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Health experts are talking about…

March 06, 2017 By Liz Seegert

…early detection of age-related macular degeneration (AMD). Eye experts say diagnosing AMD early is vital to slowing the progression of this incurable disease, the leading cause of blindness in people age 50 and older.

The macula is a small spot near the center of the retina, needed for sharp, central vision. AMD often progresses very slowly in the early, or “dry,” stage, but eventually it leads to blurring in the central portion of vision, according to the National Eye Institute at the National Institutes of Health.

In about 10 to 20 percent of cases, dry AMD progresses to a more severe “wet” stage. This can cause potentially serious vision loss, says Carl Regillo, MD, chief of the Wills Eye Hospital Retina Service in Philadelphia, PA.

As the disease progresses, the blurred area of vision grows larger or blank spots develop in a person’s central vision. Objects may appear darker than they were previously. These changes can interfere with everyday activities, such as the ability to see faces, drive, read, write or do close work.

But if caught early, many people can retain relatively good vision. "It's very important for people to know they have AMD, because we do have some very effective treatments," Regillo says.

According to Regillo:

• Some macular degeneration beyond age 60 is normal.
• Dry, age-related macular degeneration can be treated with a vitamin regimen to prevent or slow advancement to the more serious, wet form.
• Any sudden vision changes should be checked immediately for change from dry to wet AMD.

The American Macular Degeneration Foundation says this disease affects more than 10 million Americans—more than cataracts and glaucoma combined.

…older women who sit too much. Older women who sit for more than 10 hours a day and have low physical activity have cells that are biologically older than their chronological age by eight years, compared to women who are less sedentary, according to new research from the University of California, San Diego. The study appeared in the January 2017 issue of the American Journal of Epidemiology.

A sedentary lifestyle with less than 40 minutes of moderate-to-vigorous physical activity per day shortens telomeres, the tiny caps found on the ends of DNA strands. Telomeres are like the plastic tips of shoelaces, protecting chromosomes from deterioration.

While telomeres naturally shorten and fray as cells age, health and lifestyle factors, such as obesity and smoking, may accelerate that process. Shortened telomeres are associated with cardiovascular disease, diabetes and major cancers. However, exercise seems to mitigate this process. Telomeres did not shrink in sedentary women who exercised for at least a half hour daily, according to lead author Aladdin Shadyab, PhD, a National Institutes of Health postdoctoral fellow in the department of family medicine and public health at UC San Diego School of Medicine.

Nearly 1,500 women, ages 64 to 95, participated in the study. The women are part of the larger Women's Health Initiative, a national, long-term investigation of the determinants of chronic diseases in postmenopausal women. The participants completed questionnaires and wore an accelerometer for seven consecutive days during waking and sleeping hours to track their movements. Future studies will examine how exercise relates to telomere length in younger populations and in men.

It’s never too soon or too late to start exercising and improving health. The National Institute on Aging’s free publication, Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging! can help you or a loved one get started. Of course, check with your health provider before beginning any new activity.

…preventive services under the Affordable Care Act. While politicians argue over repeal, replace and/or repair of the Affordable Care Act (ACA)—also known as Obamacare—it’s a good idea to visit your primary care provider before any benefit changes occur.

The ACA currently covers essential preventive and wellness care for adults, including:

• blood pressure screening 
• cholesterol screening
• colorectal cancer screening for adults over 50
• depression screening
• type 2 diabetes screening and management
• hepatitis C testing
• HIV testing
• immunizations and vaccines against hepatitis A and B, herpes, influenza, pneumococcal pneumonia and other diseases
• lung cancer screening for high-risk adults age 55-80
• sexually transmitted disease screening
• breast cancer genetic test counseling and screening for women at high risk
• breast cancer mammography screening
• cervical cancer screening
• osteoporosis screening
• well-woman visits for women younger than 65 (some plans also cover annual well visits for men, although it’s not a requirement of the health law)

All insurance purchased through government health exchanges (also known as marketplaces) must cover these and other preventive services without charging a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. Many privately purchased plans must also cover these services, although nominal fees for laboratory or facility use are permitted.

The ACA also requires that traditional Medicare Part B cover certain preventive care and screenings for adults over age 65. This includes many of the screenings listed above as well as: 

• bone-mass measurements
• cardiovascular disease screenings
• vaginal cancer screenings
• glaucoma tests
• a one-time “welcome to Medicare” preventive visit
• prostate cancer screenings
• hepatitis B, flu and pneumococcal pneumonia shots
• yearly wellness visits for women and men

If you have a Medicare Advantage (MA) plan, it must cover all of the services that original Medicare covers except hospice care. MA plans are not required to cover services that traditional Medicare deems not medically necessary. If you're not sure whether a service is covered, check with your provider before you get the service. MA plans may also offer additional services, like vision and dental care.

While little is expected to change in 2017, it’s likely shifts will occur in coming years. So it’s prudent to ensure your screenings and immunizations are up to date.

…optimism and longer life. There may be more to “don’t worry, be happy,” than just a catchy tune. An optimistic outlook on life may actually help people live longer, according to a recent study from the Harvard T.H. Chan School of Public Health.

Researchers found that women who were optimistic had a significantly reduced risk of dying from several major causes of death—including cancer, heart disease, stroke, respiratory disease and infection—over an eight-year period, compared with women who were less optimistic.

While other studies have linked optimism with reduced risk of early death from cardiovascular problems in men and women, this was the first to find a link between optimism and reduced risk from other major causes. 

Researchers analyzed data gathered from 70,000 women enrolled in the Nurses’ Health Study. They looked at participants’ levels of optimism and other factors, such as race, high blood pressure, diet and physical activity, that might play a role in how a brighter outlook may affect risk of death. The most optimistic women had a nearly 30 percent overall lower risk of dying from any of the diseases analyzed in the study, compared with the least optimistic group.

“Evidence has been mounting that enhancing psychological resilience may also make a difference,” said Eric Kim, research fellow in the department of social and behavioral sciences and co-lead author of the study.

Healthy behaviors only partially explain the link between optimism and reduced mortality risk. Another possibility is that higher optimism directly impacts our biological systems, according to Kim. More research is needed to determine whether the same effects are seen in men.

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