AAGP eNews
Mar. 12, 2013

AAGP Meeting starts this week in Los Angeles
The AAGP 2013 Annual Meeting kicks off Thursday, March 14 with workshops, sessions, the Opening Plenary and Awards session, and the Opening Reception. The next three days of the meeting offer a wealth of educational sessions; caucus, committee, and interest group meetings; a lively exhibit hall; skills workshops; and roundtable discussions. Registration opens at the JW Marriott Los Angeles L.A. LIVE on Wednesday, March 13 at 4 p.m. More

Legislative and regulatory update
As AAGP has been reporting, the country reached the edge of the fiscal cliff and the sequestration budget reductions went into effect on March 1. (See AAGP's news item of March 4 "Sequester Impacts Physician Payments".)

• The White House released a report on the impact on a state-by-state basis.
• The Center for Effective Government (a non-partisan organization) has a Web page on everything you could possibly want to know about how the budget sequestration works.

The Patient Center Outcomes Research Institute, the government agency for conducting comparative effectiveness research is soliciting research questions regarding falls and the elderly. To participate, click here.

A New York Times article describes the continued lack of funding for National Healthcare Workforce Commission authorized by the Affordable Health Care Act.More

Mental Health Parity: An update

On Feb. 27, the Health Care Cost Institute released a report indicating that the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 ("Parity Act") increased access to mental health and substance use services in hospitals. However, consumers continued to pay more out-of-pocket for substance use admissions than for other types of hospital admissions.

The "Parity Act" enhanced the 1996 Mental Health Parity Act by extending parity to substance use treatment. Under the "Parity Act," large group health plans were required to make behavioral health coverage rules similar to medical/surgical benefit rules. Large group plans were also required to make copayments, deductibles, coinsurance and out-of-pocket maximums for behavioral health care equivalent with the most common medical/surgical treatments.

The report, entitled "The Impact of the Mental Health Parity and Addiction Equity Act on Inpatient Admissions," is one of the first to look at hospital spending, utilization, prices, and out-of-pocket payments for mental health and substance use admissions. It reflects the national health care spending of more than 40 million people younger than 65 and covered by employer-sponsored insurance between 2007 and 2011. The report is focused on hospital care and looks at facility fees; it does not include payments to medical personnel. The data was contributed by a set of large health insurers who collectively represent approximately 40 percent of the U.S. private health insurance market.

Key findings of the report include the following:


Congress now focuses on spending bill for fiscal year 2013

Fresh from its failure to reach a deal on the sequester, Congress will now spend the rest of March focusing on another big-ticket item, a spending bill for the remainder of fiscal year 2013. Under the current continuing resolution, the federal government is funded through March 27, which means that Congress has less than a month to figure out a spending plan or face a government shutdown. Insiders believe that these negotiations should go a lot easier than the recent sequester talks. Following a March 1 meeting, President Barack Obama and congressional leaders in both parties seemed to be in agreement that the last thing the country needs now is a government shutdown.

However, one point of contention could surface, related to how the House of Representatives deals with the Defense and Veterans Affairs departments. House Majority Leader Eric Cantor, R- Va., said the Republicans would pass a bill that gives those departments more leeway in how to spend their money for the rest of the fiscal year, partly to help them start new programs. That is a privilege that other departments will not get. Democrats are already arguing that this appears to be a way to make it easier for the Department of Defense to handle the spending sequester, which took effect on March 1. That could be a sign that the Democratic Senate might seek to change the bill, although that remains to be seen. More

Health and Aging Policy Program: Applications due April 15

Candidates with a strong commitment to health and aging issues, leadership potential, and interest in aging-relevant policy work are invited to join the next class of Health and Aging Policy Fellows (2013-2014). The Health and Aging Policy Fellows Program aims to create a cadre of leaders who will serve as change agents in health and aging policy to ultimately improve the health care of older adults. The year-long fellowship offers a rich and unique training and enrichment program that is focused on current policy issues, communication skills development, and professional networking opportunities to provide fellows with the experience and skills necessary to help affect policy. Applications are due April 15. For more information on the Health and Aging Policy Fellows Program and how to apply, please visit here.More

AAGP Members: Log on to AJGPonline.org for Journal access
Claim online access to The American Journal of Geriatric Psychiatry via AJGPonline.org and on your mobile device via Elsevier's HealthAdvance journal app. Have your AAGP member number handy.

  1. Go to AJGPonline.org. Click on "Register" and "Activate Your Subscription" in the banner at the top right.
  2. Register. Enter your email (username) and click on "Continue" (next to "Register a New Account"). At the "Register a New Account" page, provide a password and all the requested profile information. Select that you have read the terms of use and click "Register." You are now registered and can log in: Your username and password are your login credentials.
  3. Claim your access. On the "Claim Your Online Access" page, click "I receive my subscription through a society membership." Enter your AAGP member number and last name. Then click "Claim."
  4. On the "Online Access Claimed" page, you can click the "Journal" link or "Finish"; both links will direct you to the journal home page.
Important Notes: AJGP Mobile. As an AAGP member and Journal subscriber, you will have access to recent AJGP content via your mobile device: abstracts, tables of contents, full text articles.
To download AJGP content via your mobile device, search for "“HealthAdvance" or "Elsevier" in either the App Store (for the iPhone or iPad) or in Google Play (formerly the Android Market) or by using the links below.

NOTE: After you download the app, the name below the icon shown at left will be "My Journals."
You will be asked to log in. Please review the instructions above to ensure you have valid login credentials for the mobile app. You will need to use the same username and password you registered on the AJGP Journal website.

AAGP's new Jobs page
Looking for a new position or a new hire? Check out AAGP's new Jobs page here.

Here are a few of the positions available:

Geriatric Psychiatrist (Portland, Maine)
BE/BC Psychiatrists (New York)
Inpatient Geropsychiatry Position in Triangle Area, N.C.
Adult Psychiatry, Scott & White Healthcare System, Central Texas — Temple

To see the complete listings, click here.More

More evidence links atrial fibrillation and dementia risk
Annals of Internal Medicine via Medscape
Atrial fibrillation is significantly associated with cognitive impairment and dementia, independent of history of clinical stroke, a new meta-analysis has found. Previous research had highlighted the association between AF and cognitive decline, but it was assumed that this association was mediated through clinical stroke because patients with AF are 4 to 5 times more likely to develop clinical stroke, said lead author Shadi Kalantarian, MD, MPH, research fellow, Massachusetts General Hospital Cardiac Arrhythmia Service, Boston.More

Eliminating useless information important to learning, making new memories
GRU News
As we age, it just may be the ability to filter and eliminate old information — rather than take in the new stuff — that makes it harder to learn, scientists report. "When you are young, your brain is able to strengthen certain connections and weaken certain connections to make new memories," said Dr. Joe Z. Tsien, neuroscientist at the Medical College of Georgia at Georgia Regents University and Co-Director of the GRU Brain & Behavior Discovery Institute. It's that critical weakening that appears hampered in the older brain, according to a study in the journal Scientific Reports.More

Middle-aged fitness may stave off dementia
Runner's World
The statistics are not comforting: 1-in-8 adults aged 65 and older suffers from Alzheimer's disease. But a new study in the Annals of Internal Medicine offers the heartening news that being fit in middle age may help stave off dementia later in life. The researchers are among the first to use a large sample size to examine the relationship between cardiovascular fitness and loss of brain function. They analyzed data from The Cooper Center Longitudinal Study, a database of patient visits to the Cooper Clinic in Dallas which has been previously used to link greater fitness to longer life-expectancy and a lower risk of stroke, diabetes and other diseases.More

AAGP Meeting starts this week in Los Angeles
The AAGP 2013 Annual Meeting kicks off Thursday, March 14 with workshops, sessions, the Opening Plenary and Awards session, and the Opening Reception. The next three days of the meeting offer a wealth of educational sessions; caucus, committee, and interest group meetings; a lively exhibit hall; skills workshops; and roundtable discussions. Registration opens at the JW Marriott Los Angeles L.A. LIVE on Wednesday, March 13 at 4 p.m.More

New hope for dementia sufferers
Monash University via Medical Express
Research that aims to rid dementia sufferers' brains of toxins could lead to a new treatment that reverses the symptoms of Alzheimer's disease in the future. Researchers are investigating new ways to treat Alzheimer's by targeting the blood-brain barrier, which acts as a door to the brain, and is responsible for pumping toxins in the blood away from the brain.More

A call to restructure psychiatry general and subspecialty training
AAGP — AAGP President Paul D.S. Kirwin, MD
Over the past few months an AAGP working group convened to formulate ways to restructure general psychiatry residency and fellowship programs in order to incentivize training in geriatric psychiatry. For several years the AAGP has proposed similar positions to the American Council of Graduate Medical Education. We now seek support of other psychiatry subspecialties and psychiatry professional organizations to advocate our position before the ACGME and the American Board of Psychiatry and Neurology. Read the entire article at AAGPonline.org.More

New system can help spot sleep disturbance in people with early dementia
The Medical News
A new sleep pattern monitoring system has been developed by U.K. researchers to help spot sleep disturbance in people diagnosed with early dementia. The system, known as PAViS, could be used remotely by health care workers to view sleep profiles and analyze sleep patterns based on sensory data gathered at the patient's home. Writing in the International Journal of Computers in Healthcare, Huiru Zheng and colleagues at the University of Ulster at Jordanstown, County Antrim, Northern Ireland explain how sleep disturbance is one of the most distressing of symptoms in Alzheimer's disease and might also be an early indicator of the onset of the disease in some cases. They point out that so-called "telecare" systems allow healthcare workers to monitor patient activity whether in normal or supported housing.More

Study: Alzheimer's seen on scans decades before dementia
Abnormal deposits in the brain thought to trigger Alzheimer's disease can be detected decades before the memory-robbing illness ensues, a finding that will help guide future treatments, researchers in Australia said. Doctors at Melbourne's Austin Hospital followed 200 seniors, including people with Alzheimer's disease and mild cognitive impairment, for more than three years to chart any decline in cognition and brain size against the deposition of abnormal protein in their brains. They found it takes about 20 years for the deposits, known as amyloid beta, to lead to dementia.More

Report: Alzheimer's disease now fastest-growing threat to US health
Alzheimer's disease is the fastest-growing threat to Americans' health, while early childhood illnesses and interpersonal violence are declining in frequency, according to the most detailed research on the causes of death and disability in the country published recently. The findings of a research project show that among rich countries, noncommunicable diseases like Alzheimer's, diabetes and drug and drink disorders now loom largest, while poor countries are still chiefly threatened by infectious and infant diseases, especially HIV/AIDS.More