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Baltimore Sun Examines Debate Over Howard County, Md., Health Program
About 200 uninsured people have enrolled in the Howard County, Md., Healthy Howard program since it began on Oct. 1, 2008, county health officer Peter Beilenson told a county council budget panel, the Baltimore Sun reports. Healthy Howard is a network of local doctors who charge members between $50 and $115 monthly for comprehensive medical coverage. The program uses health coaches to improve residents" overall health and seeks to lower costs related to emergency care over time. Beilenson had set a goal of enrolling 2,000 people in the program"s first year. According to Beilenson, "The biggest problem with all this is me. I made the definition of success this arbitrary 2,000 number." His new prediction is for 908 enrollees by July 2010. He said, "I think it"s very clear people just don"t know about it." He added that some residents are hesitant to pay even a small monthly charge during the continuing recession. County council member Greg Fox questioned if the enrollment level justifies a second county outlay of $500,000 for the program in fiscal year 2010, adding that he supports cutting county funding in half for the program in that year. Supporters of the program, however, say it needs more time and money in order to succeed, noting that enrollees have been seeing doctors through the program only since January. Commonwealth Fund President Karen Davis said the program "seems like it"s off to a great start" compared with similar local programs nationwide. She added that the program has helped 2,500 county residents, including children, find coverage through state and federal insurance programs, in part thanks to an electronic enrollment system that identifies programs they are eligible for. Howard Health Department Director of Policy and Planning Glenn Schneider said, "None of those applications would have happened without announcing the (Healthy Howard) program" (Carson, Baltimore Sun, 5/18).
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Huntington's: Researchers Gain Insight Into Mechanism Underlying The Disease
Researchers at the University of Kentucky Markey Cancer Center and Graduate Center for Toxicology (GCT) have gained new insight into the genetic mechanisms underlying Huntington"s disease and other neurodegenerative or neuromuscular disorders caused by trinucleotide repeats (or TNRs) in DNA.
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Expert Available To Discuss Alternative Cold Remedies, FDA Advice On Zicam
Consumers of over-the-counter homeopathic and "natural" cold remedies should carefully research such treatment options and properly follow dosage instructions, urges a UMDNJ physician who specializes in integrative medicine.
Oncology

Cognitive Impairment Associated With Reduced Survival Among Both African-American And White Older Adults

Alzheimer"s disease and its precursor, mild cognitive impairment, appear to be associated with an increased risk of death among both white and African American older adults, according to a report in the June issue of Archives of Neurology, one of the JAMA/Archives journals. Alzheimer"s disease reduces life expectancy and has emerged as a leading cause of death in the United States, according to background information in the article. "Data from two national surveys suggest that life expectancy among patients with Alzheimer"s disease may be greater for African Americans than for whites," the authors write. "However, not all surveys have reported this difference. Furthermore, in these surveys, the diagnosis of Alzheimer"s disease is not based on a uniform clinical evaluation but derived from medical records, increasing the likelihood of substantial variation in the quality of diagnostic classifications." Robert S. Wilson, Ph.D., and colleagues at Rush University Medical Center, Chicago, studied 1,715 older adults (average age 80.1, 52.5 percent African American) from four adjacent neighborhoods in Chicago. Each participant had a clinical evaluation that included medical history, a neurological examination and cognitive (thinking, learning and memory) function testing. Based on these evaluations, an experienced physician diagnosed 296 (17.3 percent) of the participants with Alzheimer"s disease, 597 (34.8 percent) with mild cognitive impairment and 20 (1.2 percent) with other forms of dementia, while 802 (46.8 percent) had no cognitive impairment. During up to 10 years of follow-up (average observation period, 4.7 years) 634 individuals died (37 percent), including 25.8 percent of those without cognitive impairment, 40.4 percent of those with mild cognitive impairment, 59.1 percent of those with Alzheimer"s disease and 60 percent of those with other forms of dementia. "Compared with people without cognitive impairment, risk of death was increased by about 50 percent among those with mild cognitive impairment and was nearly three-fold greater among those with Alzheimer"s disease," the authors write. "These effects were seen among African Americans and whites and did not differ by race." Among individuals with mild cognitive impairment, risk of death increased as cognitive impairment became more severe, another association that did not differ by race. A similar association between disease severity and survival was seen among patients with Alzheimer"s disease, although that effect was slightly stronger for African Americans than for whites. "Overall, these results do not suggest strong racial differences in survival for persons with mild cognitive impairment and Alzheimer"s disease," the authors conclude. Arch Neurol. 2009;66[6]:767-772. Archives of Neurology


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