September 18 is National HIV/AIDS and Aging Awareness Day

Established in 2008 by The AIDS Institute, National HIV/AIDS and Aging Awareness Day is an opportunity to dispel the myth that HIV/AIDS is a disease exclusive to younger people. It is an opportunity to encourage older adults to be tested for the virus, and to learn how to avoid contracting or spreading it.

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people in the U.S. who are living with HIV/AIDS are older than 55. Close to 20 percent of newly diagnosed cases are in older adults. They also are more likely to be diagnosed later in the course of the disease, making treatment more challenging.

Some seniors, thinking they are not at risk, know very little about HIV/AIDS. They should know the basics: HIV (human immunodeficiency virus) weakens the immune system, which puts an infected person in danger of getting other life-threatening diseases, infections and cancers. The virus is spread by unprotected sex with, sharing needles with, or coming into contact with the blood of a person who carries the virus. If the body can no longer fight off these diseases and infections, HIV can lead to AIDS (acquired immunodeficiency syndrome), a more serious illness. Not everyone with HIV will get AIDS.

Seniors are at high risk of HIV/AIDS for several reasons. They may be less aware of the disease and how to protect themselves. For example, after years of a monogamous marriage, they might be widowed and dating again, unaware that they should take precautions to avoid infection. Women who no longer worry about pregnancy are less likely to use a condom—yet age-associated physical changes make their bodies more susceptible to transmission of the virus. Seniors are also less likely to talk frankly with their doctor about sexual health or drug use.

Despite being at high risk, seniors are less likely to be tested for the disease. Often doctors fail to recommend testing for older patients—and older patients may be too embarrassed to ask for a test. Seniors who notice symptoms that are associated with HIV, such as weight loss, pneumonia, fatigue, confusion or vision problems, might chalk up these symptoms to the normal aches and pains of aging, or to other health conditions they’re already living with. And they might hide their concerns, fearing the reaction of loved ones and caregivers—both to their diagnosis, and to the behaviors through which they contracted the infection.

The U.S. Administration for Community Living (formerly the Administration on Aging) recommends that older men who have sex with men be tested at least once a year; women should be tested whenever they have a new sex partner. The National Institute on Aging (NIA) says that people who had a blood transfusion between 1978 and 1985 may also be at risk. The cost of the test is covered by Medicare.

People of every age can prevent the spread of HIV/AIDS. The NIA says seniors should practice the following steps to lower the risk:

• If you are having sex, talk with your partner about HIV/AIDS. Know his/her sexual and drug history and make sure your partner has been tested and is free of HIV.
• Use male or female condoms (latex or polyurethane) during sexual intercourse.
• Do not share needles or any other equipment used to inject drugs.
• Get tested if you or your partner has had an operation or blood transfusion in a developing country at any time.
• Get tested if you or your partner had a blood transfusion between 1978 and 1985.

Aging with HIV/AIDS

Many older adults are diagnosed with HIV/AIDS each year, and many others have been living with the disease for a long time. Though there is no cure for HIV, it can be managed with antiretroviral therapy (ART), drugs that allow many infected individuals to live a long and healthy life. Experts say these senior patients face a special set of health challenges:

They may be living with other health conditions that complicate their treatment.

• HIV causes chronic inflammation, which increases the risk of a number of age-related diseases, such as heart disease, osteoporosis, diabetes, cognitive problems and certain cancers.
• Seniors with HIV, more than younger adults, may be affected by the stigma, putting them at risk for isolation, loneliness and depression.
• Expecting to have their lives cut short, many seniors who have been living with HIV for a long time failed to save for their retirement, or make other plans for the extra years they weren’t expecting to have.

Early diagnosis  raises the possibility that older adults with HIV/AIDS can continue to live independently with the disease, and to access support services that they need.

Learn More

The AIDS Institute (www.theaidsinstitute.org)  sponsors National HIV/AIDS and Aging Awareness Day (www.nhaad.org) and offers information and resources for older adults with or at risk of HIV/AIDS.

AIDS.gov is the U.S. government portal for information about HIV/AIDS, including information for older adults.

The National Institute of Aging offers a concise, readable online brochure with an overview about HIV/AIDS for seniors and caregivers.

Find a testing location through your local health department, the AIDS.gov test locator (https://locator.aids.gov), or the Centers for Disease Control and Prevention toll-free at 1-800-232-4636 or gettested.cdc.gov.

Get On Up! Avoiding the Harm of a Sedentary Lifestyle

Researchers from University of Copenhagen wanted to learn more about the effects of inactivity. In a recent study, they had a group of men wear a leg pad that caused them to be highly inactive for two weeks.

The startling results: After only two weeks, young test subjects lost a third of their muscle strength, leaving them, as the researchers reported, “on a par with a person who is 40 to 50 years their senior.” Older test subjects lost less muscle mass, but they could ill afford to lose it! Said researcher Martin Gram, “Even though older people lose less muscle mass and their level of fitness is reduced slightly less than in young people, the loss of muscle mass is presumably more critical for older people, because it is likely to have a greater impact on their general health and quality of life.”

We know that immobility due to a stroke or hip fracture can have a very bad impact on overall health. Today, “complete bed rest” is seldom prescribed for most people who are hospitalized. But for many of us, our lifestyle might be called “couch rest” or “desk rest.” We sit at a desk all day, and then plop down in front of the TV or gaming console for most of the evening. Bad idea!

Here are just a few of the recent studies warning of the damage caused when we sit down for most of our waking hours. Leading a largely sedentary lifestyle:

Raises the rate of many diseases. Kansas State University researchers found that people who sit most of the day have a higher rate of diabetes, cancer, heart disease, stroke and other serious conditions. A number of studies also show that the more TV we watch, the greater our risk of diabetes and heart disease—and that’s because we sit while we’re watching.

Impairs blood flow. University of Indiana researchers say sitting affects our arteries, cutting down blood flow by half after just one hour of sitting. And the American Heart Association warns that binge watching your favorite TV shows could raise the risk of blood clots.

Increases disability. Northwestern University School of Medicine researchers found that for seniors, every additional hour per day spent seated raises the risk of disability, causing limitations in performing basic activities such as eating, dressing, walking across the room and getting in and out of bed.

Leads to back pain. Our bodies aren’t designed for chairs, say many experts. Sitting in a chair is about the same as lying in bed—and we certainly wouldn’t stay in bed all day. Beyond the inactivity, the sitting posture is hard for our spines.

Shortens life. Research published in the British Medical Journal showed that sitting for more than three hours each day lowers our life expectancy by two years. And scientists from Harvard, Cornell and a number of other research also found that people who spend more time sitting down during the day don’t live as long.

What can we do to lessen the damage from prolonged sitting?

Researchers aren’t quite in accord about whether we can sit at a desk all day and then make up for it with an hour on the treadmill. Some studies are encouraging. A recent study from the University of Leicester in the UK reported that people who sit down a lot of the time but also get some exercise have a lower rate of heart disease and diabetes than those who are sedentary all day. Said researcher Kishan Bakrania, “This research is significant because it demonstrates yet again why physical activity and exercise is so important. It shows that people who spend large amounts of time not moving either through work, leisure or lifestyle can counteract some of the negative effects of sedentary behavior by regularly exercising.”

On the other hand, the Cornell research team found that people who spend more time sitting during the day have a shorter life expectancy even if they get some exercise during their off hours. In other words, even if we work out in the evening, the effects of nonstop sitting during the day persist. Many experts say the solution is to break up our day with small bouts of exercise. The University of Indiana researchers found that breaking up an hour of sitting with walking for five minutes reversed the negative effect on the arteries. University of Utah School of Medicine professor Srinivasan Beddhu reports that even taking a two-minute walk once an hour can have good results, though he reminds us that for best health, we also need around 150 minutes of regular exercise per week in addition to those hourly short strolls.

Oregon State University researchers also report that small amounts of activity make a big difference. Professor Brad Cardinal recommends enough one or two-minute increments to add up to 30 minutes during the day. Says Cardinal, “We are designed by nature as beings who are supposed to move. In our society, you will always be presented with things that entice you to sit or be less active because of technology, like using a leaf blower instead of a rake.” His co-author Paul Loprinzi advises, “Seek out opportunities to be active when the choice is available. For example, rather than sitting while talking on the phone, use this opportunity to get in some activity by pacing around.”

Exercise need not be formal or even planned. Meeting a friend for coffee? Suggest a brisk walk instead. Park at the far end of the parking lot from your destination. If you’re physically able, take the stairs instead of the elevator. Stand up from your desk and stretch several times an hour to be kind to your back. Keep some weights by the couch and use them while watching TV. For a little extra motivation, invest in a pedometer to see how you’re doing.

One last thought: Recent research from the University of Leeds in the UK found that people who describe themselves as “fidgety” seem to gain health benefits from their small, frequent movements. So if Mom told you to “stop squirming” when you were a kid, this might be a time when Mother did not know best.

“Mom, You Forgot to Pay the Gas Bill….”

An expert says a decline in financial management skills might be an early sign of Alzheimer’s disease, and family may need to step in.

What’s the most challenging topic to discuss with older loved ones? Family caregivers often name end-of-life wishes, driving safety and incontinence as tough-to-talk-about subjects—but according to many experts, money management is right at the top of the list. Most older adults view taking care of their financial affairs as a private matter, and pride themselves on doing a good job of it. Yet, according to the Consumer Financial Protection Bureau, seniors may have cognitive challenges that make it hard to keep track of money matters and could make them vulnerable to scam artists and financial elder abuse.

Daniel Marson, Ph.D., J.D., of the University of Alabama at Birmingham (UAB) has studied this topic for a number of years. In a 2009 study, Marson, who is a professor of neurology and director of the Alzheimer’s Disease Center at UAB, noted that poor money management might even be an important early sign of Alzheimer’s disease.

Marson and his team studied a group of people who had mild cognitive impairment, and found that some of them remained able to manage their financial affairs, while others became less able to balance their checkbook, pay their bills or understand their bank statement. This latter group, the researchers found, were far more likely to be later diagnosed with Alzheimer’s. According to Marson, “Impairments in financial skills and judgment are often the first functional changes demonstrated by patients with incipient dementia.”

What signs should families be alert for? In 2014, Marson presented at a symposium called “Financial Planning in the Shadow of Dementia,” put on by the Massachusetts Institute of Technology AgeLab and Transamerica.

He listed the following warning signs:

• Memory lapses, such as forgetting to pay bills or taxes, or paying bills twice.
• Poor organization of financial information flow, where a previously neat desk is now in disarray and disorganized. An individual might be confused about when an activity transpired, and mail might not be opened in a timely manner.
• Math mistakes in everyday life, such as figuring out a tip, balancing a checkbook or needing help with the steps of a calculation.
• An erosion in the ability to comprehend basic financial concepts.
• Impaired financial judgment, particularly a new interest in get-rich-quick schemes. A classic sign is that the person would not have considered the scheme five years ago and is now listening and interested.
• An unrealistic anxiety about personal finances.

It’s important to note that some of us are more money-savvy than others, so what families should be looking for is a change in their loved one’s abilities.

When it’s time to step in, Marson suggests caregivers can:

• Oversee their loved one’s checking transactions.
• Contact their loved one’s bank to detect irregularities such as bills being paid twice.
• Become cosigners on a checking account so that joint signature is required for checks above a certain amount.
• Help their loved one with online banking and bill payment.

If a family is worried about their loved one’s financial safety, it’s time for a conversation. You might need to call in an expert—your loved one’s physician, an elder law attorney, an aging life care professional (geriatric care manager) or a financial advisor. These are sensitive conversations indeed, but very important to help loved ones with cognitive impairment preserve self-esteem while avoiding financial damage and exploitation.

Avoiding Mosquito Bites Is More Important Than Ever

With all the recent news coverage of the Zika virus and its tragic shadow over the 2016 Olympics in Rio, more Americans today are aware of the role of mosquitoes in spreading disease. As of this writing, the Centers for Disease Control and Prevention (CDC) has determined that several cases in the U.S. were spread by mosquitoes within the U.S., and they’re warning women of childbearing age in particular to take precautions.

Experts are trying to determine whether seniors are at higher risk of complications from the Zika virus. But one thing we know for sure: For seniors, protecting against mosquito bites is still the best way to avoid the West Nile virus, another mosquito-borne illness that’s been around for years. The West Nile virus spreads through the U.S. during summer and into the fall. The CDC says that around 20 percent of people bitten by a West Nile-carrying mosquito will experience symptoms such as fever, head and body aches, nausea and vomiting, swollen glands and a rash. These symptoms might last for a week or so, and are not life threatening. Many people who contract the West Nile virus have no symptoms at all, but can still pass it on if a mosquito that’s bitten them bites someone else.

However, a small percent of patients will develop severe illness, including high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. Neurological effects may be permanent, and the disease can be fatal. People who develop symptoms of severe West Nile virus should seek medical attention immediately.

People older than 65 are most likely to become seriously ill or to die from West Nile. According to Michael Diamond of Washington University in Saint Louis, seniors may have an impaired early immune response that makes their brains more vulnerable to the virus.

Protecting against mosquito bites

Our states and cities are taking steps to eliminate mosquitoes, such as applying pesticides and removing stagnant water sources where mosquito larvae thrive. Individuals can protect themselves and their community, as well. Here are recommendations from the CDC:

• Reduce the number of mosquito bites you get. When you are outdoors, use insect repellent containing an EPA-registered active ingredient, and follow the directions on the package. (You can find more information about recommended insect repellents on the CDC website at www.cdc.gov/westnile/faq/repellent.html.)
• Prime mosquito-biting hours are usually dusk to dawn. Pay special attention to protection during these hours. Wear long sleeves and pants during these hours, or stay indoors.
• Reduce the number of mosquitoes around your home. Mosquitoes breed in standing water, so give your yard or balcony a mosquito-proofing inspection once a week. Get rid of containers that aren’t being used, empty water from flower pots, keep gutters clean, change water in bird baths and pet dishes often, and drill holes in tire swings so water can’t collect there. If you have a children’s wading pool, keep it empty and on its side when not in use.
• Install or repair window and door screens, and make sure they are in good condition.

Help older loved ones select a recommended insect repellent and mosquito-proof their yard. If your loved one has symptoms of West Nile disease, contact their healthcare provider right away.

Source: IlluminAge AgeWise with information from the Centers for Disease Control and Prevention (CDC).