Active Aging

1 R Special Advertising Section | Sunday, October 24, 2021 13 ACTIVE AGING Similarly, a study ana- lyzing medical records and consumer credit reports for more than 80,000 Medicare beneficiaries showed that seniors who eventually received a diagnosis of Alzheimer’s disease were signifi- cantly more likely to have delinquent credit card payments than those who were demographically similar but never received such diagnoses. They also were more likely to have subprime credit scores. “We were motivated by anecdotes in which family members discover a rela- tive’s dementia through a catastrophic financial event, like a home be- ing seized,” said Lauren Nicholas, the lead author and a health economist at the University of Colorado School of Public Health. “This could be a way to identify patients at risk.” The problems appeared early, with at least two consecutive payments skipped as much as six years before a diagnosis, and subprime credit two and a half years before. Although smaller studies have pointed to an asso- ciation between self-re- ported financial misman- agement and dementia, this is the largest and the first to use actual financial data, Nicholas added. Comparing vocal patterns In Japan, research- ers have developed a machine-learning tool that scrutinizes phone conversations for signs of preclinical Alzheimer’s. Using audio files recorded during interviews last year, they compared healthy patients’ vocal features — pitch, intensity, silent in- tervals — with those with Alzheimer’s and found that the models could predict cognitive status. IBM researchers have picked up elevated risk in writing tests, finding that word patterns and usage predicted later Alzheimer’s diagnoses. Any of these findings might, one day, be used for early screen- ing. Such approaches raise concerns about privacy, however. “Are people com- fortable with a bank or an auto insurance company having and communicat- ing that information?” Largent asked. “It becomes medical information in the hands of people who are not physicians.” At the Penn Memory Center, where information is indeed in health profes- sionals’ hands, “some people who are cognitively unimpaired, after test- ing in the clinic, indicate they’d like to be moni- tored,” she said. “Others find that unbelievably intrusive.” Bioethicists have grappled for years with questions about informing patients of higher-than- normal risk for a feared disease for which there is, still, no effective treat- ment. Studies have shown that in research settings, results can be communi- cated safely and effectively. But fears of discrimina- tion and stigma remain. Even using established biomarkers like amyloid in PET scans, these advance findings aren’t defini- tive, which researchers take pains to point out to patients. “It’s neither necessary nor sufficient to have these risk factors,” Largent explained. People with elevated amyloid have higher risk but may not progress to cogni- tive impairment; people without it can nevertheless develop dementia. Still, Largent said, “I generally think having that information can be useful to people.” In a number of stud- ies, Largent has examined what happens when de- mentia risks are disclosed to patients and families. She has found that about one-third of patients respond to the informa- tion by changing their health behavior, under- taking legal and financial planning or taking other preparatory steps. “They do things like update their wills, draft advance directives, exercise more, maybe move closer to an adult child,” she said. Paul Gondek, 68, who lives in Philadelphia and teaches social psychology at Drexel University, chose to learn his risk status two years ago, volunteering for several studies at the Penn Memory Center. Alzheimer’s tends to run in families and, having watched his mother’s slow decline from the disease, he knew he had a higher chance of developing it. To Gondek’s relief, the PET scan showed that he did not have elevated amounts of amyloid in his brain. And a calculated risk score showed that his odds of Alzheimer’s by age 85 were about 19%— higher than the 11% risk for the general population, but lower than he had feared. If other early indicators were available through driving or financial records or other behav- iors and were reliable, he said, “I would want to use them. I’d rather know than not.” Continued from previous page OSHER LIFELONG LEARNING INSTITUTE OLLI-UW invites adults over 50 to explore a variety of short courses offered via remote learning. Learn for the joy of learning, without tests, grades or papers, from the comfort and safety of your own home. We also offer several monthly lectures on a variety of topics. Become a member of OLLI-UW and register for courses today! BELOWARE JUSTA FEWOF OUR EXCITING FALL COURSES: OSHER.UW.EDU OLLI@UW.EDU | 206-685-6549 • Contemporary Ethics • Jazz • Islam through the Ages • The Canterbury Tales • The Drake Equation • Nations of the Northwest