to their interests. They are bloggers, survey takers, shoppers, reviewers, photographers, and more.

8. Senior Citizens Still Drive, Even When They Shouldn’t

About 80% of seniors own a car and drive frequently. Whereas only 1% of senior deaths are due to a motor vehicle accident, they are more likely to have crashes at intersections than other age groups. Elderly men have three times higher death rate from car accidents than women. Although there are many jokes about the elderly driving too slowly, they are just as likely to get pulled over for speeding.

9. Senior Citizens Enjoy Hobbies that are Creative or Useful

The majority of senior citizens, whether working or retired, enjoy hobbies and social activities. Crafting, woodworking, dancing, exercise, pets, travel, charity work and church are some of the preferred activities.

10. Senior Citizens are Individuals

You can group them together, you can study them statistically and you can stare at infographics for days. But it still comes down to individuality.

Seniors come from all classes, all ethnicities and all educational backgrounds. They run marathons, go to college, work at jobs, take dance classes, use online dating sites, and play games on Facebook. Until you reach out and get to know a senior, you will never know for sure what makes them tick.

Reference:

http://eldercareissues.blogspot.com/2014/01/10-interesting-facts-about-senior.html

AGEC

Division of Aging and Adult Services, Arkansas Department of Human Services. Senior Hunger in Arkansas. https://arhungeralliance.org/wp-content/uploads/2014/12/Senior-Hunger-in-Arkansas-2014-FINAL.pdf. Accessed June 5, 2018.

Arkansas Hunger Relief Alliance. (2018). Senior Hunger. https://www.arhungeralliance.org/programs/senior-hunger/. Published 2018. Accessed June 5, 2018.

American Geriatrics Society (2018) How common is food insecurity among older adults? https://www.eurekalert.org/pub_releases/2018-03/ags-hci030818.php. Published March 8, 2018. Accessed June 5, 2018.

Ziliak J, Gunderson G. The state of senior hunger in America 2015: An Annual report. Feeding America and the National Foundation to End Senior Hunger. http://www.feedingamerica.org/research/senior-hunger-research/state-of-senior-hunger-2015.pdf. Published August 16, 2017. Accessed June 5, 2018.