Annual Aging Retreat Offers Insight into Economics of Health Costs for Aging Population

Each spring, the Penn Institute on Aging (IOA) hosts an afternoon retreat, pausing to try to pin down a lofty age-related topic. In years past, topics have ranged from vision and bone health to metabolic disorders and healthy brain aging.

This year, the Penn Institute on Aging partnered with the Penn-CMU Roybal P30 Center on Behavioral Economics and Health to present the 2012 retreat, with a focus on “Behavioral Economics and Health for an Aging Population.”

Troyen A. Brennan, MD, MPH, Executive Vice President and Chief Medical Officer, CVS Caremark, gave the keynote lecture, highlighting the challenges in medication costs and compliance and the benefits of preventative measures to improve the health of the workforce.

Excerpts from Dr. Brennan’s presentation, as well as the panel discussion that followed, are included below:

The Sylvan M. Cohen Annual Retreat with Poster Session on Aging was named in memory of the founding Chair of the Institute on Aging and his unparalleled commitment to older persons and the IOA. The Cohen family and contributors generously support the program in his memory.

Alma Cohen enjoyed the 2012 retreat in memory of her late husband, and is pictured here with Penn Medicine CEO Ralph Muller, Roybal Center director Kevin Volpp, MD, PhD, and Institute on Aging director John Trojanowski, MD, PhD.


Time is Precious in Brain Diseases 

EAan-logovery moment counts for brain diseases. The saying among medical experts is that “time is brain.” The earlier you receive treatment, the better. This week, a diverse team of researchers from the Perelman School of Medicine at the University of Pennsylvania is in New Orleans at the American Academy of Neurology’s 64th Annual Meeting, sharing the latest data aimed at enhancing the speed of diagnosis and treatment, and ultimately helping people with neurologic conditions.

Michael Mullen, MD, a fellow in Neurology and Vascular Medicine, started the day with a presentation showing that the emergence of primary stroke centers certified by The Joint Commission has steadily improved the treatment of stroke patients. Previous studies, from collaborations between Penn’s Departments of Emergency Medicine and Neurology, have shown that nearly half of Americans live more than an hour away from primary stroke centers and do not have ready access to the specialized stroke care they need when blood supply to their brain has been cut off. The data presented provides evidence supporting the efficacy and importance of primary stroke centers. Continue reading

Investigating Subset of People Resistant to Alzheimer’s Plaques and Tangles

People can have a brain full of Alzheimer’s disease, but not have the dementia that typically goes along with it. By the numbers, this subset of people can have many plaques and tangles in the brain, enough to qualify them for a diagnosis of Alzheimer’s disease, but in reality, they don’t have the memory loss or other clinical symptoms of Alzheimer’s.

In most cases, people have more and more symptoms of dementia as the plaque and tangle  Alzheimer’s disease lesions accumulate in the brain.  And, most people who have normal memory and thinking are found to have very few plaques or tangles.

Yet, there’s this outlier group, who should, by most definitions, have dementia due to Alzheimer’s disease, but they are resistant.

In a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania with colleagues from Rush University, published online in Neurobiology of Aging, the team investigated why these people are resilient to Alzheimer’s and found several biological factors that help distinguish the resilient group from those with dementia. They discovered that synapses are preserved in resilient cases and found an increase in the number of brain cells called astrocytes, that may provide a protective response to the “toxic” effects of plaques and tangles.

The team also identified new biochemical targets that may be associated with resilient cognitive brain aging in the subset of people who have Alzheimer’s pathology, which they’ll investigate further, thanks to a new grant from the National Institute on Aging.

In a disease with no known treatments or cures, this will be one more angle researchers will pursue, to thwart the diseases’ advances. While research continues to progress in understanding how plaques and tangles develop and cause damage in the brain, it is also important to understand how the brain can fight this damage and preserve cognition. Arnold SE, Louneva N, Cao K, Wang LS, Han LY, Wolk DA, Negash S, Leurgans SE, Schneider JA, Buchman AS, Wilson RS, & Bennett DA (2012). Cellular, synaptic, and biochemical features of resilient cognition in Alzheimer’s disease. Neurobiology of Aging PMID: 22554416