Daily Rounds: Ryan's Burdensome Plan; False Alzheimer's; Fit Middle-Agers; Aspirin For Cancer

Romney-Ryan Medicaid Plan Woud Burden Massachusetts (The Boston Globe) — "The Ryan plan, which has been endorsed by Romney, would cut federal Medicaid funding over the next decade by a third, according to the nonpartisan Urban Institute. Massachusetts would see its share drop from roughly $109 billion to $78 billion, in today’s dollars. That shift that would strain Massachusetts more than other states because seniors and disabled individuals are an outsized proportion of the Commonwealth’s Medicaid rolls — 44 percent, compared with just 35 percent nationwide. Most Medicaid spending goes toward those two demographics, a fact that Ryan doesn’t account for. He would tie the amount of state aid to overall population changes and inflation alone. The result for Massachusetts would be fewer funds for the most costly Medicaid enrollees. The other major concern for Massachusetts stems from Ryan’s plan to give state officials much more leeway in running the program. Current Medicaid law gives states incentives to provide a minimum level of health coverage to beneficiaries. Ryan’s block grants would remove many of those strings, but that would give cash-strapped states the options of reducing eligibility or covering fewer services. Massachusetts, as a liberal state with a proud tradition of health care innovation, would probably look for ways to fill in the gaps — and thereby attract poor people from less-affluent or less-generous states."

The False Alzheimer's Diagnosis (The Wall Street Journal) — "More than 100 other conditions, from vitamin and hormone deficiencies to rare brain disorders, can mimic Alzheimer's disease, experts say. Some are readily treatable. Alzheimer's symptoms such as confusion, memory loss and personality changes also can be side effects from medication—even commonly used drugs. For example, the entire class of anticholinergic drugs, which includes many antihistamines, antianxiety drugs, muscle relaxants and sleeping pills, block the brain chemical acetylcholine, which sends signals in the nervous system. It is the same chemical that many Alzheimer's medications boost. Cholesterol-reducing statins have also been linked to brain fog in some people. In many cases, the cognitive symptoms vanish when medication is stopped. "I have had people referred to me with a clear history of dementia and when I started to peel back the medications, they were much better," says Gary Kennedy, chief of geriatric psychiatry at Montefiore Medical Center in the Bronx, N.Y."

Less Chronic Disease In Store For Fit 50-Year-Olds (Reuters) — "Fit 50-year-olds are less likely to get chronic diseases as they age than are couch potatoes, according to a new U.S. study. It may seem like a no-brainer, but the study helps fine-tune our understanding of the link between fitness and healthy aging, researchers say. "It has been known for decades that if you are more fit, you live longer," Dr. Jarett Berry at the University of Texas Southwestern Medical Center, Dallas, told Reuters Health. "But it has not been clear that you have a higher quality of life, that you age better." It's possible that fit people just delay the onset of chronic illness, for instance, and end up being sick just as long as their weaker peers. But that doesn't appear to be the case, according to the new research, published in the Archives of Internal Medicine. "We see truly reduced chronic disease, rather than just delaying the inevitable," said Berry, who led the work."

Aspirin May Aid Cancer Recovery (The New York Times) — "Men treated for prostate cancer who took aspirin regularly for other medical conditions were less likely to die of their cancer than patients who weren’t taking aspirin, according to a new study published on Tuesday in The Journal of Clinical Oncology. The new report is not a randomized controlled clinical trial of the kind considered the gold standard in medicine, but it adds to an intriguing and growing body of evidence suggesting that aspirin may play a beneficial role in the treatment and possibly the prevention of a variety of cancers. Much of the earlier research on aspirin focused on colon cancer. “This is another piece of evidence suggesting aspirin does seem to have this effect against cancer across different body sites,” said Dr. Andrew T. Chan, an associate professor of medicine at Harvard Medical School, who studies the role of aspirin in preventing colorectal cancer but was not involved the new research."