Increased Broken Bones Among Boomers Is Precursor Of Future Long-Term Care Needs

A new study suggests that the number of baby boomers visiting hospital emergency rooms for broken arms could rise by nearly a third by 2030. That is when the youngest baby boomers will have just turned 65.

The scientists reported that 370,000 cases of fractures in the humerus bone of the upper arm occur each year in both the United States. While younger individuals between the ages of five and nine accounted for the highest overall number of breaks, they found that arm injuries also spiked among women after age 40 and men after age 60.

Researchers at the University of California, Davis, reported that 38.7 million Americans were 65 or older in 2008, but that by the year 2030, that number will be 71.5 million. They project a significant increase in hospital emergency room visits with much of the increase likely to be among older Americans.

The highest number of proximal humerus breaks was seen in both men and women after age 45, and rates kept rising until about age 84. Women were more than twice as likely as men to suffer a proximal humerus break, and saw an uptick in the breaks earlier in life, starting after age 40, which the researchers attributed to lost bone density.

“Conditions like osteoporosis will increases a person’s likelihood of sustaining a bone fracture as a result of even a simple fall,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “Some can be fixed with a cast but other broken bones especially those that occur at older ages will require long periods of care and at could seriously disable a person for long periods of time.”

Indeed, the researchers found that 88 percent of upper-arm breaks were caused by falls, prompting them to call for more rigorous safety measures to reduce falls and better treatments to prevent osteoporosis.

“Prevention is vital, but so is planning for living a long life,” Slome explains. “If you live into your 80s or beyond, the likelihood you will need long term care is vastly increased but you need to start preparing for this in your 50s and early 60s when the most planning options are still available to you.”

Less Risk Of Alzheimer’s Found Among Fish Eaters

Adults who eat baked or broiled fish as little as once a week may lower their risk for mild cognitive impairment and Alzheimer’s disease.

According to research findings, eating non-fried fish that includes baked and broiled fish helps to preserve gray matter neurons. The scientists note that this strengthens the areas of the brain deemed critical to cognition and memory.

“Scientists report that people with larger brain volume the risk for Alzheimer’s and mild cognitive impairment went down with eating fish as little as one to four times a week. “We’re talking about just a half serving a day,” notes Jesse Slome, executive director of the American Association for Long Term Care Insurance. ”We would encourage millions of aging Americans to make a very small lifestyle change that can affect their risk of this terrible disease.”

The number of U.S. adults aged 65 years and older is projected to nearly double over the next two decades, Slome, head of the national long term care insurance trade organization explains. “As a result, the incidence of cognitive issues especially Alzheimer’s disease and other dementias is also expected to rise as will the need for costly long term care,” he adds. Alzheimer’s disease is the number one reason individuals with long term care insurance file claims.

More than 5 million Americans have Alzheimer’s disease the age-related disorder that slowly destroys memory and thinking. Older adults with mild cognitive impairment have less severe memory loss than those with Alzheimer’s but often go on to develop the disease.

The scientists found that those who ate baked or broiled fish had larger mass in the hippocampus, and orbital frontal cortex regions of their brains. This was regardless of age, gender, physical activity routines, and/or educational achievement, race or weight. No benefit was evident with respect to consumption of fried fish.

Financial experts advise adults in their mid-50s to learn more about long-term care planning and get long-term care insurance costs from a designated expert.

More Exercise Can Help You Sleep Better

Regular physical activity while you are awake can result in better sleep. According to a just reported study, individuals who participated and met national exercise guidelines reported less daytime fatigue and better sleep patterns than those who didn’t exercise.

While researchers note that the research doesn’t confirm that exercise directly leads to improved rest, the findings are mostly consistent with previous research, according to Jesse Slome, executive director of the American Association for Long Term Care Insurance which tracks health related issues pertinent to longevity matters.

Inadequate sleep has been linked to depression, cardiovascular disease and other health problems notes Slome. Increased risk of cardiovascular disease puts aging Americans at greater risk of needing benefits from their long-term care insurance Slome explains.

The researchers noted that hoping that a daily walk or jog will clear up sleep problems might be a bit too optimistic. More than one-third of U.S. adults have trouble falling asleep at night or staying alert during the day, according to background information in the study.

The new study by researchers at Oregon State University examined data from a U.S. health survey conducted from 2005 to 2006. The researchers focused on over 2,500 men and women between ages 18 to 85. They measured their activity levels and answered questions about sleep.

All study participants wore accelerometers, devices that measure physical activity for a one-week period.

The researchers adjusted their statistics so they wouldn’t be thrown off by unusually high or low numbers of people of certain ages, weight, health condition, smoking history or other factors. Participants met or exceeded national exercise guidelines by getting at least 150 minutes a week of moderate exercise or 75 minutes a week of vigorous exercise or a combination of both.

Those who met the guidelines were 65 percent less likely to report often feeling sleepy during the day compared to those who got less exercise. They were also 68 percent less likely to report sometimes having leg cramps and 45 percent less likely to report having trouble concentrating while tired.

Heart Healthy Study On Salt Intake Changes Rules

Too much salt is dangerous for adults suffering from conditions including heart disease or diabetes. Now a new study finds that too little salt may be almost as dangerous.

According to researchers reporting in the Journal of the American Medical Association reducing salt is still very important in people consuming more than 6,000 or 7,000 milligrams of sodium per day. It is estimated that the average American consumes 3,400 milligrams of sodium a day.

The lead scientists who conducted studies report that people who already consume moderate or average amounts of salt may not need to reduce their intake further. “Apparently, after years of agreement among medical experts that people should lower their salt intake, there is new debate,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The national trade organization tracks health issues which can impact American’s need for costly long term care.

A recent research study found that while cutting back on salt did lower blood pressure, it may also increase levels of cholesterol, triglycerides and other risk factors for heart disease. Heart disease is a major risk factor facing adults Slome notes.

The latest study looked at levels of sodium and potassium excreted in urine in a group of about 30,000 men and women with heart disease or at high risk for heart disease. Participants were followed for an average of more than four years.

The researchers found that people who excreted higher levels of sodium than those with mid-range values had a greater risk of dying from heart disease, heart attack, stroke and hospitalization for heart failure. When the researchers assessed potassium levels, they found that a higher level of excretion of the nutrient was associated with a lower risk of stroke.

New U.S. dietary guidelines now recommend that people aged 2 years and older limit daily sodium intake to less than 2,300 milligrams (mg). People aged 51 and older, blacks and anyone with high blood pressure, diabetes or chronic kidney disease should consider going down to 1,500 mg per day, many experts say.

Financial planning experts note that most people wait too long to consider their options because the right time to plan is prior to turning age 65 before medical conditions like cancer, high blood pressure are diagnosed or become problematic.

Fewer Dying From Mouth And Throat Cancers

U.S. death rates for throat and mouth cancers has decreased according to new national data. According to research and a study of analysis by the National Center for Health Statistics, the largest decreases in death rates for mouth and throat pharynx) cancers were among black patients with at least 12 years of education.
Researchers studied data on both white and black men and women residing in 26 states. The data was based on individuals between the ages of 25 and 64. Death rates increased among white men with fewer than 12 years of education, according the American Cancer Society and researchers participating in the study. A second study found that poor overall quality of life, pain and continued tobacco use seem to be associated with poorer outcomes and a higher death rate two years after diagnosis for patients with head and neck cancer.

This national study included 276 patients diagnosed between September 2001 and September 2008. The overall survival rate two years after diagnosis was 90.8 percent.
The likelihood of death within two years of diagnosis was: four times higher for those who reported low quality of life than for those who reported a high quality of life; four times higher for those who continued to use tobacco than for those who had quit or never used tobacco; and two times higher for those who reported pain than for those who said they had no pain.

“Americans are surviving dreaded diseases like cancer and hearty attack,” explains Jesse Slome executive director of the American Association for Long-Term Care Insurance and the American Association for Critical Illness Insurance “Survival comes with a steep price that often includes bankruptcy and cancer remains one of the leading causes for long term care insurance claims.”

Regular Dental Cleaning Lowers Stroke A Leading Risk For Long Term Care Need

Regular doctor visits are important for your good health. Turns out, so are regular visits to your dentist for tooth cleaning.

Those regular cleanings may provide more than just a brighter smile. Researchers have found that people who have their teeth professionally scraped and cleaned had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke compared to those who never had a dental cleaning.

“Poor oral hygiene has been associated with an increased risk of heart disease by a number of studies,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The national organization tracks and reports data relevant to the increasing risk of needing long term care services.

The findings of the multi-year study were presented at the American Heart Association scientific meeting in Orlando, Florida this past week. The researchers reported that professional tooth cleaning appeared to reduce inflammation-causing bacterial growth that can lead to heart disease.

The scientists reported that protection from heart disease and stroke was more pronounced in study participants who got tooth scaling at least once a year.
Researchers studied over 100,000 people beginning in 2007.

According to the report, none of the study subjects had a history of prior heart attack or stroke. The study however did not take into account or adjust for risk factors such as smoking or obesity.

The medical scientists noted that a higher frequency of professional tooth cleaning led to a greater reduction in heart risk. They defined higher frequency as at least two visits to the dentist for a cleaning in two years.

Stroke is a leading cause of claims for benefits by the eight million Americans who own long term care insurance according to yearly research by the American Association for Long-Term Care Insurance. Each year, about 600,000 Americans experience their first stroke according to the American Association for Critical Illness Insurance.

Financial planning experts note that most people wait too long to consider their options because the right time to plan is prior to turning age 65 before medical conditions like heart disease are diagnosed or become problematic. “The sweet spot for long term care insurance is between ages 52 and 64,” Slome adds. “You do not want to wait until after a doctor has diagnosed even a mild stroke because at that point it will very likely be too late to medically qualify for this protection.”

Divorce And Changed Family Roles Will Impact Available Care

The elderly population of the United State will nearly double by the year 2050 creating both an enormous care giving problem for an increasing number of families.

As aging baby boomers enter retirement years, there is a growing concern as to who will care for them as they reach into their 80s, 90s and beyond. Traditionally in the United States, adult children have accepted the care giving responsibilities for aging parents.

“Those care giving roles are becoming increasingly blurred as more families are affected by divorce and remarriage than in previous decades,” explains Jesse Slome, executive director of the American Association for Long Term Care Insurance, the national organization. “There will not be the same family network and expect much stress and strife over who is going to care for mom or dad, if anyone is even willing to take on that enormous burden.”

Relationship quality trumps genetic ties when determining care giving obligations according to a study by University of Missouri researchers. They studied how divorce and remarriage affect beliefs about who should care for aging relatives.

The researchers found that relationship quality, including a history of mutual help, and resource availability influenced decisions about who cares for aging parents and stepparents. The old concept that family obligations are based on genetic ties is no longer true for most Americans, the researchers report. How close family members are to each other, how much they have been helped by them in the past, and what hardships care giving might place on family members are important factors when people consider caring for older relatives.

“We are clearly no longer a society that singularly relies on families to provide much of the care for aging parents and that is why every family needs to have the long term care discussion and a plan in place to address the eventuality of some need,” Slome adds. “I like to say, long term care insurance allows a loved one to care about you, not to have to care for you.”

Financial planning experts note that most people wait too long to consider their long term care planning options because the right time to plan is prior to turning age 65 before common medical conditions are diagnosed or become problematic. “The sweet spot for long term care insurance is between ages 52 and 64,” Slome adds. “You do not want to wait until after a doctor has diagnosed even a mild stroke because at that point it will very likely be too late to medically qualify for this protection.”

For more information on long term care insurance feel free to eMail or call me!!

Women Can Eat Chocolate To Reduce Stroke Risk

A new study has wonderful news for women chocolate lovers. Researchers report women enjoy health benefits from eating more chocolate.

According to an article appearing in the Journal of the American College of Cardiology women with the highest chocolate consumption, on average at least two candy bars per week had a twenty percent less likelihood of stroke.

The researchers studied nearly 35,000 women who did not have any medical history of stroke, heart disease, cancer or diabetes. The women were all between the ages of 49 and 83. The scientists studied over 350 different dietary and lifestyle indicators.

The scientists noted that cocoa, the primary ingredient in chocolate, contains flavonoids, which have antioxidant properties. These suppress oxidation of low-density lipoprotein also known as ‘bad’ cholesterol that can cause cardiovascular disease including stroke.

“Chocolate has long been associated with positive attributes,” explains Jesse Slome, executive director of the American Association for Long Term Care Insurance, which monitors health issues related to the risk f long term care need. Stroke is a leading cause of claims for benefits by the eight million Americans who own long term care insurance. “Chocolate was said to have magical powers by the Mayan’s who first used it hundreds of years ago,” Slome adds. “This is great news for women who love the wonderful confectionary.”

The scientists reported that of the 33,000 study participants some 1,549 women had a stroke. Most of them, around 1,200, were reported as having an ischemic stroke which means the blood vessel in the brain is blocked. They noted that some 244 suffered from hemorrhagic strokes.

Each year, about 600,000 Americans experience their first stroke according to the American Association for Critical Illness Insurance. “People who have had a mild stroke are five times more likely to have a stroke over the next two years than the general population,” reports one scientist affiliated with the research. “Proper treatment and management of risk factors can help prevent another stroke.”

Financial planning experts note that most people wait too long to consider their options because the right time to plan is prior to turning age 65 before medical conditions like heart disease are diagnosed or become problematic. “The sweet spot for long term care insurance is between ages 52 and 64,” Slome adds. “You do not want to wait until after a doctor has diagnosed even a mild stroke because at that point it will very likely be too late to medically qualify for this protection.”

Long Term Care Insurance Claims Likely For Arthritis Suffering Women Over Age 85

Two new reports should concern millions of aging women. The first reports that women diagnosed with arthritis are twice as likely to use their long-term care insurance as men. The second reveals that the lifetime prevalence of arthritis is 65.4% in individuals aged 85, occurring more commonly in women.

“Arthritis is one of the top reasons people need long term care as they age and no longer are able to perform normal daily functions,” explains Jesse Slome, executive director of the American Association for long term care insurance. “We found that 10 percent of nursing home claimants receiving insurance benefits are women diagnosed with arthritis.”

A second study revealed that arthritis is strongly connected with age. Researchers examined how the oldest individuals, those aged 85 years or older, are affected by the disease. They looked at adults over the age of 85.

The findings revealed that for any arthritis the lifetime prevalence was high, with 673 (65.4%) of the participants having arthritis, they also discovered that the disease was more common in women than men (69.1% vs 58.8%).

Osteoarthritis was more common in women than men (57.1% vs 42.5%). Osteoarthritis was most prevalent in the knee joint followed by the hip and hand. Several of those participating in the study identified the knee as the most painful joint, even though the foot, ankle and lower back received the highest pain score.

“The impact of arthritis on disability, health and long term care need is significant,” Slome notes. “The economic burden of musculoskeletal disease in the oldest old is potentially huge and its management presents a major challenge to American families.

According to the American Association for Long-Term Care Insurance planning is especially important for women who are far more likely to need care as a result of living longer lives. “Because of the need to medically qualify for long term care insurance women need to start planning well before reaching age 70,” Slome advises. “The sweet spot is between ages 52 and 64 before Medicare kicks in and people take advantage of the free medical screenings the Medicare program offers.

Long Term Care Insurance Industry Leader Warns More Medicaid Changes To Come

Illinois State lawmakers along with private estate planning attorneys have finally worked out a deal on long-delayed rules to carry out a 2005 federal law restricting the way residents can shelter assets and still qualify for Medicaid benefits to cover nursing-home care.

“Lawmakers realize that taxpayers simply will no longer allow lawyers to shelter the wealth of families while taxpayers pay the growing tab for long-term care,” declares Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “With State Medicaid budgets in shambles, more states are going to have to take a serious look at the ways lawyers transfer this costly burden to working taxpayers.”

The agreement, approved unanimously by the Illinois General Assembly’s Joint Committee on Administrative Rules, deals with the practice of gifting assets to relatives and other people. The new rules, which take effect January 1, 2012 make Illinois one of the last states to implement the federal Deficit Reduction Act of 2005.

State experts say the changes deal with many of the provisions elder-law attorneys considered harsh. “The rules apparently still are quite generous in terms of granting hardship waivers to seniors who have made asset transfers in the past five years and want those transfers treated under the old rules,” Slome adds. “But, it’s just a matter of time until younger taxpayers wake up and demand more money for their childrens’ schools and less money to pay for nursing home care for seniors with assets. More changes will be forthcoming to force people to take personal responsibility for their care costs.”

Under the new rules, the look-back period will be extended from the current three years to five years when calculating Medicaid eligibility. Under the current system, the penalty period starts based on the date assets were transferred. Under the new rules, the penalty period won’t start until a person already is in a nursing home and has spent almost all of his or her assets.

The new restrictions on Medicaid eligibility increase the need for people to look into long term care insurance costs, Slome advises. “But you can not wait until you are in need of care,” Slome adds. “Insurance companies will only issue coverage to those who can medically qualify so the right time to start planning is between ages 52 and 64.”

The Deficit Reduction Act is designed to save the publicly funded Medicaid system an estimated $3.9 billion nationwide from 2006 through 2015.

More Seniors Surviving Cancer Adds To Long-Term Care Crisis

Over the next decade there will be a dramatic rise in the number of people over the age of 65 either living with cancer or with a history of the disease according to a new study.

According to an analysis of US cancer data, the greying of the baby boomer generation is at the root of the issue. “Americans are already living longer lives and that will create a long-term care tsunami in the years to come,” explains Jesse Slome, executive director of the Los Angeles-based American Association for Long-Term Care Insurance. “Because long-term care insurance can only be purchased when you can medically qualify, the tsunami will wreak havoc on family savings and state Medicaid welfare budgets.”

National Cancer Institute (NCI) researchers found the number of people over age 65 with cancer will rise by about 42% in the next decade. Cancer is largely a disease of aging, the researchers noted.

The scientists analyzed data the revealed that in 1971, the number of people in the US who had survived cancer was about 3 million. By 2008, the figure had risen to nearly 12 million. In 2008, the proportion of cancer survivors aged 65 and over was 60% and is set to reach 63% by 2020.

The most commonly diagnosed cancers among survivors were: female breast cancer (22% of diagnoses), prostate cancer (20%), and colonrectal cancer (9%). The high rate of survival among this population is most likely due to improved detection and screening.

In contrast, the percentage of lung cancer survivors is only 3%, despite it being by far the most frequently diagnosed cancer in both men and women.
“When you live a long life and now are even more likely to survive diseases like cancer, you are increasingly likely to need costly long term care, states Slome. “With more Americans living into their 80s and beyond, having a long term care plan in place is more important than ever.”

Financial planning experts note that most people wait too long to consider their options because the right time to plan is prior to turning age 65 before medical conditions like cancer, high blood pressure are diagnosed or become problematic. “The sweet spot for long term care insurance is between ages 52 and 64,” Slome adds.

Comedy Is Good Medicine For Alzheimer’s Patients

Exposing individuals suffering from Alzheimer’s disease to humor therapy appears as effective as psychiatric drugs in reducing the agitation that often plagues those struggling with dementia. Researchers found that nursing home residents who actively participated in a weekly two-hour clowning session involving music, mime and humorous props showed a significant reduction in both physically and verbally aggressive behavior.

“The number of U.S. adults aged 65 years and older is projected to nearly double over the next two decades,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance , the national trade organization. “As a result, the incidence of cognitive issues especially Alzheimer’s disease and other dementias is also expected to rise as will the need for costly long term care.”

Scientists found that laughter resulted in a 20-percent plunge in overall agitation. The benefit lasted for at least 14 weeks beyond the conclusion of the clowning program. They noted an added bonus, the fact that change was achieved without running any of the risk of serious side effects, including falling and premature death, that have been previously associated with prescription antipsychotic drugs.

The study authors noted that between 70 percent and 80 percent of dementia patients experience some form of agitation and distress, which can include bouts of wandering, screaming and repetitive behaviors.

The scientists utilized the services of an elder clown who was trained to engage in humor-based therapy in a medical setting. Sessions were conducted weekly and involved humorous improvisation skills, similar to those used by clown doctors who perform for sick children.

While agitation remained lower 26 weeks following therapy launch, the boost in both happiness and positive behaviors seen during the program faded once the program ended.

George T. Leamon, CLTC, a long-term care insurance expert advises adults in their mid-50s to learn more about long-term care planning and get long-term care insurance costs. He explains that the best ages to look into this protection is prior to age 65 when health issues including early diagnosis of cognitive issues can make it harder or more costly to medically qualify for coverage.

Long Term Care Insurance Risk Faced By 55 Million With High Blood Pressure

One-quarter of American adults receive treatment for high blood pressure.

New research reported by the U.S. Agency for Healthcare Research and Quality reveals that of the estimated 55.1 million people with high blood pressure, 29 percent were black patients and 25 percent were white adults. Among others treated for high blood pressure, 15 percent were Hispanics and 20 percent were other races.

Total costs for treatment of high blood pressure amount to over $47 billion, including $21.3 billion for prescription drugs, $13 billion on doctor visits and an additional $13 billion spent on hospitalizations, emergency room visits and home health care.

Most people treated for high blood pressure are age 65 or older. This age group accounted for nearly 60 percent of reported treatments. Meanwhile, patients ranging in age from 45 to 64 accounted for about 32 percenhttp://www.blogger.com/img/blank.gift of reported treatments and those between the ages of 18 and 44 were just 5 percent.

The federal agency noted that 25 percent of women received treatment for high blood pressure compared to 23 percent of men.

According to Jesse Slome, executive director of the American Association for Long Term Care Insurance, high blood pressure is a treatable condition but also connected with a higher risk of needing long term health care and thus creating a greater risk of utilizing long-term care insurance.

“With more Americans living into their 80s and beyond, having a long term care plan in place is more important than ever,” declares Slome. “Most people wait too long to consider their options because the right time to plan is prior to turning age 65 before medical conditions like high blood pressure are diagnosed or become problematic.”

Low Vitamin B12 Linked To Cognitive Decline In Elderly

Older individuals who have low levels of vitamin B12 in their blood have a greater risk of brain shrinkage, losing cognitive skills and greater risk of needing long term health care.

“The number of U.S. adults aged 65 years and older is projected to nearly double over the next two decades,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance, the national trade organization. “As a result, the incidence of cognitive issues especially Alzheimer’s disease and other dementias is also expected to rise as will the need for costly long term care.”

According to Chicago researchers foods rich in vitamin B12 include those derived from animals and include, eggs, milk, liver, meat, and fish. Vitamin B12 plays a key role in normal nervous system functioning and brain development. It is also involved in the formation of red blood cells.

Scientists undertook a study of individuals aged at least 65 years. They underwent blood tests to check for B12 and B12-related metabolites levels. They were also assessed for memory and other cognitive skills. Some five years later magnetic resonance imaging scans of their brains were taken to measure comparative brain size and to identify other signs of brain damage.

Those with four of five markers for vitamin B12 deficiency were found to have a higher risk of getting lower cognitive test scores and smaller total brain volumes. The National Institute of Aging funded the study.

Vitamin B12 plays a key role in normal nervous system functioning and brain development. It is also involved in the formation of red blood cells.

Planning experts advise those seeking to learn more about long-term care planning and get long-term care insurance cost contact a designated expert. They point out that the best ages to look into this protection is prior to age 65 when health issues can make it harder or more costly to medically qualify for coverage.

Study Links Diabetes With Dementia And Long Term Care Insurance Risk

Adults with diabetes face a significantly higher risk of developing all types of dementia, including Alzheimer’s disease, the leading cause of long term care insurance claims.

A new study published in the current issue of Neurology reaffirms previous research connecting the two illnesses. According to the American Association for Long-Term Care Insurance some 5.4 million Americans are living with Alzheimer’s disease and as many as 16 million will have the disease by mid-century.

The study of more than 1,000 Japanese adults found that 27 percent of those with diabetes developed dementia, compared to 20 percent of people with normal blood sugar levels. The study also revealed that pre-diabetes, reported as higher than normal blood sugar levels. also raised the risk of dementia.

The study, conducted from 1988 to 2003, followed over 1,000 men and women, age 60 and older, who took a glucose test to find out if they were diabetic or pre-diabetic. These adults were then tracked over an average of 11 years each. In all, 232 developed dementia, either Alzheimer’s, vascular dementia, all-cause dementia or another form.

Of the 150 who had diabetes, 41 developed dementia, compared to 115 of the 559 people without diabetes. Among the 308 people with pre-diabetes, 76, or 25 percent, developed dementia.

Diabetes affects close to 26 million children and adults in the United States, with 7 million of them undiagnosed, according to the American Diabetes Association. “Another 79 million have pre-diabetes,” explains Jesse Slome, a leading long term care insurance expert. “Obesity increases the risk of diabetes, and as Americans become heavier, more are developing diabetes and thus will be at greater risk of needing costly long term care.”

In type 2 diabetics, the more common form of the disorder, people don’t have enough of the hormone insulin to convert glucose in food into energy, or they don’t process insulin properly.

Educating Consumers and Providing Current and Objective Information

My main goal is educating consumers and providing the most current and objective information to help you make smarter decisions. I am here to inform, not sell or push any particular solution. In fact, even my American Association for Long-Term Care Insurance membership does not sell insurance. If you would like information or actual cost quotes from myself a leading expert licensed in Florida just feel free to email or call me. What information should you read to get started. There is a wealth of information on this website. If you are looking for the latest information on tax deductible rules for long-term care insurance, feel free to contact me at anytime!

Long Term Care Insurance Information from America's Long-Term Care Insurance Experts

Chances are you'll live well into your 80s, your 90s and possibly even longer.

When you live a long life, the likelihood you'll need long-term health care is greatly increased. Younger people also need long term care as a result of accidents or illnesses.

Long-term health care is generally not covered by medical insurance, by Medicare supplement plans or group / employer insurance. For seniors on Medicare, the long-term care benefits are quite limited.

That is why over 10 million Americans have purchased long-term care insurance. The American Association for Long-Term Care Insurance was established in 1998 to educate individuals and to support insurance and financial professionals who market this protection.

Our Long-Term Care Insurance Consumer Information Center is the nation's most comprehensive resource. Find the most current information including long term care insurance costs, ways to save, tax deductibility rules and long term insurance companies and their ratings.

Our 2011 Long Term Care Insurance Price Index found that rates for virtually identical coverage could vary by as much as 90 percent. It pays to compare - the yearly savings can be substantial.

Do all long-term care insurance policies cost the same?

Definitely not and that's one reason why it pays to speak with a knowledgeable long-term care insurance professional. For example, an American Association for Long-Term Care Insurance member ran price quotes for a "generous" plan of protection assuming equal conditions for a 55 year old spouse. A policy from Genworth or John Hancock would cost about $1,400. The same coverage from New York Life would run $1,945 and from Northwestern Mutual $2,400. These are all great companies and rates vary for a variety of reasons. But, as you can see, it clearly pays to check around. The savings can be substantial.

I'm 57 and married, how much does long-term care insurance cost?

What you pay is determined by your age, your health and how much protection you select when you apply. But, you want a bottom line. We do a Price Index study every year and someone age 55 who qualifies for preferred health and spousal discounts may pay $$709-per-year if they are married for what I'd call a base plan of protection today. That's about $115,000 in current benefits. With inflation protection coverage, that will grow to over $305,000 in 20 years. That's taking advantage of spousal and preferred health discounts.

I've read about rate increases. Should I be concerned?

It's hard to give a complex answer in just a few words, but let me try. The policies you are reading about in some news stories typically were issued 10 or 15 years ago when LTC insurance was still relatively new and conditions and policy pricing was very different. Just one example of what's changed. Interest rates paid on investments used to be 10% in 1985 and about 7% in 1995. Long-term care insurance is very interest rate sensitive. So, declining interest rates are great when you are looking to refinance your mortgage but lousy for an LTC insurer with older policies. But that was then; and this is now. Policies issued today in most states are governed by new regulations issued by the National Association of Insurance Commissioners and adapted by most states. These regulations mandate that policies are priced fairly and accurately based on everything that's been learned. So, while no one can guarantee the future … nope not even me … there are many more safeguards in place today to protect you. And, there's a cumulative experience that has been gained along the way.

Make me smarter! Are there secrets worth sharing before I meet with an agent?

Ah, the Internet … making us all smarter. Each insurance carrier has one or more "sweet spots" generally based on which ages and health conditions they believe are most desirable based on their experience or future expectations. Some offer advantageous discounts for couples buying together. Others will offer a discount even when only one buys. Fortunately, most knowledgeable long-term care insurance professionals have access to policies from multiple insurers and can show you an apples-to-apples comparison without you having to be a NASA scientist (with all respect to those NASA scientists and engineers reading this!). The savings to you could be significant.

What age is too young for long-term care planning?

The American Association of Long-Term Care Insurance surveyed LTC insurers at the end of 2007 and the youngest policyholders receiving benefit payments are ages 23 and 25.

Yesterday's image of long term care is something that people need when they are old … and old is subjective. It is true that most people will need long-term care as a result of getting older. But, younger people have accidents -- skiing, riding motorcycles all come to mind. Surgery will fix that busted knee -- but you'll need long-term care for months of recovery and your health insurance doesn't cover that. And, younger people get illnesses in their 40s and 50s like MS and Parkinson's that can require the need for years of care. Just something to think about.

Women Buy Majority Life – Long-Term Care Insurance

Sales in 2010 of life insurance policies offering long-term care benefits surged 79 percent for the industry’s leading insurance carriers.

According to annual research conducted by the American Association for Long-Term Care Insurance women comprised just over 60 percent of new buyers the study found.

“Linked life insurance policies that offer long-term care benefits experienced significant growth in 2010,” states Jesse Slome, the national trade organization’s executive director. “Consumers are finding these products offer a significant advantage when it comes to long-term care planning.”

Newer life insurance policies offer the ability for the policyholder to access funds should a need for long-term care occur. “For those with sufficient savings to purchase coverage, these new forms of protection help overcome the what if I don’t need long-term care,” Slome explains. If the policy benefits are not used for long-term care, the designated beneficiaries receive the death benefit.

According to data published in the Association’s 2011 Long-Term Care Insurance Sourcebook, over one-third (34%) of women who purchased new life+LTC policies in 2010 were between ages 55 and 64. Nearly 40 percent were between ages 65 and 74. Male purchasers tended to be slightly older Slome acknowledged.

“You need to have a fair amount of savings or what I call lazy money,” Slome explains. “Lazy money consists of funds sitting in low-paying Certificates of Deposit that can be easily put to far better use on your behalf.”

The single premium face amount of just over two-thirds of new policies purchased in 2010 was over $100,000. About a quarter of buyers opted for a face amount of over $200,000.

The complete findings are published in the Association’s 2011 Long-Term Care Insurance Sourcebook that can be obtained from any of the organizations 3,000 members. Slome advises consumers considering long-term care insurance to carefully compare coverage with a knowledgeable professional. ”Costs for virtually identical coverage can vary by as much as 40-to-60 percent,” he warns.

Free Guide Examines Long Term Care Insurance Cost Savings

The cost for virtually identical long-term care insurance protection for a 55-year-old couple can vary by as much as 92 percent according to a recent report.

The cost variation is due to the fact that each of the leading insurance companies sets their own rates. “Every company has their sweet spots where they are the most competitive in terms of cost,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “The lowest cost may not be the best long-term buy but because switching rarely is advisable, it is important to shop around.”

Long term care insurance experts acknowledge that few consumers are aware of common discounts available that can significantly reduce the cost of the protection. “Some of the discounts will also vary from company to company,” Slome explains. “While they may all offer the savings, the percentage discount offered may be quite different.”

Leading insurance companies offering long-term care insurance protection today include Genworth Financial, John Hancock, Mutual of Omaha and Prudential. “There are a number of significant companies like Transamerica, MedAmerica and LifeSecure that are leaders with very attractive and well-priced products as well,” Slome notes.

The Association recently reported that the number of Americans who would apply for new long-term care insurance coverage in 2011 would exceed 500,000. In 2010, some 475,000 purchased coverage according to the Long-Term Care Insurance Sourcebook, an increase over 2009. “More consumers in their 50s and 60s are clearly aware of the importance of planning,” Slome notes, “and the risk of putting it off too long.”

A free online guide that explains available discounts and planning techniques that can help reduce the cost for long-term care insurance is now available on the Association’s Consumer Information Center. “We believe helping educate more people is the first step to creating better understanding,” Slome concludes. The free guide is available without any required sign-in information.

Read the free guide by clicking here.

Cancer Death Rate Declines, Impact On Long-Term Care Need

A steady decline in overall cancer death rates among America’s aging adult population will create added stress on the long-term care needs of seniors.

Medical advances and better lifestyles among the aging population appears to have saved 898,000 deaths from cancer between 1990 and 2007. According to the latest statistics presented today by the American Association for Long-Term Care Insurance, this is both good and bad news for the primary targets of cancer – senior citizens.

“When you live a long life, the risk of needing costly long-term care services is great,” explains Jesse Slome, AALTCI executive director. “When you live a longer life, the risk and cost will be even greater. More Americans will need home care and nursing home care services.”

Progress in the survival rate of those once impacted by cancer has not benefited all segments of the population equally. According to researchers, cancer death rates for individuals with the least education are more than twice those of the most educated.

Cancer death rates according to the American Cancer Society are still declining in the U.S., but some are declining faster than others — and cancer remains the leading cause of death for Americans younger than 85.

In it’s yearly report they estimated that 1,596,670 new cancer diagnoses and more than 570,000 cancer deaths are expected to occur this year.

Slome shared that death rates fell by about 22% for men and 14% for women between 1990 and 2007. Since the early 2000’s, the decline has been 1.9% a year in men and 1.5% each year in women. Better early detection and better treatment as well as reduced tobacco use over the past half-century that helped turned the tide in cancer-related deaths.

Olive Oil May Reduce Stroke Risk

Older people who use olive oil for cooking, or eat it as salad dressing or with bread may be protecting themselves against stroke.

French researchers found that seniors whose diet included a lot of olive had a 41% lower risk of stroke compared to those who had never consumed it. Stroke is a leading cause of needing long-term care among seniors according to the American Association for Long-Term Care Insurance, the national trade group.

The study appearing in the journal Neurology’s online report may prompt a change in the dietary recommendations for preventing strokes in people aged 65 and over:

Researchers examined the medical records of 7,625 people aged 65 and over residing in three French cities: Bordeaux, Dijon and Montpellier and who had no history of stroke. They had available two measures of olive oil intake: dietary consumption from all the participants and blood levels of oleic acid.

The researchers categorized users as follows: A moderate user was someone who used olive oil either with cooking or as salad dressing or with bread. An intensive user was someone who used olive oil for both cooking or as a dressing or with bread.

After just over 5 years of follow up, there were 148 strokes in the whole group. Intensive users had a 41 percent lower risk of stroke compared to never users.

National Family Caregiver Award Seeks Entries

Do you know a family caregiver deserving of $10,000 and the title of National Family Caregiver of the Year?

Homewatch CareGivers and the National Family Caregivers Association (NFCA) are proud to cosponsor the National Family Caregiver of the Year award, which was established to honor and recognize the strength and perseverance of family caregivers who dedicate their lives to the care of their loved ones. Homewatch CareGivers and NFCA share a common mission to provide support and resources to family caregivers.

The campaign is supported by the American Association for Long-Term Care Insurance. Jesse Slome, AALTCI’s executive director serves as a judge for the program. “We’re proud to work together to celebrate family caregivers and their inspirational stories,” Slome noted.

Nominaton Rules:

The nominations for the caregiver award must be submitted by a third party, such as a nurse, doctor, support group leader, friend or family member.

Nominations must be received by July 29, 2011.

The nominee must have provided care for this individual within the 12 months prior to July 29, 2011.

Local winners will be announced September 1, 2011. Local winners qualify for the National Family Caregiver of the Year Award $10,000 Grand Prize, to be notified on October 25, 2011.

Homewatch CareGivers will provide a donation of $5 to National Family Caregivers Association (not to exceed $5,000) for every valid, complete, unique nomination submitted via the web nomination form. (http://www.homewatchcaregivers.com/family-caregiver-award.aspx)

Local winners will receive a free day of respite care and a scholarship to Homewatch CareGivers University, which will give the educational foundation, skill set and confidence to continue this very important labor of love. Homewatch CareGivers University is a professionally developed caregiver training platform designed to train our caregiver employees, family members providing care, and the greater caregiver community.

500,000 Long-Term Care Insurance Applicants Expected

Over half a million Americans are expected to apply for long-term care insurance before the year concludes according to a projection from an industry trade group.

This marks significant continued growth in awareness and action among consumers explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “In 2010 the Association reported that 475,000 Americans obtained long-term care insurance coverage either on an individual basis or through their employer an increase over the prior year.”

According to the projection, interest and sales continue to trend up which can be attributed to several factors. “Consumers in their 50s and young 60s are more aware than ever of the risks involved in living into their 80s and 90s,” Slome explains. “The millions of pre-retirees understand that government programs will not be sufficient to deal with the burgeoning number of aging baby boomers and that new federal programs will be more suited to those with existing health limitations.”

The Association director notes that significant growth in sales will result from the thousands of federal employees signing up for coverage through the Federal Long-Term Care Insurance Program (FLTCIP) where open enrollment closes June 24. “I would expect tens of thousands of newly covered individuals in the program with an equal number who searched and compared coverage on an individual basis,” Slome adds.

Over eight million Americans currently have long-term care insurance protection and roughly 200,000 received benefits from their coverage in 2010 according to the 2011 Long-Term Care Insurance Sourcebook. The majority (56 percent) of individual applicants are between the ages of 55 and 64. “People increasingly understand the need to look into this protection prior to retirement age,” Slome concludes. “That is when costs are more affordable and you are still most likely able to health qualify for coverage.”

First Long-Term Care Insurance Almanac Published

What percentage of adults over age 65 will need between 2 and 5 years of long-term care after age 65? [Answer: 20%]. What percentage of assisted living residents transfer to a skilled nursing facility? [Answer: 58.9%]. What are the two largest causes for women’s home health care claims on LTC insurance policies? [Answer: Arthritis at 18% and Alzheimer's at 17%].

A compilation of hundreds of facts, statistics and data compiled from numerous industry reports has been published in the first Long-Term Care Insurance Almanac And Book of Facts, made available from the American Association for Long-Term Care Insurance http://www.aaltci.org. The resource is intended to help insurance and financial professionals address the increasing number of questions raised by prospective clients and professionals who may refer clientele.

“As awareness grows so does the complexity of questions pertaining to long-term care and LTC insurance,” explains Jesse Slome, executive director of the Association. “We wanted one easy-to-use resource that an agent could leave with an inquiring prospect without having to do hours of research.”

The Long-Term Care Insurance Almanac divides information into six categories: Aging and Need, Home Health Care, Assisted Living, Nursing Home Care, Claims and Federal and State Protections. “Few, if any consumers considering long-term care insurance have heard of the State Guaranty Associations that exist for their protection,” Slome adds.

Much of the data comes from proprietary research conducted annually by the Association. “The rest comes from countless hours of reading detailed government studies and pulling the most relevant data that pertains to this field,” Slome notes. “While many acknowledge that inundating prospects with facts and figures isn’t an effective selling strategy, not being able to address questions with specific factual information will kill any chance of appearing as a knowledgeable expert,” Slome concludes. “The Almanac was created to remove that barrier.”

Pattern Predicts Dementia Onset And Long Term Care Need

According to the Alzheimer’s Association, mild cognitive impairment (MCI) is “a condition in which a person has problems with memory, language, or another mental function severe enough to be noticeable to other people and to show up on tests, but not serious enough to interfere with daily life.” This type of mental state is considered a risk factor for dementia, the longest and most costly of all long-term care needs according to the American Association for Long-Term Care Insurance.

Some scientists studies have found that about 10 percent to 15 percent of those with MCI will progress to dementia each year. The new study which appears in the September issue of the Archives of Neurology, sought to deterine if telltale signs within MCI could determine those individuals who would progress more rapidly to full-blown dementia.

Researchers collected data on people with mild cognitive impairment and evaluated these individuals using brain scans and cognition tests. Over the next two years of follow-up, some 25 percent of the individuals did go on to develop dementia.

The researchers noted that if an older adult is starting to display problems in daily life, such as problems shopping independently, problems managing their own finances, problems performing household chores, and problems maintaining their hobbies, they are more likely to develop a dementia within several years.

Dr. Ronald C. Petersen, director of the Alzheimer’s Disease Research Center at the Mayo Clinic in Rochester, Minn., agreed that, despite the lack of effective treatments, spotting Alzheimer’s disease early remains important. “If people in the family start to recognize a change in memory/learning patterns, that might be sufficient to identify someone who could develop Alzheimer’s disease,” Peterson said. “Don’t wait until the person is having trouble driving, is having trouble paying their bills or having trouble functioning in the community — that’s dementia,” he said. “This study tells us that we can identify important symptoms earlier and it may be worthwhile doing so.”

Technology Aiding Alzheimer’s Patients

Kaiser Health News, in collaboration with The Washington Post, reports on “high-tech but simple devices”

According to a new report by Kaiser Health news, simple devices are giving older people a better chance at independence later in life as pilot projects in homes and retirement communities see if these approaches can lead to improved at-home patient monitoring.

The goal of the efforts experts note is to help control problems before they escalate and cut back on the need for costly long-term care and hospital admissions. Dementia and Alzheimer’s disease is a leading cause of the need for costly long-term care according to the American Association for Long-Term Care Insurance.

An estimated 5.3 million Americans have Alzheimer’s disease including about 200,000 Americans under the age of 65 the organization notes. Alzheimer’s generally creates the most cost of all long-term care insurance claims the Association notes.

A report notes that therapy with MP3 players such as iPods allows stroke victims or patients with Alzheimer’s to better interact with others. Caregivers have observed for decades that Alzheimer’s patients can still remember and sing songs long after they’ve stopped recognizing names and faces.

Insurance State Guaranty Directory

While most consumers are aware that bank deposits are protected and insured by the Federal Deposit Insurance Corporation (FDIC) few understand that similar protections exist for insurance products.

“Each state and the District of Columbia maintains a State Guaranty Association that protects consumers in case an insurance company fails,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance “In fact most states have two entities, one that protects life and health insurance products and one for property and casualty lines of business since each is quite different.”

Consumers are protected at levels set by the State with levels generally ranging from $100,000 to as much as $500,000.

The insurance associations operate differently than the FDIC which assesses each bank a regular ongoing fee. “That cost of the FDIC fee is actually borne by bank depositors as a fee they don’t see but definitely pay for,” Slome explains. “The State Guaranty Associations do not collect regular fees but rather only assess a fee when an insurance company fails, which is a fairly rare occurrence.”

In the case of an insurance company failure, all remaining insurance companies that operate in the state are assessed the necessary fee to protect policyholders of the failed company. “They must pay the fee to protect the consumers,” Slome adds.

A new online directory which explains insurance company limits for each of the 51 State Guaranty Associations as well as website and phone contact numbers has been created by the American Association for Long-Term Care Insurance. It can be accessed online at http://www.aaltci.org/guaranty.

“Consumers should be aware that these valuable protections exist,” Slome explains. “It is a question often asked by those looking into long-term care insurance planning.”

Estrogen Use Before 65 Linked To Reduced Alzheimer’s Risk

A study which was part of the Women’s Health Initiative Memory Study found women who used any form of estrogen hormone therapy before the age of 65 were nearly 50 percent less likely to develop Alzheimer’s disease or dementia than women who did not use hormone therapy before age 65.

Medical researchers noted that the study was one of the largest U.S. prevention studies of postmenopausal women. The study looked at prior hormone use in 7,153 healthy women ages 65-79 before they enrolled in the WHI Memory Study.

Researchers followed the women’s cognitive health over an average of five years. In that time, 106 of the women developed Alzheimer’s disease or dementia. Dementia is a general term referring to the progressive decline in a person’s cognitive function. Dementia can affect memory, attention, language and problem solving abilities. According to the American Association for Long-Term Care Insurance, Alzheimer’s is the most common type of dementia impacting older Americans.

Women who began estrogen-only therapy after the age of 65 had roughly a 50-percent increased risk of developing dementia. The risk jumped to nearly double for women using estrogen-plus-progestin hormone therapy.

Life Expectency In U.S. Hits New High

According to federal officials women born in 2007 can expect to live to 80.4 years on average and men to 75.3 years. The report from the U.S. Centers for Disease Control and Prevention notes that while Americans can expect to live longer than their parents, life expectancy in the United States is still lower than in many other industrialized countries, including Canada and Japan.

Along with increased life expectancy, the report notes the death rate has dropped to an all-time low of 760.3 deaths per 100,000 people, continuing a long-term trend. “It is increasingly likely that Americans will live a long life into their 80s, 90s and even past 100,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “But few are prepared for the consequences of living that long.”

The death rate has been decreasing in the United States since the 1960s with fewer deaths from heart disease, stroke and cancer are driving the trend, he said. The report is based on data from nearly 90 percent of U.S. death certificates.

According to the report, life expectancy in 2007 increased to 77.9 years (77 years and 11 months) up from 77.7 years in 2006. Since 2000, life expectancy has increased 1.4 years.

The five leading causes of death, accounting for 64 percent of all deaths, are heart disease, cancer, stroke, chronic lower respiratory diseases and accidents.

Death rates in the United States vary by region and state, with the Southeast leading the nation. The researchers report that white women have the longest life expectancy (80.7 years) followed by black women (77 years). At age 65, life expectancy was 18.6 years in 2007, an increase of 6 percent since 2000.

Experts note that living longer will also have unforeseen effects on the country. “People living 20 years or more than their predecessors will have to rethink retirement planning,” Slome said. “The nation will see a significant drain on Social Security and Medicare benefits as these programs were designed to support people for only five to 10 years after retiring.”

Fat Hormone May Protect Against Alzheimer’s

New research from Boston University School of Medicine was conducted because there has been some data relating body weight to the risk of Alzheimer’s disease. Looking at animal studies, scientists found some data to indicate that leptin not only produces a feeling of satiety but also has a beneficial effect on the hippocampus. They noted that it was important to see if that was true in humans.

The hippocampus is a portion of the brain that plays a role in important aspects of memory.

Some human studies have shown that people with Alzheimer’s disease have lower levels of leptin, but those studies didn’t show which came first, the lower leptin levels or the decline in mental function.

Leptin levels had been measured in 785 study participants in the early 1990s. For the new study, 198 of them had MRI scans that measured brain volume an average of 7.7 years after leptin was measured. The study authors also kept track of new Alzheimer’s diagnoses among the study participants.

The researchers found that higher leptin levels were associated with a lower incidence of Alzheimer’s and all other forms of dementia. The 25 percent of participants with the lowest leptin levels had a 25 percent risk of developing Alzheimer’s over a 12-year period; the incidence was only 6 percent for those with the highest leptin levels. And lower leptin levels were associated with a greater decrease in total brain size.

Another report issued today described disappointing results in a trial of a once-promising drug to prevent Alzheimer’s disease. The drug, tarenflurbil, was designed to reduce production of amyloid, a protein that forms plaques in the brains of people with Alzheimer’s disease. The study of 1,684 people who began taking the drug in the early stages of Alzheimer’s disease showed no benefit, the report said.

Smoking Increases Risk of Blindness In Old Age

AMD causes a darkening and/or blurring of central vision, and prevents you from being able to read, drive and recognize people you know. It is a progressive degeneration of the macula, the centre of the retina, the part of the membrane inside the back of the eye that allows us to see fine details.

Advanced AMD with loss of vision affects about 1.75 million Americans: this figure is expected to rise to just under 3 million by 2020 according to the American Association for Long-Term Care Insurance. “Smoking is the second most common risk factor for AMD; age is the first,” explains Jesse Slome, executive director of the trade group. “The medical experts show it is never too late to find a reason to quit.”

Researchers at the Jules Stein Eye Institute at University of California, Los Angeles (UCLA), and colleagues wanted to find out whether age was linked to the effect of smoking on AMD risk. The research provides the first accurate snapshot of how smoking affects AMD risk later in life.

For the study, researchers compared the retinal photographs of nearly 2,000 women taken at age 78 and 83, looked for signs of AMD and then did logistical regression statistical tests to find out whether smoking affected the women’s risk of developing the disease.

They found that smokers had 11 per cent higher rates of AMD than the non-smokers of the same age. But among those over age 80, the smokers were 5.5 times more likely to develop AMD than the non-smokers.

People Who Look Young For Their Age Tend To Live Longer

According to researchers, doctors frequently use perceived age as a general indication of a patient’s health. They note however, that there is little research upon which to base validity of the belief.

Researchers at the University of Southern Denmark, examined whether perceived age is linked with survival. They investigated important age related traits, such as physical and mental (cognitive) functioning and a molecular biomarker of aging (leukocyte telomere length).

Telomere length indicates the ability of the body’s cells to reproduce. Shorter length is associated with a host of diseases related to aging, lifestyle factors and death.

A total of 1,826 Danish twins aged 70 years and over underwent physical and cognitive tests in the spring of 2001. Their faces were also photographed. Assessors rated the perceived age of the twins from their facial photographs. The assessors did not know the age range of the twins. In addition, each twin of a pair had their age assessed on different days.

Following the assessments, death records were used to track the survival of the twins over a seven year period. Perceived age was significantly associated with longer life survival. This was true even after adjusting for chronological age, sex, and the environment in which each pair of twins grew up. Perceived age, adjusted for chronological age and sex, also correlated with physical and cognitive functioning as well as leukocyte telomere length.

Also, the bigger the difference in perceived age within a twin pair, the more likely it was that the older looking twin died first. The age, sex and professional background of the assessors had no relevance to any of the results.

The researchers concluded that perceived age based on facial photographs is a strong biomarker of ageing. It predicts survival among people aged 70 years and over and correlates with important functional and molecular age related characteristics.

Report gathered by the American Association for Long-Term Care Insurance.

Taking Blood Pressure Medication Cuts Dying Risk

A study of U.S. Medicaid patients found that the more closely a person adhered to his or her doctor’s recommendations for filling their blood pressure medication prescription, the lower his or her risk of stroke and death.

Stroke is one of the primary reasons older individuals require long-term care acciording to the American Association for Long-Term Care Insurance which tracks medical research that impacts individuals.

Taking just one more pill as recommended each week (from a one-a-day regimen) cut stroke risk by 9 percent and death risk by 7 percent, researchers with the University of Tennessee Health Science Center in Memphis reported in the Journal of General Internal Medicine.

The medical experts studied the medical records of about 49,000 Tennessee Medicaid patients for 1994 to 2000 to determine if blood pressure medication refill adherence or frequency of physician visits influenced risk of stroke or death. The researchers also investigated whether the type of blood pressure-lowering drugs a patient took was associated with stroke or risk of dying.

Patients were taking two different types of blood pressure drug on average, although some were taking as many as six. Sixty percent of the patients filled their prescriptions less than 80 percent of the time, and were classified as non-adherent to their medication.

During follow-up, which ranged from 3 to 7 years, 619 study participants had a stroke and 2,051 died.

Patients who were non-adherent were a half-percent more likely to die over a five-year period compared to adherent patients. Blood pressure drugs known as thiazide diuretics, ACE inhibitors, calcium channel blockers and beta blockers all cut death risk by 3 to 4 percent, while thiazide diuretics also cut stroke risk.

Patients in the study averaged about five doctor office visits a year, although there was a wide range, with some not seeing a doctor at all and others logging nearly 90 visits a year. Patients who visited the doctor more often were 1 percent less likely to die.

Five States With Most Under Age 65 Nursing Home Residents

According to a report, the following five states have the largest percentage of nursing home residents under the standard Medicare eligibility age. In Arizona, 16.57 percent of new nursing home residents admitted were under age 65.

Other states reporting the highest percentages were Louisiana (15.71%), California (15.19%), Illinois (14.74%), Ohio (14.56) and Maryland (14.44%). Data comes from the Brown University Shaping Long Term Care In America Project.

While most people associate long-term care with nursing home stay, according to the American Association for Long-Term Care Insurance the majority of long-term care takes place at home or increasingly in assisted living communities.

The average age for nursing home residents upon admission for the five states was Arizona (78.24), Louisiana (77.84), California (77.76), Illinois (80.37), Ohio (78.81) and Maryland (79.23).

Pattern Predicts Dementia Onset And Long Term Care Need

According to the Alzheimer’s Association, mild cognitive impairment (MCI) is “a condition in which a person has problems with memory, language, or another mental function severe enough to be noticeable to other people and to show up on tests, but not serious enough to interfere with daily life.” This type of mental state is considered a risk factor for dementia, the longest and most costly of all long-term care needs according to the American Association for Long-Term Care Insurance.

Some scientists studies have found that about 10 percent to 15 percent of those with MCI will progress to dementia each year. The new study which appears in the September issue of the Archives of Neurology, sought to deterine if telltale signs within MCI could determine those individuals who would progress more rapidly to full-blown dementia.

Researchers collected data on people with mild cognitive impairment and evaluated these individuals using brain scans and cognition tests. Over the next two years of follow-up, some 25 percent of the individuals did go on to develop dementia.

The researchers noted that if an older adult is starting to display problems in daily life, such as problems shopping independently, problems managing their own finances, problems performing household chores, and problems maintaining their hobbies, they are more likely to develop a dementia within several years.

Dr. Ronald C. Petersen, director of the Alzheimer’s Disease Research Center at the Mayo Clinic in Rochester, Minn., agreed that, despite the lack of effective treatments, spotting Alzheimer’s disease early remains important. “If people in the family start to recognize a change in memory/learning patterns, that might be sufficient to identify someone who could develop Alzheimer’s disease,” Peterson said. “Don’t wait until the person is having trouble driving, is having trouble paying their bills or having trouble functioning in the community — that’s dementia,” he said. “This study tells us that we can identify important symptoms earlier and it may be worthwhile doing so.”

Nursing Home Closures Hit

A five percent drop in available nursing home beds across the United States have affected many but worst hit are poor, urban neighborhoods.

According to new research, the country’s minority population is aging at a steeper rate compared with the white population. The study conducted by the Center for Gerontology and Health Care Research at Brown University in Providence, R.I. found that the potential need for long-term care is rising fastest in minority communities, even as nursing home closings are happening more often in their areas.

“The impact of nursing home closings on minority and low-income communities will have all sorts of implications in terms of access and quality of care issues for all,” states Jesse Slome, executuive director of the American Association for Long-Term Care Insurance. “We are heading to a twp-class society, those who can pay and those dependent on whatever government programs exist.”

The study findings, published in the Archives of Internal Medicine, explored nursing home trends and analyzed information drawn from the National Online Survey Certification and Reporting database on closings of Medicare- and Medicaid-certified facilities between 1999 and 2008.

During that time, the research team found that 11 percent of stand-alone nursing homes (1,776) and almost half (1,126) of all hospital-based nursing homes in the country shut their doors. Together, they represented a loss of 16 percent of all Medicare/Medicaid-certified nursing homes and nearly 97,000 — or more than 5 percent — of nursing home beds.

Using U.S. Census data from 2000, the authors further noted that overall closure rates were about twice as high in zip codes that are home to low-income and minority (black/Hispanic) communities than in the richest zip codes.

Nursing homes in zip codes comprised primarily of Hispanic or black residents were 37 and 38 percent more likely, respectively, to close than those in areas with the fewest Hispanics or blacks.

The team concluded that nursing homes in minority and low-income communities are bearing the lion’s share of financial pressures and closures, which raises concerns about rapidly diminishing senior care options and the quality of the remaining facilities in those places.

Experts explain that people in low-income neighborhoods who use nursing homes are generally Medicaid recipients, whose reimbursement rates are lower than the fees of private-pay patients. The result is that those places that care for these patients are more likely to close.

More than 27 million Americans will need long-term care by 2050, nearly twice as many as in 2000. Either the federal government will have to increase the reimbursement rate for nursing home services, or state and federal policies will have to fund less expensive — and perhaps more preferable lifestyle — options, such as assisted living, the study researchers concluded. Otherwise, only the wealthy will have access to nursing homes, the authors said.

Walk To Prevent Diabetes, Study Reports

Walking more lowers your risk of diabetes.

This comes from a just released study by Australian rearchers who studied nearly 600 middle-aged adults. The adults participated in a study to map diabetes levels across Australia between 2000 and 2005.

Diabetes is a major health condition increasingly affecting aging adults according to the American Association for Long-Term Care Insurance (AALTCI). “Diabetes is one of the conditions that can cause many to need long-term care,” states Jesse Slome, AALTCI executive director. “It is also one of the conditions that can make it harder to get this insurance coverage.”
Participants underwent a health examination at the start of the study and provided details about their eating and lifestyle habits. The volunteers were also given a pedometer and instructed how to use it.

Follow-up with the participants five years later showed that a higher daily step count was associated with a lower body-mass index (BMI), lower waist-to-hip ratio and better insulin sensitivity, even after adjusting for factors such as diet, smoking and alcohol intake.

They calculated that a sedentary person who changed his or her behavior and started walking 10,000 steps every day would achieve a threefold improvement in insulin sensitivity, compared with a similar person who walked 3,000 steps a day, five days a week.

The 10,000 steps per day is a popular guideline, but a more recent recommendation is 3,000 steps per day, five days a week.

The findings confirm an independent beneficial role of higher daily step count on body-mass index, waist-to-hip ratio and insulin sensitivity, provide further support to promote higher physical activity levels among middle-aged adults. The study appears in the online edition of the British Medical Journal.

Parent Longevity Matters Less

How long your parents lived does not affect how long you will live.

According to researchers, what matters it is how you live your life. That determines how old you will get.

According to research from the University of Gothenburg, Sweden, published in the Journal of Internal Medicine, shows that hereditary factors don’t play a major role and that lifestyle has the biggest impact.”

The study group consisted of men born in 1913 that have participated in health and longevity studies in Gothenburg for many years.

Those in the 1913 Men Study who did not smoke, consumed moderate amounts of coffee and had a good socio-economic status at the age of 50 (measured in terms of housing costs), as well as good physical working capacity at the age of 54 and low cholesterol at 50 had the greatest chance of celebrating their 90th birthday.

Many of these factors have previously been identified as playing a role in cardiovascular disease, but the study shows for the first time that they are important for survival in general.

This has enabled researchers to follow the development of illnesses in a specific age group, and to compare the health of 50-year-olds in 2003 with that of 50-year-olds in 1963, for example.

Women have also been included in the study since 2003. Several variables have been studied over the years, including BMI, smoking habits, cholesterol, exercise habits and blood pressure.

The men born in 1913 were examined when they were 50, 54, 60, 67, 75 and 80. Of the 855 men who took part in the study from the start, 111 (13%) were still alive at the age of 90.

Over the years the material has generated many research articles and doctoral theses. An interesting result came in 2008 when researchers were able to show that the drop in the number of smokers, combined with lower cholesterol levels and lower blood pressure, between 1963 and 2003 could offer an explanation for the marked downturn in the number of heart attacks during this 40-year period.

2011 Long-Term Care Insurance Price Index

A 55-year-old couple purchasing long-term care insurance protection can expect to pay $2,350-per-year (combined) for about $338,000 of current benefits ($169,000 each) which will grow to about $800,000 of combined coverage for the couple when they turn age 80.

The data comes from the 2011 Long-Term Care Insurance Price Index published by the American Association for Long-Term Care Insurance http://www.aaltci.org that analyzed rates for 11 long-term care insurance policies. According to the Association report, a 55-year old single individual pays $1,480 annually for comparable coverage. If the 55-year-old couple did not qualify for preferred health discounts, their cost would increase by $325 annually.

“We significantly expanded this year’s survey to include more relevant scenarios for both couples and individuals at varying ages, health conditions and to take into account the significant spread in costs among insurers for virtually identical coverage,” explains Jesse Slome, executive director of the long-term care insurance industry trade organization. The study found that rates for comparable coverage from leading insurers could vary by between 41-to-48 percent.

According to Association research, three-fourths (78%) of long-term care insurance policies are purchased by couples where either both or just one spouse purchases coverage. The average age for individual purchasers is 57, Slome explains with some 76.3 percent of purchases made between ages 45 and 64 according to the Association’s research. The 2011 Price Index analyzed costs for couples at ages 55, 60 and 65.

The study reported rates for individuals who qualify for good-health discounts as well as those who qualify for standard rates as a result of having one or more health issues. In addition, for the first time, the analysis included a three percent compound inflation growth factor versus the five percent formula that has been used in prior studies. “More purchasers are opting for this formula which significantly reduces the cost of coverage and can be quite adequate in terms of future benefits,” Slome explains. The Price Index also looked at rates for policies including the newer Shared Care option whereby two policyholders can each access a combined pool of benefits.

“The shared care option is now highly attractive to couples,” states Larry Moore, Director of Marketing for American Independent Marketing, a leading national marketer. “The ability to purchase a more affordable shorter duration policy but have access to a much larger combined pool of dollars is easy to explain and of great value to the buyer.”

Including the ‘Shared Care’ option, a 65 year old couple with average (standard) health can expect to pay $4,660-per-year (combined) for about $338,000 of current combined benefits which will grow to about $527,000 of coverage at age 80. “To best educate consumers, the Price Index reports average rates individuals can obtain from leading insurers,” Slome explains. “However, for this same level of protection, a 65-year old couple could pay as much as $7,200 a year.”

The complete Price Index will be published in the Association’s 2011 Long-Term Care Insurance. For more information, visit the American Association for Long-Term Care Insurance’s website by clicking here.

Parent Longevity Matters Less

How long your parents lived does not affect how long you will live.

According to researchers, what matters it is how you live your life. That determines how old you will get.

According to research from the University of Gothenburg, Sweden, published in the Journal of Internal Medicine, shows that hereditary factors don’t play a major role and that lifestyle has the biggest impact.”

The study group consisted of men born in 1913 that have participated in health and longevity studies in Gothenburg for many years.

Those in the 1913 Men Study who did not smoke, consumed moderate amounts of coffee and had a good socio-economic status at the age of 50 (measured in terms of housing costs), as well as good physical working capacity at the age of 54 and low cholesterol at 50 had the greatest chance of celebrating their 90th birthday.

Many of these factors have previously been identified as playing a role in cardiovascular disease, but the study shows for the first time that they are important for survival in general.

This has enabled researchers to follow the development of illnesses in a specific age group, and to compare the health of 50-year-olds in 2003 with that of 50-year-olds in 1963, for example.

Women have also been included in the study since 2003. Several variables have been studied over the years, including BMI, smoking habits, cholesterol, exercise habits and blood pressure.

The men born in 1913 were examined when they were 50, 54, 60, 67, 75 and 80. Of the 855 men who took part in the study from the start, 111 (13%) were still alive at the age of 90.

Over the years the material has generated many research articles and doctoral theses. An interesting result came in 2008 when researchers were able to show that the drop in the number of smokers, combined with lower cholesterol levels and lower blood pressure, between 1963 and 2003 could offer an explanation for the marked downturn in the number of heart attacks during this 40-year period.

Americans With Diabetes Now Nearly 26MM

Nearly 26 million Americans have diabetes, according to new estimates from the Centers for Disease Control and Prevention (CDC).

Half of Americans aged 65 and older have prediabetes, and nearly 27 percent have diabetes. Diabetes is the seventh leading cause of death in the United States. Diabetes costs $174 billion annually, including $116 billion in direct medical expenses.

In addition, an estimated 79 million U.S. adults have prediabetes, a condition in which blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. Prediabetes raises a person’s risk of type 2 diabetes, heart disease and stroke explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance .

Diabetes affects 8.3 percent of Americans of all ages, and 11.3 percent of adults aged 20 and older, according to the National Diabetes Fact Sheet for 2011. About 27 percent of those with diabetes—7 million Americans—do not know they have the disease.

Prediabetes affects 35 percent of adults aged 20 and older. In 2008, CDC estimated that 23.6 million Americans, or 7.8 percent of the population, had diabetes and another 57 million adults had prediabetes. The 2011 estimates have increased for several reasons:

More people are developing diabetes. Many people are living longer with diabetes, which raises the total number of those with the disease. Better management of the disease is improving cardiovascular disease risk factors and reducing complications such as kidney failure and amputations.

Hemoglobin A1c is now used as a diagnostic test, and was therefore incorporated into calculations of national prevalence for the first time. The test, also called glycated hemoglobin, measures levels of blood glucose (sugar) over a period of two to three months. Because of this change, estimates of populations with diabetes and prediabetes in the 2011 fact sheet are not directly comparable to estimates in previous fact sheets.

In a study published last year, CDC projected that as many as 1 in 3 U.S. adults could have diabetes by 2050 if current trends continue. Type 2 diabetes, in which the body gradually loses its ability to use and produce insulin, accounts for 90 percent to 95 percent of diabetes cases. Risk factors for type 2 diabetes include older age, obesity, family history, having diabetes while pregnant (gestational diabetes), a sedentary lifestyle, and race/ethnicity. Groups at higher risk for the disease are African-Americans, Hispanics, American Indians/Alaska Natives, and some Asian-Americans and Pacific Islanders.

Half of Americans aged 65 and older have prediabetes, and nearly 27 percent have diabetes. Diabetes is the seventh leading cause of death in the United States. Diabetes costs $174 billion annually, including $116 billion in direct medical expenses.

Federal Long-Term Care Insurance Program Re-Opens

January 29, 2011 Beginning this Spring, federal employees, retirees and their relatives, including same-sex domestic partners, will be able to apply for the government’s long-term care insurance option.

According to a Federal Register notice issued on Friday, the Office of Personnel Management (OPM) announced that open season for the Federal Long-Term Care Insurance Program will run from April 4 through May 27.

Active federal employees, their spouses and same-sex domestic partners who currently are not enrolled can apply under abbreviated underwriting rules and will have to provide only limited health information. Retirees and other qualified relatives will undergo a longer review of medical and health history in the application process.

“The federal long-term care insurance plan is excellent coverage and several hundred thousand individuals participate in the program,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The program does not offer certain discounts available from individual policies sold by insurance agents. “If you are married and in good health, you may be able to get more coverage for less cost,” Slome notes.

Same-sex domestic partners of federal workers for the first time will be able to enroll in the program, which helps pay for the cost of care when participants need help with daily activities, or have a severe cognitive illness such as Alzheimer’s disease.

OPM in June 2010 issued a final regulation broadening the definition of relatives qualified to participate in the long-term care insurance program to include the same-sex domestic partners of federal employees, U.S. Postal Service workers and retirees. Prior to the new rule, which took effect on July 1, 2010, only spouses, parents and adult children were eligible for coverage.

The expansion of coverage follows a June 2009 presidential memorandum asking that government do as much as it can legally to put same-sex domestic partners on equal footing with heterosexual married couples.

Coverage will begin on the first day of the month after an application is approved, and premiums will be based on the enrollee’s age and option selected, according to the notice.

Tests May Predict Alzheimer’s Disease

A scanning test that aims to reveal the presence of Alzheimer’s disease may allow doctors to try to treat the illness in its early stages.

According to researchers, another study found that blood tests could indicate higher risks of dementia later in life.

Alzheimer’s disease is not curable and existing treatments only have limited effects notes Jesse Slome, director of the American Association for Long-Term Care Insurance. Alzheimer’s is the leading cause of costly long-term care need among seniors.

The ability to precisely diagnose Alzheimer’s disease during life, which is now impossible, could lead to improved research.

The findings from the study were published Jan. 19 in the Journal of the American Medical Association. Currently, doctors correctly diagnose Alzheimer’s disease about 85 percent of the time. The illness can be confirmed only through brain analysis after death.

In one of the new studies, researchers led by a team from Avid Radiopharmaceuticals reported that they were able to find signs of Alzheimer’s disease by using PET scanning technology. They had scanned 35 people who appeared to have the disease before their deaths and looked for signs of beta amyloid, a kind of gunk that clogs the brain in people with the illness.

The other study attempted to measure levels of beta amyloid in the blood. It linked lower levels — a sign that the gunk is getting tied up in the brain — to higher cognitive problems in 997 elderly people over a nine-year period.

The researchers also found that people with higher levels of “cognitive reserve” — such as those with higher levels of education and literacy — seemed to be buffered against dementia, said the study’s lead author at the University of California, San Francisco.

Cancer Costs Will Soar

A new report predicts that by 2020, the annual cost of cancer care in the United States is expected to reach at least $158 billion.

According to the report from the U.S. National Cancer Institute that’s a 27 percent jump from 2010. The surge in cost will be largely driven by an aging population that is expected to develop more cases of cancer in the near-term.

Projected costs could go even higher if the price tag for care rises faster than expected. Experts described the 2020 cost estimate as “on the low side” according to the American Association for Long-Term Care Insurance which tracks medical and health issues impacting aging Americans.

Cancer is a disease of aging and the population of elderly Americans is expected to rise from 40 million in 2009 to 70 million by 2030 notes Jesse Slome, executive director for the trade group. Improvements in screening mean cancer is becoming more identifiable and treatable, but therapies are becoming increasingly expensive.

If the trend in survival and costs continue as they have been, then the estimates could be as high as $207 billion by 2020 one reseracher predicted. The report is published online Jan. 12 and in the Jan. 19 print issue of the Journal of the National Cancer Institute.

To estimate the cost of cancer treatment, the research team looked at data on 13 cancers in men and 16 in women. Tracking the rate of these cancers and the current costs to treat them in 2010, they were able to project costs in 2020.

In these calculations researchers assumed that costs would rise by only 2 percent a year. The largest increases in cost over the period will be for breast cancer at 32 percent and prostate cancer at 42 percent, simply because more people will be living longer with these diseases, the researchers noted.

For example, while the cost of treating breast cancer remains relatively low (compared to other tumor types), by 2020 this cancer will incur the highest costs — about $20.5 billion — since there are expected to be many more women living with the disease.

Commenting on the study, Elizabeth Ward, at the American Cancer Society, said that “a big component of the rise in cost is just the growth and aging of the population. We are just going to have more people developing cancer and under treatment for cancer,” she said.

Small Business Owners Unaware of Long-Term Care Tax Deductions

The majority of small and mid-sized business owners are not familiar with the tax deductible benefits available when offering long-term care insurance plan to employees. According to one insurance company executive, tax-deductible long-term care insurance remains the best-kept secret and employers are missing out on billions of dollars of potential tax savings.

Federal and a growing number of states now offer tax deductions and tax credits for the purchase of long-term care insurance. The cost of coverage may be fully tax deductible to the business and a great deal of flexibility can be offered when initiating a plan. In addition, corporate pricing breaks of 5 percent to 10 percent, in addition to substantial spousal or couples discounts, are the norm.

According to the 2009 edition of A Business Owner’s Guide To Long-Term Care Insurance, any form of business ownership can enjoy deductions for a long-term care insurance premium. Benefits received are, as a rule, always tax-free. Premiums might be considered imputed income to an employee depending on how the company is held.

Insurers offer various forms of long-term care insurance plans designed specifically to meet the needs of either small or large employers. Policies can be personally owned but company-paid, thus staying with the insured after he or she leaves a company or retires.

Long-term care insurance offers great design flexibility for employers. For example, employers can pick and choose who participates in a plan. Properly done, there are no ERISA issues, unlike group health insurance, according to tax experts. These plans are often called “carve-outs” which allow employers to be “selective” when determining who would be covered under a long-term care insurance benefit.

Policy design provisions enable employers to pay premiums for fixed periods of time, at which point the policy is paid up for life. One of the significant benefits is that policy benefit amounts keep increasing under inflation protection options with no risk of future long-term care insurance rate hikes.

According to American Association for Long Term Care Insurance experts, policies available to employers may allow two spouses to share one benefit pool. This has the potential to double the benefit any single insured might have and eliminates much of the problem as it pertains to the benefit period chosen. At the death of one spouse, the other typically inherits the other remaining benefits free of charge.

New Study Ties Diet To Longer Life

According to medical researchers, today’s leading causes of death have shifted from infectious diseases to chronic diseases. These include cardiovascular disease and cancer.

Both of these illnesses may be affected by diet a study published in the January 2011issue of the Journal of the American Dietetic Association reveals.

Researchers examined data regarding the associations of dietary patterns with mortality through analysis of the eating patterns of over 2500 adults between the ages of 70 and 79 over a ten-year period. They found that diets favoring certain foods were associated with reduced mortality.

By 2030, an estimated 973 million adults will be aged 65 or older worldwide according to the American Association for Long-Term Care Insurance. This study sought to determine the dietary patterns of a large and diverse group of older adults, and to explore connections between these dietary patterns with survival over a 10-year period.

Researchers were able to group the participants into six different clusters according to predominant food choices including healthy foods, high-fat dairy products, meat, fried foods, and alcohol and sweets and desserts.

The “Healthy foods” cluster was characterized by relatively higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables, and lower consumption of meat, fried foods, sweets, high-calorie drinks, and added fat. The “High fat dairy products” cluster had higher intake of foods such as ice cream, cheese, and 2% and whole milk and yogurt, and lower intake of poultry, low-fat dairy products, rice, and pasta.

The study was unique in that it evaluated participants’ quality of life and nutritional status, through detailed biochemical measures, according to their dietary patterns.

After controlling for gender, age, race, clinical site, education, physical activity, smoking, and total calorie intake, the “High-fat dairy products” cluster had a 40% higher risk of mortality than the “Healthy foods” cluster. The “Sweets and desserts” cluster had a 37% higher risk. No significant differences in risk of mortality were seen between the “Healthy foods” cluster and the “Breakfast cereal” or “Refined grains” clusters.