Debate: Are depression and dementia two sides of the same coin? And, if they are, how to best approach treatment?

Every seven seconds, someone in the world is diagnosed with dementia. A typical case that I often see in my practice is as follows: A 76-year-old woman has a two-year history of progressive worsening of short-term memory and cognitive decline. She can’t recall the names of her grandchildren and is devastated by her deteriorating abilities.

However, this is not the first time in her life that she has had feelings of loss and despair. Over the past 30 years, she has intermittently struggled with depression and anxiety. Her family has many questions: Does she have dementia or Alzheimer’s? Could her depression have led to a dementia diagnosis? Is it only depression and not dementia? These are all good questions and the collective answer to them is “yes.”

Dementia and depression

Dementia and depression are the two dreaded “D” diagnoses that are increasingly robbing our aging population of health and happiness Read the rest

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If You Are Vaccinated, You Can Dance the Night Away

Marissa Castrigno was walking through downtown Wilmington, North Carolina, when she spotted the sign in the window of one of her favorite dance clubs. After months of being shuttered by the pandemic, Ibiza Nightclub was reopening April 30, it announced.

This story also ran on Raleigh News & Observer. It can be republished for free.

Thrilled, Castrigno immediately made plans with friends to be there.

About 50 miles north in Jacksonville, Kennedy Swift learned of Ibiza’s reopening on social media. He, too, decided to attend with friends.

But on the night of April 30, the two groups were in for a surprise — one they would react to in starkly different ways.

In addition to IDs, they learned, they’d need to show covid-19 vaccination cards for entry. The club was letting in only people who had had at least one shot.

“I was shocked,” said Swift, 21. He learned of … Read the rest

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KHN’s ‘What the Health?’: Roe v. Wade on the Ropes

Can’t see the audio player? Click here to listen on SoundCloud.

The Supreme Court agreed to hear a case next term that could result in a significant modification or overturn of Roe v. Wade, the 1973 case that legalized abortion nationwide. At issue is a Mississippi law that would ban the procedure after 15 weeks of gestation. That is well before a fetus is viable outside the womb and, under Roe, states may not ban abortion prior to viability.

Meanwhile, the unexpected announcement by the Centers for Disease Control and Prevention that fully vaccinated people could stop wearing masks inside and outside has caused considerable confusion, as the U.S. does not have a way for people to prove they are vaccinated.

And despite a successful voter referendum, Missouri Gov. Mike Parson, a Republican, has announced his state will not expand the Medicaid program after the Republican-led legislature failed … Read the rest

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Teladoc Health, having acquired Livongo and myStrength, launches integrated mental health service for the workplace

Teladoc builds out mental healthcare services with myStrength Complete (MobiHealthNews):

Virtual care giant Teladoc is building out its behavioral health services through its latest program, myStrength Complete.

The new offering is designed to give users a single integrated mental healthcare experience. It combines the app-based models of care from myStrength with Teladoc’s on-demand therapists and psychiatrists … The myStrength platform uses evidence-based clinical models such as cognitive behavioral therapy, positive psychology and mindfulness to help treat behavioral health conditions such as depression, anxiety, insomnia and substance use disorder.

The company was bought by Livongo in 2019 and was then absorbed in Teladoc’s acquisition of Livongo last year.

myStrength Complete will be available to individuals through their health plans or employers in July, Teladoc said in its announcement.

The Announcement:

Teladoc Health Launches “myStrength Complete” As First Unified Mental Health Care Experience (press release):

Teladoc Health, Inc. (NYSE: TDOC) today announced

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Why Your Dentist Might Seem Pushy

In 1993, Dr. David Silber, a dentist now practicing in Plano, Texas, was fired from the first dental clinic he worked for. He’d been assigned to a patient another dentist had scheduled for a crown preparation — a metal or porcelain cap for a broken or decayed tooth. However, Silber found nothing wrong with the tooth, so he sent the patient home.

This story also ran on U.S. News & World Report. It can be republished for free.

He was fired later the same day. “Never send a patient away who’s willing to pay the clinic money,” he was told.

Silber said what happened to him then still happens today, that some dentists who don’t think they receive enough from insurance reimbursement — whether private insurance or Medicaid — have figured out ways to boost their bottom lines. They push products and procedures a patient doesn’t need or recommend higher-cost … Read the rest

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Study finds MDMA-assisted therapy to be safe and highly effective to treat severe PTSD

The First Phase 3 Success for Psychedelics Will Pave the Way for an Industry (Barron’s):

Post-traumatic stress disorder is a crippling, hard-to-treat psychiatric affliction. America spends billions of dollars yearly just on the veterans who suffer from PTSD. So it’s heartening to see the report of a promising new treatment, published Monday in Nature Medicine.

In Monday’s report, an international team of researchers describe their test of a treatment combining psychotherapy with doses of MDMA—the illegal drug popularly known as Ecstasy or Molly. The MDMA-assisted therapy was dramatically effective at reducing PTSD symptoms and improving daily functioning in the 42 treated participants, when compared with the 37 participants who got psychotherapy and a placebo drug.

Two months after their last drug-assisted session, two-thirds of the MDMA-treated patients no longer met the diagnosis for PTSD, compared with one third of those treated with placebos … The Nature authors speculate that MDMA-assisted

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Doctors Now Must Provide Patients Their Health Data, Online and On Demand

Last summer, Anna Ramsey suffered a flare-up of juvenile dermatomyositis, a rare autoimmune condition, posing a terrifying prospect for the Los Angeles resident: She might have to undergo chemotherapy, further compromising her immune system during a pandemic.

This story also ran on Los Angeles Times. It can be republished for free.

After an agonizing three-day wait, the results of a blood test came back in her online patient portal — but she didn’t understand them. As hours passed, Ramsey bit her nails and paced. The next day, she gave in and emailed her doctor, who responded with an explanation and a plan.

For Ramsey, now 24, instant access to her test results had been a mixed blessing. “If there’s something I’m really nervous about,” she said, “then I want interpretations and answers with the result. Even if it takes a few days longer.”

On April 5, a federal rule went … Read the rest

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‘Kicking You When You’re Down’: Many Cancer Patients Pay Dearly for Parking

For cancer patients, the road from diagnosis to survivorship feels like a never-ending parade of medical appointments: surgeries, bloodwork, chemotherapy, radiation treatments, scans. The routine is time-consuming and costly. So, when hospitals charge patients double-digit parking fees, patients often leave the garage demoralized.

This story also ran on NBC News. It can be republished for free.

Iram Leon vividly remembers the first time he went for a follow-up MRI appointment at Dell Seton Medical Center in Austin, Texas, after he had been treated at another hospital for a brain tumor.

The medical news was good: His stage 2 tumor was stable. The financial news was not. When he sat down at the receptionist’s desk to check out, Leon was confronted by a bold, red-lettered sign on the back of her computer that read: “WE DO NOT VALIDATE PARKING.”

Below that all-caps statement was a list of parking rates, starting with … Read the rest

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KHN’s ‘What the Health?’: Drug Price Effort Hits a Snag

Can’t see the audio player? Click here to listen on SoundCloud.

The high cost of prescription drugs is a top health issue for the public and politicians, but concerns raised by a group of moderate Democrats threaten to derail a bill being pushed by House Democratic leaders.

Meanwhile, the Food and Drug Administration has authorized the use of the Pfizer covid-19 vaccine for everyone age 12 and up, and Pfizer is applying for full licensure of that vaccine. It is currently being distributed under emergency authorization. Full approval could open the door to vaccine requirements in some workplaces, schools or other gathering spots, which will likely touch off more controversy.

And the Biden administration reinstated an Obama-era policy barring discrimination in health care for LGBTQ individuals, even as more states pass anti-LGBTQ legislation.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of Politico, Sarah Karlin-Smith of the Pink … Read the rest

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What Does Approval of the Pfizer Vaccine for Teens and Preteens Mean for My Child?

Q: The federal government approved the Pfizer vaccine for 12- to 15-year-olds. What does this mean for my child?

This story also ran on PolitiFact. It can be republished for free.

Extending the emergency use of the Pfizer-BioNTech vaccine to preteens and young adolescents adds nearly 17 million more Americans to the pool of those eligible to be immunized against covid-19, helping to build a vaccinated population closer to herd immunity. Moderna and Johnson & Johnson are also testing the efficacy of their vaccines in teens and children.

Although children appear to catch covid less often and develop milder symptoms than adults, they can develop a rare, severe inflammatory response or “long-haul covid” symptoms. It also remains to be seen what, if any, long-term effects these younger patients may experience from covid.

The share of covid cases in children and teens is increasing — nearly a quarter of the new … Read the rest

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