Medicare research study suggests many patients treated for Alzheimer’s do not have the disease

Do you know anyone with Alzheimer’s Disease?  If you do, then you may be aware that it can a rather time-consuming process for the patient to receive a diagnosis.  Alzheimer’s is one of those conditions in which the physician generally has to look to the patient’s symptoms without the benefit of a definitive, objective test to confirm the diagnosis,  The disease is marked by the presence of amyloid plaques in the brain, but until recently those deposits were only detectable by an autopsy.

Physicians can now use a PET scan to detect the presence of the amyloid plaques.  A positive finding does not necessarily mean that the patient has the disease, but it does correlate with an increased risk of the disease.  A negative finding (or the absence of amyloid plaques) means that the patient does not have Alzheimer’s and the physician should continue to search for a different diagnosis and treatment.  Unfortunately, most insurers (and Medicare) refuse to pay for the cost of a PET scan so physicians have to rely on a myriad of subjective complaints related by the patient and family.

It should probably not come as a surprise that the accuracy of such diagnoses is not very good.  A recent study by Medicare indicates that almost 50 % of the patients diagnosed with Alzheimer’s do not actually have the amyloid plaques that are indicative of the disease.  Scientists hope that Medicare and insurers will consider paying for PET scans so that physicians can make a more accurate diagnosis.  Researchers are also working on creating a blood test that could be administered in a physician’s office to confirm the presence of amyloid plaques.  You can read more about the study and its possible effect on diagnosis, treatment, and management of Alzheimer’s Disease in this excellent Washington Post article by Tara Bahrampour.

Do you have a Health Savings Account?

After a decade of considering various proposals for creating a medical savings account in the 1980s, Congress authorized the Archer Medical Savings Account test project in 1996.  The idea was to let individuals set up tax-advantaged savings accounts that could be used to pay medical expenses.  The project called for up to 750,000 self-employed taxpayers to set up the accounts.  Unfortunately (and predictably), the rules for the accounts were very restrictive and not many people opted to set up an account.  The Archer accounts were made obsolete in 2003 when Congress passed the Medicare Part D

The Archer accounts were made obsolete in 2003 when Congress passed the Medicare Part D benefit and authorized the creation of a Health Savings Account (HSA) for individuals in qualified medical plans.  HSAs offer some pretty great advantages if you are eligible to create one: (1) contributions to the account are tax-deductible; (2) The account can gain interest (or if set up as an investment account, can accrue gains) without being subject to tax; and (3) amounts can be withdrawn tax-free if used for qualified medical expenses, including long-term care insurance premiums.  (As with all things created by Congress, there are statutes and IRS regulations that set limits to the deductibility of contributions, etc.  Those limits and exceptions are outside the scope of this post, but you can learn more about HSAs at www.treasury.gov ) Although individuals enrolled in Medicare cannot contribute to a previously setup HSA, they can make withdrawals from the HSA while on Medicare.  You can learn about the interplay between HSAs and Medicare by reading this post at aarp.org.

MIT Develops New Procedure to Allow Amputees to Receive Sensory Feedback from Prothestic Limbs

Prosthetics have come a long way in 3,000 years.  Yesterday, I posted an article describing how Swiss Egyptologists had discovered a wooden toe prosthetic estimated to be 3,000 years old.  Jump forward three millennia and today’s post is about a new surgical procedure developed at the Massachusetts Institute of Technology that allows a patient to receive sensory feedback from a prosthetic.  You can read about the procedure in this article on Science Daily…. Making prosthetic limbs feel more natural: Muscle grafts could help amputees sense and control artificial limbs — ScienceDaily

Researchers Discover 3,000-year-old prosthetic toe in Egypt

Swiss researchers have discovered a wooden big toe prosthesis in the necropolis of Sheikh ´Abd el-Qurna.  The prosthesis is approximately 3,000 years old and demonstrates a high degree of craftsmanship.  You can read more about the discovery at Science Daily… A wooden toe: Swiss Egyptologists study 3000-year-old prosthesis — ScienceDaily

2 Vietnam Veterans Receive State of the Art Prothesis

If there is anything good that can come from the destruction of war, it is that the conflicts tend to drive innovation in health care, especially in the fields of trauma treatment and prosthetics.  David Gonzalez of the New York Times has written a wonderful article about the new prosthesis that two Vietnam veterans received this month.  I encourage you to read it at For Two Veterans, a Freedom Restored for Independence Day – The New York Times