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Submit your session and case presentation abstracts
for AAGP's 2014 Annual Meeting
Submissions due June 11

AAGP is accepting proposals for sessions, case presentations, and posters for the 2014 Annual Meeting to be held March 14-17 in Orlando, Fla., at the Renaissance Orlando at SeaWorld®. Submit your innovative and interactive programs targeted towards clinicians, researchers, and educators. Clinicians and investigators in all arenas of geriatric psychiatry, psychology, neurology, medicine, nursing, social work, and other related disciplines are encouraged to submit abstracts of original work for presentation at the AAGP 2014 Annual Meeting. Session proposals are due June 11. Submit online at
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AAGP participates in APA's meeting of the Coalition on Mental Health and Violence Issues
On April 29, AAGP participated in the first meeting of the Coalition on Mental Health and Violence Issues, which was held by the American Psychiatric Association. AAGP Immediate Past President Paul D.S. Kirwin, MD, and Chris deVries, AAGP CEO/executive vice-president, along with representatives of other psychiatry organizations, and the American Medical Association, discussed ways to promote better public awareness of the complex sources of violence in the United States and strategies for improving mental health care. The group, convened by APA President Dilip Jeste, MD, emphasized that only three to five percent of all violent crimes are directly related to mental illness, and that people with mental illnesses are much more frequently victims rather than perpetrators of violence. The coalition acknowledges that there is a small minority of individuals who are at high risk of committing violence against themselves and others, and special measures are needed to identify these individuals and implement effective preventive and therapeutic strategies.

In addition to APA, AAGP, and the AMA, coalition participants included the American Academy of Child and Adolescent Psychiatry, American Academy of Psychiatry and the Law, American Academy of Addiction Psychiatry, American Association of Community Psychiatrists, Academy of Psychosomatic Medicine, and American Association for Emergency Psychiatry. The group agreed that the problem of violence is complex in American society, but that steps can be taken to lessen its occurrence. Those steps entail the cooperation of mental health organizations, federal, state and local government agencies, the legislative and judicial branches of government, and the public at large to identify potentially dangerous individuals and intervene before major violent acts have been committed.

The coalition plans to continue its work to meet both short- and long-term goals, including:
  • Identifying and promoting legislation that could lessen the risk of violence by promoting early identification and treatment of those at risk
  • Identifying role models in other countries that have successfully reduced the incidence of violence
  • Establishing guidelines for psychiatrists and other mental health professionals to deal with the possession of firearms by patients
  • Establishing policies to keep weapons out of the hands of individuals with dementia and individuals who are at higher risk of suicide
  • Compiling a list of potential sources to fund research on violence
  • Conducting a public awareness campaign to educate the public about the role of mental illness in violence, including the risks of suicide
  • Studying the issue of patient confidentiality, and when mental health professionals should notify law enforcement that an individual is a potential danger to himself or others
  • Creating a webinar to help psychiatrists identify potentially violent patients
  • Recommending a Mental Health Commission to advise the White House on ways to ameliorate violence
  • Examining the long-term effects of trauma in individuals who have been the victims of violence
For more information, access a PDF of the APA news release.

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Eldercare Workforce Alliance urges CMS to guide states in caring for older Duel Eligibles
AAGP, as part of the Eldercare Workforce Alliance, is urging the Centers for Medicare and Medicaid Services to include in their guidance and oversight to states participating in the State Demonstrations to Integrate Care for Dual Eligible Individuals and The Financial Alignment Initiative education and training guidance for states on how they can ensure that all providers caring for older adults have the knowledge and skills needed to meet the unique needs of this population, which makes up two‐thirds of dual eligible individuals. One of the suggestions to CMS is to use monthly conference calls with states and the interim and final progress reports submitted by states as an opportunity to encourage them to consider what actions they have taken and will take to ensure that all participating providers know how to meet the unique needs of dually‐eligible participants over 65 years of age. EWA suggested that CMS ask states to provide a description of their efforts at these regular intervals. AAGP will continue to strongly advocate for legislative and regulatory provisions to strengthen the workforce for older adults with mental illness.
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Missed the last issue? See which articles your colleagues read most.

    The Long Goodbye: An interview with author Patti Davis (By Marc E. Agronin, MD)
Mayo study: No link between anesthesia and dementia (WCCO)
No increased risk for death with antipsychotics in Alzheimer's? (Medscape)
Depression linked to later vascular dementia, Alzheimer's (

Don't be left behind. Click here to see what else you missed.

Foundation challenges researchers to identify gender differences in early cognitive decline
The Geoffrey Beene Foundation Alzheimer's Initiative launched the 2013 Geoffrey Beene Global NeuroDiscovery Challenge at the Society for Women's Health Research Gala in Washington, D.C. It is the Foundation's second innovation challenge but the first to ask solvers to identify male/female differences in early cognitive decline, to promote earlier interventions for both women and men. Winning submissions will share $100,000 in prize awards. The challenge is being launched in support of WomenAgainstAlzheimer's, a new network of prominent women leaders nationwide working to speed up the pace of Alzheimer's research. WomenAgainstAlzheimer's (WA2) officially was formed in April with the goal of harnessing the power and creative energy of women to foster new urgency for finding a cure and building a movement that commits our nation to an aggressive plan for prevention and treatment of Alzheimer's disease. WA2's research agenda focuses on sex-based differences. "Women are two-times at risk for Alzheimer's because we outlive men, but we know little about other possible male/female differences. It's time to find out if what's true in cardiovascular disease with different diagnostics and treatment of men and women is also true for Alzheimer's disease," said Meryl Comer, president and CEO of the Geoffrey Beene Foundation Alzheimer's Initiative, and a founder of WomenAgainstAlzheimer's. Proposals will be accepted through Aug. 31. For more information, click here.

Learn about WomenAgainstAlzheimer's here.

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    Alzheimer's Disease News

    AAGP comments to FDA
    As a member of the LEAD coalition, AAGP submitted formal comments to the U.S. Food and Drug Administration in support of the adoption of its draft guidance on drug efficacy. The draft guidance outlines the FDA's current thinking on how a drug developer may demonstrate efficacy in clinical trials in individuals in the early stages of Alzheimer's disease before the onset of overt dementia.
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    2 new AD reports
    Two separate reports were released recently by the Alzheimer's Association and the RAND Corporation on the prevalence and cost of Alzheimer's disease. While the two organizations use separate methodologies and reach somewhat different statistical conclusions, both support the conclusion that Alzheimer's disease presents a vast threat to America's public health and economic prosperity.
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    New legislation
    Bipartisan legislation, entitled the Health Outcomes, Planning and Education for Alzheimer's Act, was reintroduced in both the House of Representatives and the Senate in April. The House bill, H.R. 1507, was introduced by Reps. Edward Markey, D-Mass., and Chris Smith, R-N.J., and 37 cosponsors and has been referred jointly the House Energy and Commerce and Ways and Means Committees. The Senate bill, S. 709, was introduced by Reps. Debbie Stabenow, D-Mich., and Susan Collins, R-Maine, and nine cosponsors and has been referred to the Senate Finance Committee. The Hope for Alzheimer's Act is designed to help combat Alzheimer's disease and support those suffering or caring for a family member with this illness. The bill is designed to help physicians detect Alzheimer's disease and other dementias in their patients earlier, and provide information for newly diagnosed patients and their families about treatment options and support programs available to them. The legislation does this by enhancing Medicare by providing a package of services specifically for the diagnosis and treatment of Alzheimer's disease that includes comprehensive diagnostic evaluation and care planning services to help patients manage any other chronic conditions.

    AAGP believes that all Americans seeking treatment for mental disorders need and deserve access to the full-range of services and health care providers. AAGP has been a long-time supporter of the Hope for Alzheimer's Act and will continue to work closely with the bills' sponsors to advance it at the earliest possible date.

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    Department of Veterans Affairs

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    Medicare's sustainable growth rate: Reform efforts accelerate
    Congress has redoubled its focus on Medicare's flawed physician payment formula this month as both House and Senate committees took up the issue. Repealing and replacing Medicare's sustainable growth formula, which mandates reimbursement cuts that have piled up for years as lawmakers have struggled to find a long-term solution. Those cuts create the need for the so-called annual "doc fix". Members of Congress have long sought to fix Medicare's payment system, but enthusiasm for the task rose this year after the Congressional Budget Office cut the estimated cost for reforming it.

    Most stakeholders agree that the current formula is broken because it calls for ever-increasing cuts in doctors' payment, and there is significant interest in moving to a system that won't pay physicians based on each service that they provide. Medicare's current formula calls for deep cuts to physician payments. Congress routinely delays the cuts, causing them to grow. The cut has snowballed so far that if it were allowed to take effect, physicians would see their Medicare payments reduced by almost 30 percent. However, the details of a new system — and how to pay for repealing the existing one — still need a lot of work.

    On May 7, the Subcommittee on Health of the House Ways and Means Committee held a hearing to field input on SGR repeal from surgeons, cardiologists, and policy experts. Both the Ways and Means Committee and the House Energy and Commerce Committee have called SGR repeal a major priority for the current legislative session. On the day of the hearing, Rep. Kevin Brady, R-Texas, chairman of the Health Subcommittee, said that lawmakers are genuinely working toward a bipartisan agreement this year. Recent talks have focused on what should replace the current formula, and how to move Medicare away from paying physicians based on the number of services that they provide. Since the Congressional Budget Office recently slashed the cost of permanent repeal of the SGR formula by more than $100 billion, enthusiasm for a permanent fix has increased, although finding a way to pay for it still remains difficult.

    The Senate Finance Committee held a hearing on this issue on May 14. That hearing focused on short-term improvements to the Medicare payment system that will ease the program's transition out of fee-for-service and into performance-based reimbursements. Mark Miller, the executive director of the Medicare Payment Advisory Commission, testified.

    AAGP remains committed to continuing to work with other medical organizations and consumer organizations to reform the Medicare payment system on a permanent basis. In addition, AAGP is providing feedback on this issue to key members of Congress. There needs to be a permanent solution to this problem in order to preserve Medicare's beneficiaries' access to care and provide for fair reimbursement for all practitioners under the Medicare system.

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    Senate confirms Tavenner as CMS administrator
    On May 7, Senator Tom Harkin, D-Iowa, chairman of the Senate Committee on Health, Education, Labor and Pensions, lifted his hold on the nomination of Marilyn Tavenner to lead the Centers for Medicare and Medicaid Services, putting her back on track for Senate confirmation. The nomination had easily moved through the Senate Finance Committee by a voice vote and seemed likely to win bipartisan support in the full Senate until Harkin announced his hold. He was upset about cuts the Obama administration has made to the health care law's prevention and public health fund. The White House agreed to cut $5 billion from the prevention fund last year, but has since repurposed the rest of the fund to help implement other parts of the law. Harkin reiterated those objections during a speech on the Senate floor, saying, "I thought we had an agreement that last year was it, that the $5 billion was it." He said that prevention is key to actually lowering health care costs. He said that the federal government is paying ever-increasing health care bills without investing in prevention, and then wonders "like clueless dodos," why costs continue to rise. Nevertheless, he said that he would allow Tavenner's nomination to go forward.

    Senate Majority Leader Harry Reid, D-Nev., had stated that he would like to move Tavenner's nomination forward as soon as possible. The Senate then confirmed her nomination on May 15.

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    HHS proposed HIPAA privacy rule linked with gun control
    The Department of Health and Human Services issued a proposed rule on the Health Insurance Portability and Accountability Act privacy rule and the National Instant Criminal Background Check System to remove barriers to firearm background check reporting and ensure that consumers receive access to mental health services, a move also aimed at addressing the issue of gun control. The proposed rules were published in the April 23 Federal Register. The public comment period ends on June 7.

    HIPAA establishes national standards to protect individuals' medical records and other personal health information. NICS is the database that houses information on individuals prohibited by law from possessing firearms. A 2012 Government Accountability Office report showed that 17 states had submitted fewer than ten records of individuals prohibited for mental health reasons, according to a statement from HHS.

    According to the proposed rulemaking notice, concerns have been raised that, in certain states, HIPAA may be a barrier to states' reporting the identities of individuals in the mental health prohibitor category in the NICS. The prohibitor category refers to individuals who have been involuntarily committed to a mental health institution, have been found incompetent to stand trial or not guilty by reason of insanity or otherwise have been determined through an adjudication process to have a severe mental condition resulting in the individuals presenting a danger to themselves or others or being unable to manage their own affairs.

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    Submit your session and case presentation abstracts
    AAGP is accepting proposals for sessions, case presentations, and posters for the 2014 Annual Meeting to be held March 14-17 in Orlando, Fla., at the Renaissance Orlando at SeaWorld®.

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    Mayo study: No link between anesthesia and dementia
    Can anesthesia from surgery cause dementia in elderly patients? That question was the subject of a recent Mayo Clinic study. Dr. David Warner, a Mayo Clinic anesthesiologist, said it's not uncommon for elderly patients to have dementia-like symptoms for extended periods of time after surgery.

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    The Long Goodbye: An interview with author Patti Davis
    By Marc E. Agronin, MD
    In her book "The Long Goodbye" (Knopf, 2004), author Patti Davis, daughter of former U.S. President Ronald Reagan, reflects on her father's struggle with Alzheimer's disease, describing it as a "thief that steals a human being like nothing else can.

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    A new way to care for patients with dementia
    VideoBrief The big facts on dementia and Alzheimer's are scary. Five million Americans with Alzheimer's already, and the big Baby Boom generation just moving into the Alzheimer's years. But the little facts are imposing too. How hard it can be to care, day in and day out, for a loved one or a patient with Alzheimer's. And how tough it can be on the aging, struggling victim of dementia. There's a push on for a better way. Less restraint. Fewer drugs. More respect. And maybe more joy, even in the difficulty.
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    Skin cancer tied to a lower risk of Alzheimer's
    There's no positive side to developing skin cancer, but the latest research ties certain forms of the disease to a reduced risk of dementia. Researchers from the Albert Einstein College of Medicine in the Bronx, New York found that people who have skin cancer may be less likely to develop Alzheimer's disease.
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    Scientists develop drug that slows Alzheimer's in mice
    Medical Xpress
    A drug developed by scientists at the Salk Institute for Biological Studies, known as J147, reverses memory deficits and slows Alzheimer's disease in aged mice following short-term treatment. The findings, published May 14 in the journal Alzheimer's Research and Therapy, may pave the way to a new treatment for Alzheimer's disease in humans.
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    Geriatric ERs: Golden idea for golden years?
    By Dorothy L. Tengler
    Older patients visit the emergency department more than any other age group except infants, and the aging population will increase as baby boomers continue to enter the 65-and-older age bracket. For years hospitals have set up separate ERs for kids, but only in the past few years have hospitals begun to consider setting up EDs for elderly patients. So, why aren't geriatric EDs more common?
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    Alzheimer's research: Biomarkers predict start of mental decline
    Huffington Post
    Researchers have figured out new ways to identify who is at risk of developing Alzheimer's, an incurable brain disease that affects 5.4 million Americans. By studying spinal fluid samples and health data from 201 research participants at the Charles F. and Joanne Knight Alzheimer's Disease Research Center, researchers at the Washington University School of Medicine in St. Louis have shown various biomarkers are reliable predictors of Alzheimer's even years before symptoms become evident. The findings, researchers say, provide more proof that scientists can detect Alzheimer's well before the onset of memory loss and cognitive decline.
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