(Dr. Ray Innis, Healthy Living columnist) Premature aging and disability are largely the result of lifestyle factors, such as smoking, excessive alcohol use, caffeine consumption, and drug abuse. Being overweight accelerates sexual and physical decline. A lifestyle of rich, refined foods and deficient in regular exercise can make people old before their time. Imagine yourself at 90 years of age, if you think you will get there. Will you be active? Will you be walking with your great grandchildren? Celebrating life with family and friends? Or will you be isolated and sick?

Here is the good news. Research shows that a healthy lifestyle can hold back the aging process by as much as 30 years. Today is a good time to be alive! Productive social activities are pushing back the aging process. So are exercise, a better understanding of the role of diet, earlier attention to health problems, and advances in modern technology. Today, people are staying fit into their 80s and 90s. Many remain sexually active…

[I]t is possible for anyone with a healthy lifestyle, worthwhile goals, and a positive mental attitude, to enjoy life well into their golden years.

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(Josh Mitteldorf, ScienceBlog.com) Starve yourself.  Exercise until it hurts.  Buy expensive supplements and stay away from the foods you love most.  You may have the impression that living a long time is no fun at all.

But the good news is that the most powerful life extension strategies are things we want to do anyway.  Live in a way that makes you happy.  Connect deeply to friends and lovers.  Spend time with your children.  Enjoy sex more frequently.  Take leadership in your community.  Express yourself artistically.

The very reason that aging evolved is to stabilize death rates for the sake of the community… It would have served the community well if evolution might have arranged for leaders to have a longer life span than followers from the same community, the same pool of genes.

The take-home message:  Cooperative leadership is good for your health.  Earn the love and respect of your neighbors for your contributions to community life.

Comment: The importance of cooperation has major implications for society, as well as for individuals. I’d write a book about it, if I could ever find a publisher (http://bit.ly/Q3zdMU).

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(Gizmodo) A compound found within pomegranates, when transformed by bacteria in the gut, has been shown to rejuvenate cellular function and reverse the effects of aging on muscles, at least in worms and rodents. On their own, pomegranates may not confer these life-extending qualities—but the discovery could lead to powerful anti-aging medicines.

The molecule responsible for this rejuvenation effect is called urolithin A, but it isn’t actually found in pomegranates. After eating the delectable juice from a pomegranate, natural substances known as ellagitannins are broken down in the stomach and then converted into urolithin A by our intestinal bacteria…

A team of scientists from the Swiss Federal Institute of Technology in Lausanne, with the help of biotech firm Amazentis, has shown that this biological byproduct enables muscle cells to protect themselves against a major cause of aging. In the words of the researchers, urolithin A conferred “powerful and measurable” anti-aging effects on nematode worms and rodents. Human trials are already underway, but these preliminary findings have already been published.

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(MIT Technology Review) An anti-aging startup hopes to elude the U.S. Food and Drug Administration and death at the same time.

The company, Elysium Health, says it will be turning chemicals that lengthen the lives of mice and worms in the laboratory into over-the-counter vitamin pills that people can take to combat aging…

[Founder Leonard Guarente, an MIT biologist, says] that it’s nearly impossible to prove, in any reasonable time frame, that drugs that extend the lifespan of animals can do the same in people; such an experiment could take decades. That’s why Guarente says he decided to take the unconventional route of packaging cutting-edge lab research as so-called nutraceuticals, which don’t require clinical trials or approval by the FDA.

This means there’s no guarantee that Elysium’s first product, a blue pill called Basis that is going on sale this week, will actually keep you young. The product contains a chemical precursor to nicotinamide adenine dinucleotide, or NAD, a compound that cells use to carry out metabolic reactions like releasing energy from glucose. The compound is believed [to] cause some effects similar to a diet that is severely short on calories—a proven way to make a mouse live longer.

Community: The Elysium product Basis is available here, and costs $50 per month if you agree to a continuing supply It contains both NAD and pterostilbene, a relative of resveratrol, which is also believed to be an anti-aging agent. However, NAD is available from other vendors at a lower cost. Pterostilbene and resveratrol are also available separately from other vendors.

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(CNN) Want to live longer? Have a piece of whole grain toast or oatmeal for breakfast, and then eat popcorn as a snack, and put some buckwheat in your pasta.

Not one but two new studies recently analyzed the wide variety of research published over the years on the benefits of whole grains and found that eating at least three servings a day could help you live longer…

Three servings of whole grains a day are what U.S. dietary guidelines suggest, but few Americans achieve this -- maybe because whole grains get a bit of a bad rap.

"People do not necessarily regard whole grain as delicious, but you can find a number of good recipes online that make delicious meals using whole grains," said Dr. Qi Sun, author of the Circulation study.

The Harvard assistant professor of nutrition said that even if you don't want to give up your beloved white rice, you could make a mix of brown and white rice, alternate whole wheat bread with something else, spread a little quinoa or bran on your salad, or try your taco fillings on whole wheat tortillas.

There doesn't have to be major change for this to work.

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(CBC) Replacing trans fat and saturated fats from foods such as red meat and butter with some plant-based foods offers health benefits, say researchers who tracked diet patterns and deaths among more than 100,000 health professionals for up to three decades…

Different types of fat had different associations with risk of death overall. For example, those who replaced saturated fats with unsaturated fats, especially polyunsaturated fats, had a significantly lower risk of death overall during the study period.

Their risk of death from cardiovascular disease, cancer, neurodegenerative disease and respiratory disease was lower than for those who continued to consume high amounts of saturated fats.

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(Medscape Medical News) Midlife memory lapses may reflect a shift in how your brain forms and retrieves memories, not a decline in thinking skills, a new study suggests…

"When you meet someone for the first time, it is likely that young adults are paying attention to where and when they met this person, and they can remember this information," says researcher Natasha Rajah, PhD, director of the Douglas Brain Imaging Centre.

"But middle-aged and older adults focus more on the social-emotional relevance of the person they met -- were they pleasant, whether they reminded them of other people they know, and so on -- and this change in focus negatively impacts their ability to remember more objective features," Rajah says.

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(Scientific American) Mice exposed to constant light experienced bone-density loss, skeletal-muscle weakness and inflammation; restoring their health was as simple as turning the lights off. The findings are preliminary, but they suggest that people living in cities flooded with artificial light may face similar health risks.

“We came to know that smoking was bad, or that sugar is bad, but light was never an issue,” says [Johanna Meijer, a neuroscientist at Leiden Medical Center in the Netherlands]. “Light and darkness matter.”

Many previous studies have hinted at a connection between artificial light exposure and health problems in animals and people. Epidemiological analyses have found that shift workers have an increased risk of breast cancer, metabolic syndrom and osteoporosis. People exposed to bright light at night are more likely to have cardiovascular disease and often don’t get enough sleep.

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(Genetics Society of America) A new screening approach uses several types of roundworms to identify chemicals that might one day help people stay healthy longer. Researchers will present initial findings from their search for anti-aging compounds at The Allied Genetics Conference, a meeting hosted by the Genetics Society of America.

"There is a key need for pharmaceuticals that can combat Alzheimer's and Huntington's disease, cancer, and other diseases related to aging," said lead author Mark Lucanic, Ph.D., a postdoctoral fellow in the lab of Gordon Lithgow, Ph.D., at the Buck Institute for Research on Aging. "We are trying to identify chemicals or compounds that have potent effects on improving lifespan across multiple organisms because these might have a good chance at turning into future drug leads for treating age-related diseases in humans."...

The processes involved in aging are quite complex and are likely influenced by a person's genes. The idea behind CITP is that if scientists can find agents that show effects in organisms with diverse genetic backgrounds, those agents might be more likely to be effective in humans, as well. Since roundworms live only about three weeks, they can be used to screen for chemicals affecting lifespan in a short amount of time.

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(Government Technology) [O]lder Americans are much more likely to vote. So as community leaders look for ways to provide older Americans with what they want and need, they can draw guidance from a recent national survey conducted by DHM Research in partnership with the Institute on Aging at Portland State University, Oregon Public Broadcasting and AARP-Oregon:

·         While nine in 10 Americans over age 75 feel it is important for their communities to work toward becoming more age-friendly, eight in 10 percent of adults of all ages agree with that sentiment. Among 10 choices, the top three that survey respondents identified for making a community age-friendly were housing (25 percent), health services (24 percent), and employment and the economy (21 percent).

·         When asked specifically about the most important strategies for supporting seniors and people with disabilities, topping the list for Americans of all ages, at 33 percent, was better alignment of housing, transportation and social needs. The next most popular strategies: providing more physical and mental health promotion and preventive services (25 percent) and better access to help and information including personal financial planning resources (18 percent).

None of these issues are new, of course; what's new is the increasing amount of attention being paid to them…

And it isn't just about older Americans. The development of age-friendly communities deserves the support of all ages, for one very important reason: We're all growing older. As Portland State's Margaret Neal and Alan DeLaTorre wrote in a report published in February, "What we do now to make our communities good places to grow up and grow old will yield returns not only for today's elders but also tomorrow's -- that is, for all of us."

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(Winston-Salem Journal) The Center for Disease Control defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” The concept of aging in place represents the desire of many older adults to remain in their own home for as long as possible.

There are a variety of resources and services available, such as in-home aide service, adult day care, and transportation assistance, which can support a person’s decision to age in place. However, it may be difficult to find and arrange the necessary services for an older adult seeking to remain at home. Reasons for this may include unfamiliarity with community resources and/or the financial inability to pay for services.

An older adult may be covered by programs such as Medicare, Medicaid, long-term care insurance or the Veteran’s Administration. It is important for the individual (or primary caregiver) to know their specific coverage and have a deep understanding of the financial and insurance benefits available to them.

A second important consideration is the specific support a person needs to make staying at home a viable option.

Community: There’s an online source for aging in place information, according to the Washington Post.

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(Christopher Soto, NPR) [I]n the past two decades, a large and still-growing body of research has established that personality traits are very much real, and that how people describe someone's personality accurately predicts that person's actual behavior…

We've also gained a clear sense of which personality traits are most generally useful for understanding behavior…

And while personality traits are relatively stable over time, they can and often do gradually change across the life span. What's more, those changes are usually for the better. Many studies, including some of my own, show that most adults become more agreeable, conscientious and emotionally resilient as they age. But these changes tend to unfold across years or decades, rather than days or weeks. Sudden, dramatic changes in personality are rare.

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(University of Massachusetts Medical School) Using a systems-biology approach, scientists at the University of Massachusetts Medical School made a startling discovery that immune system signaling can directly affect, and even change, social behavior in mice and other model animals… [T]hese findings could have great implications for neurological diseases such as autism-spectrum disorders and schizophrenia…

The researchers note that a malfunctioning immune system may be responsible for "social deficits in numerous neurological and psychiatric disorders." But exactly what this might mean for autism and other specific conditions requires further investigation.

"For the first time we have a platform capable of systematically investigating the complex connections between immune signaling and various brain functions," [said Vladimir Litvak, PhD]. "I believe that anybody can use our technology as a template to investigate the involvement of various immune components in different brain dysfunctions."

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(Rush University Medical Center) Cinnamon is a delicious addition to toast, coffee and breakfast rolls. Eating the tasty household spice also might improve learning ability, according to new study results…

The study by neurological scientists at Rush University Medical Center found that feeding cinnamon to laboratory mice determined to have poor learning ability made the mice better learners.

"This would be one of the safest and the easiest approaches to convert poor learners to good learners," said Kalipada Pahan, PhD, the lead researcher of the study.

Community: Cassia cinnamon, the most common cinnamon sold in the U.S., contains a toxin called coumarin, which can be toxic to the liver in some people. The safer cinnamon is "true cinnamon" (cinnamon verum), which comes from Ceylon. It’s more expensive, but may be better for your health. I buy our spices from Whole Foods’ bulk section, and they’ve assured me that their cinnamon does not come from the cassia tree.

Also, it may be better not to use a lot of sugar with the cinnamon, because sugar can also be detrimental to your health.

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(Tech Times) Engaging in physical activities has long been linked with improved health. Just 15 minutes of daily exercise, for instance, has been shown to extend the lifespan of older adults. Being physically active in midlife may also lower risk for stroke later in life.

Now, a new study has yet again provided another evidence of the benefits of engaging in physical activities and this time involving breast cancer survivors.

Excessive stress in breast cancer survivors may result in memory problems. Findings of the new study, however, have suggested that physical exercise may help improve self-reported memory issues among breast cancer survivors.

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(NJ.com) Studies have shown regular exercise is one of the best ways to prevent dementia. Strong social connections also can help keep your brain sharp. However, a study of Japanese sports clubs found that if you want the greatest benefit, you should mix the two. It turns out that socializing while you sweat is far better for your brain than working out alone.

The study followed more than 11,000 Japanese adults over the age of 64, dividing them into those who:

·         Went to sports clubs to work out.

·         Went to sports clubs to socialize, but didn't exercise.

·         Worked out at home.

·         Stayed home and didn't exercise at all.

Researchers wanted to know whether there's an additional benefit from working out with other people. As far as they could tell, that had never been studied. What they found out surprised them.

Four years later, the first group, made up of people who went to sports clubs regularly to exercise, showed the least decline in physical health and cognitive ability.

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(Huffington Post) A good night’s sleep can do wonders for women’s intelligence, whereas napping has a similar effect on men, a new study suggests.

Professor Martin Dresler and a team of researchers from the Max Planck Institute in Munich found that sleep boosts intelligence in women, but not in men.

Napping for 100 minutes in the afternoon was thought to have a similar effect on intelligence among men.

Researchers believe this might be down to differences in hormones at different times of the day. 

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(Alzheimer's News Today) A single oral dose of methylene blue is able to increase the response of brain regions that control attention and short-term memory, according to University of Texas Health Science Center researchers. Methylene blue has proven useful as a surgical stain to guide procedures and in the treatment of methemoglobinemia, a blood disorder in which hemoglobin in red blood cells does not effectively release oxygen to the tissues.

This study suggests that methylene blue may be also used to enhance memory formation in patients with cognitive impairments, such as those with Alzheimer’s disease... The effects of methylene blue on long-term memory were demonstrated in animal models more than 30 years ago. The treatment was shown to improve spatial memory retention, the type of memory responsible for recording information about the environment and spacial localization — required to navigate around a familiar city, for example — in healthy and Alzheimer’s mice models.

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(International Business Times) The ability to deal with abstract concepts, including patterns of “same” and “different,” is not uniquely human. With extensive training, even animals are capable of demonstrating the same. But, results of a new study show that the newly hatched ducklings can be so smart that they can make a distinction between "same" and "different" — without any training.

As part of the study, … professor Alex Kacelnik of the University of Oxford and his student Antone Martinho III performed a behavioral test with ducklings that can quickly learn the traits of their mothers within hours of hatching — a process known as imprinting. The researchers found that the newly hatched mallards can do more than we thought they could.

“In a way, imprinting appears to be simple," the Atlantic quoted Kacelnik as saying. “But it’s extremely complex because mum is an extremely complex collection of properties. So what is it that a young animal stores in its brain to recognize the identity of its mother?”

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(MedPage Today) Magnesium supplementation leads to decreases in blood pressure among both hypertensive and normotensive adults, according to the findings of a meta-analysis.

Taking 368-mg magnesium per day for 3 months led to 2.00 mm Hg reductions in systolic blood pressure (95% CI 0.43-3.58) and 1.78 mm Hg reductions in diastolic blood pressure (95% CI 0.73-2.82), Yiqing Song, MD, ScD, of the Indiana University School of Public Health in Indianapolis, and colleagues reported in a meta-analysis of 34 separate trials.

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(WTNH) It turns out that covering up your face in cold weather could be what your body needs to avoid catching that miserable cold.

“Our research has really shown that the temperature can impact the immune response to the virus,” says Akiko Iwasaki, Professor of Immunobiology at Yale School of Medicine. She is the lead investigator of the latest study linking cool weather conditions to the common cold.

It happens particularly in the nose, where the rhinovirus is better able to replicate.

She explains: “When you inhale the cooler air, you actually cool the airway of the inside of the nose, and this is not what we have evolved to deal with. So the virus has found a nice home to replicate.”

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(The Mount Sinai Hospital / Mount Sinai School of Medicine) Traumatic brain injury (TBI) with a loss of consciousness (LOC) may be associated with later development of Parkinson's disease but not Alzheimer's disease or incident dementia, according to a study conducted at the Icahn School of Medicine at Mount Sinai and the University of Washington School of Medicine. The research … contradicts common assumptions about the relationship between TBI and Alzheimer's disease as found in other high-profile studies...

These findings suggest that clinicians may be misdiagnosing late-life TBI-related neurodegeneration as Alzheimer's disease, and therefore treatment targeting Alzheimer's would be ineffective in helping late-life decline among patients who experienced TBI. Further work is needed to characterize post-TBI neurodegeneration.

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(Scientific American) Researchers at Stanford University have coaxed brain cells involved in vision to regrow and make functional connections—helping to upend the conventional dogma that mammalian brain cells, once damaged, can never be restored. The work was carried out in visually impaired mice but suggests that human maladies including glaucoma, Alzheimer’s disease and spinal cord injuries might be more repairable than has long been believed.

Frogs, fish and chickens are known to regrow brain cells, and previous research has offered clues that it might be possible in mammals. The Stanford scientists say their new study confirms this and shows that, although fewer than 5 percent of the damaged retinal ganglion cells grew back, it was still enough to make a difference in the mice’s vision. “The brain is very good at coping with deprived inputs,” says Andrew Huberman, the Stanford neurobiologist who led the work. “The study also supports the idea that we may not need to regenerate every neuron in a system to get meaningful recovery.”

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(UPI) Despite the promise of studies stimulating the brain with low-voltage electricity, nearly 40 researchers in the field have banded together to warn about a growing trend of people buying or building devices to stimulate their own brains at home.

Do-it-yourself transcranial direct current stimulation, or tDCS, is not very well understood and people attempting to treat conditions like depression or anxiety, or to improve their cognitive function, may be endangering the proper function of their brains, researchers say in a letter…

Several methods of brain stimulation have been the subject of studies in the last several years to mixed results, in part because researchers are still learning how electricity delivered to the brain affects not only the parts stimulated, but parts of the brain that have not been stimulated.

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(UPI) Electronic stimulation of a nerve running from the brain to the gut may help ease stubborn symptoms of rheumatoid arthritis, preliminary research suggests.

The study, of 17 adults with the painful autoimmune disease, tested the effects of vagus nerve stimulation -- a technique long used to control seizures in some people with epilepsy.

It found that over six weeks, most of the patients showed some improvements in joint swelling and other symptoms.

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(California Healthline) Prescription drug prices are up, making policy experts increasingly anxious. But relief could come from a surprising source. Just ask Cheech and Chong.

New research published Wednesday found that states that legalized medical marijuana — which is sometimes recommended for symptoms like chronic pain, anxiety or depression — saw declines in the number of Medicare prescriptions for drugs used to treat those conditions and a dip in spending by Medicare Part D, which covers the cost on prescription medications.

The study, which appears in Health Affairs, examined data from Medicare Part D from 2010 to 2013. It is the first study to examine whether legalization changes doctors’ clinical practice and whether it could curb public health costs.

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(Tech Times) Researchers analyzed a vast amount of data gathered in separate small-scale studies which involved 3.9 million adults in 32 countries across the world.

They compared the mortality risk to the participants' BMI, and they defined the following: 18.5 to 25 as normal BMI; 25 to 30 as overweight; 30 to 35 as moderately obese; and more than 40 as severely obese. For instance, someone who is 5 feet 4 inches tall is obese even at a weight of 174 pounds (78 kilograms) or more.

In the end, scientists found that overweight people faced premature death compared to those who were of normal weight.

Overweight people lose one year of life on average compared to their peers, while those who were moderately overweight lose about 3 years of their life, researchers say.

A previous study also discovered that severe obesity could lead to the loss of as much as 8 years in life expectancy.

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(CNN) A little bit of what's irresistible is good for you, Italian scientists have discovered.

Their analysis of more than 23,000 people found that eating some pasta is associated with a lower body mass index. Those who enjoyed their noodles were less likely to be overweight and obese.

"Our results are in agreement with a relatively recent study examining food and nutrient intakes in association with BMI in 1,794 United States middle-aged adults, showing that pasta intake among other food groups is negatively associated with BMI," the researchers wrote.

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(LiveScience) Drinking enough water may be one key to maintaining a healthy weight, according to a new study, which finds that there may be a link between staying hydrated and staying slim.

Among the people in the study, the less hydrated they were, the more likely they were to have a higher body mass index (BMI), according to the findings, published today (July 11) in the journal Annals of Family Medicine.

This suggests that water "may deserve greater focus in weight management research and clinical strategies," the researchers wrote in their study.

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(Nature World News) Obesity is a brain disease that is only made worse by unhealthy Western diet, study said.

A person's brain retains food memories in the mind when he or she feels hungry. After eating, the food thoughts fade away so that food becomes less of a priority.

But according to researchers from Macquarie University in Australia, this natural brain process is hampered by high-fat, high-sugar and low-fruit, low-vegetable diet of Westerners.

Researchers said that sweet, fatty foods impair memory inhibition abilities of the hippocampus in the brain. As a result, the smell and sight of food trigger cravings even after eating a full meal.

"Even though they were full, they still wanted to eat the sweet and fatty junk food," Tuki Attuquayefio, co-researcher of the study, [said].

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(UPI) Although artificial sweeteners provide the taste people expect from foods, the sugar replacement chemicals also make the brain increase hunger because it thinks not enough food has been consumed for energy.

Researchers at the University of Sydney fed fruit flies and mice a diet including sucralose, and found it throws off the brain's reward centers, as they consumed far more calories than they needed.

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(Fred Hutch News Service) Whether cutting pounds or cancer risk, the crunches in your salad trump the crunches in your workout, say scientists at Fred Hutchinson Cancer Research Center.

That finding emerged in a new study of overweight and obese women who significantly lowered their weight – and levels of proteins associated with cancer – by slashing daily calories or by improving both diet and exercise.

Similar-sized women who exercised regularly but maintained their usual calorie intake did not post big drops in pounds or in those suspect proteins, reports the Fred Hutch study.

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(USA Today) In India, 194.6 million are undernourished, according to the India FoodBanking Network. But, more people in the tourist hotspot Kerala are becoming obese.

To curb the new trend, Kerala is implementing a 14.5% tax “fat tax” on burgers, pizzas, tacos, doughnuts, sandwiches and pasta sold at branded restaurants and food retail giants…

"There has been an alarming trend in the growth of unhealthy eating habits among Keralites and we hope the fat tax will be a deterrent," Rajan N. Khobragade, commissioner of commercial taxes, [said].

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(AP) The nation’s health care tab this year is expected to surpass $10,000 per person for the first time, the government said Wednesday. The new peak means the Obama administration will pass the problem of high health care costs on to its successor.

The report from number crunchers at the Department of Health and Human Services projects that health care spending will grow at a faster rate than the national economy over the coming decade. That squeezes the ability of federal and state governments, not to mention employers and average citizens, to pay.

Growth is projected to average 5.8 percent from 2015 to 2025, below the pace before the 2007-2009 economic recession but faster than in recent years that saw health care spending moving in step with modest economic growth.

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(Forbes) Health spending will rise nearly 6 percent for the next 10 years, but it won’t be due to expanded medical coverage under the Affordable Care Act.

Rather, the 5.8% growth in health spending from 2015 to 2025 “is expected to be influenced by changes in economic growth, faster growth in medical prices, and population aging,” according to the latest projections from the Centers for Medicare & Medicaid Services office of the actuary…

Projected health spending growth is ahead of growth of the gross domestic product by 1.3 percent, but medical costs are still rising much slower than they were before in the two-decade run-up to the so-called Great Recession.

Community: So allowing older Americans to buy in to Medicare should help keep prices down for younger people.

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(AP) Frustrated by the rising cost of prescription drugs, California health advocates hope sunlight and a dose of shame will discourage drugmakers from raising their prices too quickly or introducing new medications at prices that break the bank.

They're promoting legislation that would require drugmakers to provide advance notice before making big price increases. Pharmaceutical companies have come out in force against the measure, warning it would lead to dangerous drug shortages.

Community: Good luck with that, advocates. Don’t you know that greed is good, even when people have to die because of it?

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(Reuters Health) Between 2005 and 2014, U.S. cancer centers upped their spending on ads targeting the general public, with 890 centers spending $173 million on ads by 2014, according to a new analysis…

Spending on advertising does not necessarily reflect quality of care, however, the authors note.

“Previous research has shown that cancer center advertisements use emotion-based techniques to influence viewers and often do not include information about benefits, risks, or costs of cancer treatment,” Vater told Reuters Health by email. “There is a concern among some physicians that such advertising may persuade patients to pursue high-cost treatments with a low likelihood of improving outcomes.”

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(Howard Gleckman, Forbes) Medicare needs to better serve a population of older adults who live longer and with more chronic conditions than they did in the 1960s. Medicare’s fee-for-service acute care model may have worked well in the days when treating heart attacks and strokes were a primary focus of health care. But in the past half-century, medical science has turned heart disease and even some cancers into chronic conditions. Unfortunately, these advances have also made it possible for more of us to live long enough to show symptoms of dementia. Roughly 90 percent of Medicare dollars are spent on seniors with chronic conditions.

Those profound changes require a model of care that fully integrates medical treatment with personal assistance and social supports. It breaks down the artificial barriers that prevent older adults from receiving the full suite of holistic care that can help improve their quality of life. And it helps them manage those often complex multiple chronic conditions.

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