The Growing Cost of Aging

With the election looming, we’ve heard a lot of rhetoric about healthcare. Rising costs, limited access, reforming Medicare…the list goes on and on.  Whatever happens on November 6, it seems the American public has already spoken. According to new research just unveiled at the American Public Health Association’s Annual Meeting, the cost of lifestyle drugs now exceeds the cost for medications used to treat chronic disease.

The research suggests that medicines used to treat conditions considered a normal part of aging, including those related to hormone replacement therapy, sexual dysfunction, menopause, aging skin, hair loss and mental alertness, are becoming so popular that they now rank third.  Only diabetes and high cholesterol have a greater cost impact among commercially insured patients.

Researchers at Express Scripts in St. Louis looked at trends in prescriptions filled for aging medications.  In 2011 alone, the cost per person for aging medications ($73.30) was 16% greater than the amount spent on both high blood pressure and heart disease medications ($62.80).  The cost for diabetes medications was $81.12 and high cholesterol medications was $78.38.

The research found that among these insured individuals use of drugs to treat the physical impact associated with normal aging was up 18.5% and costs increased nearly 46% from 2006 to 2011. Increased use of these drugs was even more pronounced for the Medicare population (age 65+), up 32% from 2007 to 2011. The largest utilization jump among Medicare beneficiaries was from 2010 to 2011, up more than 13% and outpacing increases in the use of drugs for diabetes, high cholesterol and high blood pressure combined.

“At a time when people are forgoing care due to rising health costs, this study reveals a growing trend on where the public is placing its healthcare dollars,” said Reethi Iyengar, PhD, researcher at Express Scripts.  “Continued monitoring and potential management may be warranted for this category of medications.”

While there is no doubt that pharmaceutical advances and greater awareness have improved the quality of life for many aging Americans what was not known, until now, is the significant cost associated with treating these conditions. Couple that with the proliferation of people living longer and it’s clear that managing the trend and spend from treating conditions associated with aging will become increasingly important.

The United States is in the midst of a profound demographic change, with the number of elderly people projected to reach nearly 20% of the entire population by 2030, up from less than 13% in 2009. This increase will continue to drive both use and costs of medications to treat the natural conditions of aging.

But the problem may be even bigger. The greatest growth in cost per insured was seen among the 45 to 54 age group – up almost 21% over the last five-years. And because the study only analyzed prescription medications it may have underestimated the total costs of aging treatments, which include a variety of over-the-counter medications, cosmetic treatments and surgery.

Seems getting old hurts not only our bodies, but our wallets and the economy too.

Wouldn’t You Like to Know!

If you had a family history of developing Alzheimer’s disease, would you take a genetic test that would give you more information about your chances?

Increasingly it seems, people are saying ‘yes’. The controversial genetic test is based on Apolipoprotein E (APOE).  Having certain variants of the APOE gene has been found to significantly increase a person’s risk of developing Alzheimer’s disease.

However, possession of the APOE variant is neither necessary nor sufficient to cause Alzheimer’s disease. This limitation, along with a general lack of treatment options for Alzheimer’s, has raised concerns that the genetic information could burden rather than benefit patients. Consequently, there are a lot of consensus statements and articles against the use of APOE genotyping for predicting Alzheimer’s risk.

Nevertheless, a recent study has shown that patients want to learn about their APOE test results and are not overtly distressed by them.  The Risk Evaluation and Education for Alzheimer’s disease Study (REVEAL), showed that even if the test does not have clinical utility it has personal utility.  Study participants who discovered they have an elevated risk, not only accepted the news but were more likely to initiative preventative life-style measures and more likely to consider retirement planning and purchase long term care insurance.  Knowing their risk also helped patients to have informed discussions with their partners and families.

SRxA’s Word on Health would like to know:

A Healthy Holiday Dinner Table?

Before you click away, this is NOT one of those stories admonishing you to eat broccoli and brussel sprouts rather than turkey and all the trimmings.  This blog could improve your health without having to forego a single calorie!

Will Grandma be coming up from Florida during Thanksgiving or will Great Uncle Tony be joining you for Christmas?  Do you need something other than the Presidential candidates, Penn State sex scandal, or football scores to talk about over dinner?

Well, according to University of Alabama genetics experts you should use this opportunity to learn more about your family health history from the very people who know.

“The holidays are a great time to collect your family history,” says Lynn Holt, M.S., Director of the School of Health Professions Genetic Counseling program. “Most people don’t know much about the family history beyond their first-degree relatives, their own parents and siblings.”

She advises people to talk to their grandparents or great-grandparents about any health problems that they may have had.  Also find out about their immediate family such as  parents, siblings and children. And don’t just talk, jot down names and their year of birth and death. Ask if any siblings died during childhood and if so, why? While many people don’t like to talk about a sibling who died young, knowing if it happened – and why, can produce very valuable information.

“We sometimes hear people say they’ve been told their mother’s brother dropped dead at age 20, for example,” says Holt. “Was it because of a genetic heart condition that you might have inherited, or is it simply that brother was guilty of some accident that nobody wants to talk about?”

Likewise, if there is cancer in the family, ask about the kind of cancer and at the age at which family members first were diagnosed. Age of diagnosis is more medically valuable than age of death in determining inheritable conditions. Ask similar questions about heart disease, diabetes, mental health conditions and other common conditions. And don’t forget to look into any environmental exposures that may explain family health problems such as occupational exposures, smoking or pollution.

Not only will you learn a great deal, the knowledge you gain can help you protect your own health.  As an added bonus, older family members may welcome the chance to share their story and memories of loved ones who have passed away…and it’s a chance to grow closer as a family.

So rather than bickering over the green beans or sulking into the sweet potatoes, how about serving up a dose of health history these holidays?

After you’ve collect all this information, share it with your physician to help determine if there are any health conditions, based on your family history, that need further evaluation or monitoring.

Happy Holidays!

Green Eggs & Ham? No – Green Tea & Fava Beans!

Mothers around the world can collectively breathe a big, “I told you so.”

Vegetables are good for you…and that’s a fact!

A research review just published in the journal Clinical Epigenetics shows that vegetables, particularly broccoli and cabbage, are filled with compounds that can help prevent or reverse cancers and other aging-related diseases.

“Your mother always told you to eat your vegetables, and she was right,” says co-author Trygve Tollefsbol, Ph.D., D.O., a biology professor at the University of Alabama at Birmingham. “But now we understand why she was right. Compounds in many of these foods suppress gene aberrations that over time cause fatal diseases.”

Epigenetics is the study of the changes in human gene expressions with time. Changes that can cause both cancer and Alzheimer’s. In recent years, research has identified specific food compounds that inhibit negative epigenetic effects.

Those foods include soybeans, cauliflower, broccoli, cabbage, green tea, fava beans, kale, grapes and turmeric.

“The epigenetics diet can be adopted easily because the concentrations of the compounds needed for a positive effect are readily achievable,” says lead author Syed Meeran, Ph.D.

Simply sipping three cups of green tea has been shown to reverse breast cancer in laboratory mice by suppressing the gene that triggers the disease. Similarly, a daily cup of broccoli sprouts, has been shown to reduce the risk of developing many cancers.

“Our review article has drawn everything together from global studies, and the common theme is that compounds in the epigenetics diet foods can, at the very least, help us lead healthier lives and help our bodies prevent potentially debilitating diseases like breast cancer and Alzheimer’s,” says Tollefsbol.

Your Word on Health bloggers are now leaving for lunch.  On the menu – berries for our breathing and beans for our brains!