Number of Kentucky babies born addicted keeps rising quickly as heroin replaces harder-to-get prescription painkillers

Despite the crackdown on prescription painkillers, more Kentucky babies are being born addicted, "fueled by a recent spike in heroin use," much of it by people who have found prescription painkillers harder to get, Laura Ungar reports for The Courier-Journal.

"The state has seen hospitalizations for drug-dependent newborns soar nearly 30 fold in a little more than a decade — from 28 in 2000 to 824 in 2012, according to a recent drug report from the Kentucky Injury Prevention and Research Center. Preliminary figures suggest that number will surpass 900 in 2013, according to state officials," Ungar reports, in a follow-up to a series she did on the state's prescription-drug abuse problems in 2012.

"The financial cost is also high — and climbing exponentially," Ungar writes. "Hospital charges for drug-dependent babies in Kentucky rose from $200,000 in 2000 to $40.2 million in 2012, with $34.9 million that year paid for by government Medicaid," nearly 30 percent of which comes from Kentucky taxpayers.

"Although there are no state-by-state statistics, Dr. Henrietta Bada, a neonatal-perinatal medicine doctor at the University of Kentucky, said she believes Kentucky has one of the nation’s worst problems with drug-dependent babies." the Journal of the American Medical Association reported that U.S. hospitalizations for drug-dependent babies rose 330 percent from 2000 to 2009; "Kentucky’s hospitalizations rose more than 1,400 percent during that same time," but the state has "only 55 treatment centers serving pregnant and postpartum women, the vast majority outpatient facilities," Ungar reports. That's “a fraction of what we need,” Attorney General Jack Conway told her.

Activist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill

"Health-care industry witnesses appeared to have presented incorrect information" to the House Health and Welfare Committee in speaking March 6 against House Bill 460, which would require all health-care facilities to report infections associated with their treatment, Dr. Kevin Kavanagh of Somerset writes in an op-ed piece in the Lexington Herald-Leader. The bill remains in committee, but its goal could be accomplished by regulation.

Dr. Kevin Kavanagh

Kavanagh is chairman of Health Watch USA, a group that tries to focus attention on the problem of health-care associated infections, also called hospital-acquired infections. He said the industry witnesses "were asked if any of the various types of facilities in Kentucky were exempt from reporting. The answer was no, that all facilities had to report through the Centers for Disease Control's national reporting system. However, critical-access hospitals and ambulatory-surgery centers are not required to report infection to the CDC. Nursing homes also do not have to report through the CDC's system."

Kavanagh writes that nursing homes report urinary-tract infections to the federal Centers for Medicare and Medicaid Services, but "there is no data on the deadly staph infection, MRSA," or a deadly gastrointestinal infection caused by the bacteria C. Difficile, "which can run rampant in some nursing homes."

Kavanagh said the industry witnesses also misled the committee when asked "asked if a patient who was going to have hip surgery could find information on infection rates on Hospital Compare," a Medicare website. He writes, "The answers appeared to indicate that such information was available," but is "woefully inadequate" because the state doesn't have an adequate reporting system.

"For acute-care hospitals, only, bloodstream MRSA infections (a relatively rare event), colon surgeries, abdominal hysterectomies, urinary tract infections and central-line infection data can be found. Little use for patients needing hip surgery. In the past, CMS has posted on the Hospital Compare website information regarding hospital-acquired conditions, and was slated in the future to have information on neck and spine surgery. However, this information is now gone from Hospital Compare. I can only assume it, too, has fallen to the legions of health-industry lobbyists." (Read more)

For Kavanagh's March 6 testimony to the committee, click here. For his March 13 rebuttal to industry witnesses, go here.

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Rogers, other drug-caucus chair file bill to reverse FDA's approval of new painkiller; competing company has alternative

Illustration from PainAndDepression.com

U.S. Reps. Hal Rogers of Somerset and Stephen Lynch of Massachusetts have introduced a bill to withdraw federal approval of a new formulation of hydrocodone that is highly addictive and produced in crushable pills, which they say threatens to start a new wave of prescription drug abuse. They are the Republican and Democratic co-chairs, respectively, of the Congressional Caucus on Prescription Drug Abuse.

But the Food and Drug Administration might act against Zohydro ER on its own, because Purdue Pharma LP has completed testing of a competing, non-crushable drug and will ask for "a priority review that would cut two to three months off the 10 months the agency sets as a goal to examine applications" for regulatory approval, Drew Armstrong of Bloomberg News reports. "Purdue’s pill is hard to crush and snort or inject."

That is important to the FDA. “If and when they, or another manufacturer, are able to create an abuse-deterrent formulation that remains safe and effective for patients, we would certainly give serious consideration to assuring that any non-abuse formulations are removed from the market,” FDA pain-drug director Bob Rappaport said in his Oct. 25 review of Zohydro’s approval.

Zohydro ER is an extended-release hydrocodone medication made by Zogenix Inc. for patients who need round-the-clock, long-term pain treatment and have found other treatments to be inadequate. Unlike recent formulations of the popular painkillers OxyContin and Opana, is not crush-resistant, but the company has said it is working on a crush-resistant version.

Citing concerns about abuse, the FDA's scientific advisory panel voted 11-2 against approving Zohydro ER, and a coalition of more than 40 health, consumer and other organizations urged the FDA to revoke its approval. Attorney General Jack Conway was among 28 attorneys general who sent the FDA a letter asking it to reconsider. Sen. Joe Manchin, D-W.Va., has introduced a companion bill to the one filed by Rogers and Lynch.

Hal Rogers (Associated Press photo)

Rogers said in a press release, "“While the FDA continues to send mixed signals to drug companies about the need to invest in abuse deterrent technologies, the Act to Ban Zohydro will make it abundantly clear – life saving measures are critical to the development of powerful painkillers like Zohydro. . . . In Southern and Eastern Kentucky, we lost nearly an entire generation when crushable OxyContin was first prescribed, and I fear this crushable, pure hydrocodone pill will take us backwards with a new wave of addiction and tragic, untimely deaths."

Kentucky ranks third in the nation for overdose deaths, with more than 1,000 Kentuckians dying each year from prescription drug overdoses. The number has leveled off following passage of laws that target pill-pushing clinics and doctors, and put stricter regulations on painkillers.

Zogenix has said it is committed to exceeding FDA requirements to make sure the drug is used appropriately, will monitor for misuse, and will allow an outside group to monitor and analyze its data. It noted that Zohydro ER will be regulated as a Schedule II drug, which means it can only be dispensed through a physician’s written prescription, with no refills, and does not contain acetaminophen, longtime use of which can cause liver failure.

Hospitals try to do more with less while not compromising quality as they adjust to changes in the health-care marketplace

A. B. Chandler Medical Center at the University of Kentucky

Hospitals are laying off employees and cutting budgets because of changes in the marketplace and the ways consumers seek care, Editor Mark Green reports in an in-depth article for The Lane Report.

Now that consumers are paying more direct costs, they are paying more attention to prices and more likely to use out-patient procedures, which are cheaper, Green writes. Also, consumers are increasingly using wellness programs to avoid health problems, and "Taxpayer-funded government compensation models are making better medical outcomes and financial efficiency important bottom-line issues."

Less inpatient treatment means fewer employees are needed at Kentucky hospitals, but not all are financially burdened, Green reports; those who provide the best service at the least cost are increasingly reaping the profits.

While the Patient Protection and Affordable Care Act may make care more affordable, it also "puts pressure on health-care providers to keep costs in check,” Carl Herde, chief financial officer for Baptist Health, told Green. “However, many of the issues facing health care were in place before the ACA came into effect.”

Dr. Michael Karpf, administrator of UK HealthCare since 2003, told Green that hospitals are adjusting from a model that was based on volume to one that is based on value. Karpf has said for years that the "health-care industry is on an unsustainable financial course."

“There is a real need to decrease utilization to get healthcare costs under control. It just puts pressure on institutions,” Karpf told Green. “We won’t be doing business the same old-fashioned way we’ve been doing it.”

Some hospitals are still showing a healthy profit, but are also cutting costs and looking for increased efficiency, like UK HealthCare, whose $920 million hospital budget is producing a seven to eight percent cash flow, Green reports. But KentuckyOneHealth expects a $218 million deficit in its $2.5 billion budget, laid off 500 of its 15,000 workers last month, says that it won't fill 200 openings and will close the emergency room at Medical Center Jewish Northeast in Louisville on April 1. The company told Green that it might close an entire hospital, without telling which one.

KentuckyOne CEO Ruth Brinkley told Green, “The recession has come to health care, and that is causing the industry to transform. There are many causes for the changes, among them: the economy, reduced payments from government and commercial payers, increasing consumerism, and shifts in how care is organized and delivered. We have seen large and respected healthcare organizations announcing restructuring, budget cuts and layoffs. Among them are Vanderbilt University Medical Center and Cleveland Clinic. This situation is even more acute in Kentucky, with steep declines in inpatient volumes.”

Baptist Health, a Louisville-based system that has the most hospital beds in Kentucky, had a $22 million operating loss in fiscal 2013, but $78 million in investment income erased that deficit, Herde told Green: “There is increasing pressure for hospitals to do more with less without sacrificing quality, so we are exploring creative ways to contain costs, but we are financially sound now – and we are confident that we will remain so in the future.”

Owensboro Health's hospital (HGA.com photo)

When the state turned management of Medicaid over to insurance companies, that created higher administrative costs for hospitals, said John Hackbarth, chief financial officer for Owensboro Health, which in 2013 opened a $385 million medical center.

“After movement to a managed-care model, we have five insurance plans, plus some patients remaining on Kentucky Medicaid indemnity,” Hackbarth said. “This has increased costs in many areas such as contracting, compliance, billing, IT and case management because we are dealing with five times the amount of rules and hoops to jump through for a slower payment and ultimately less reimbursement.”

State officials say the expansion of Medicaid under health reform, to those with incomes up to 138 percent of the federal poverty level, is forecast to bring Kentucky providers an extra $15 billion for care and create 17,000 new jobs. But not yet.

Green reports that the most common response from five major hospital operators was that "Medicaid expansion eventually should lower their annual charity care and bad-debt burden, which is hundreds of millions of dollars." But first they are focused on adjusting their services to meet an increased demand for care by the formerly uninsured.

The Louisville region's biggest provider, non-profit Norton Healthcare expects that when the federal subsidy for expanded Medicaid is reduced, to 90 percent, the state will have to cut the number of Medicaid enrollees or reimbursements to providers. The reform law's overall impact to date, Gough said, is “decreases in Medicare reimbursements.”

Poll: Kentuckians who report excellent or very good sidewalks and road shoulders are more likely to be physically active

Kentucky adults who ranked their neighborhood sidewalks and road shoulders as excellent or very good are more likely to be physically active, but only 26 percent of Kentuckians rank them that highly, according to the latest Kentucky Health Issues Poll.

"Adults who report excellent or very good neighborhood sidewalks/shoulders are more likely to report being very or somewhat physically active (84 percent) than residents who report fair to poor sidewalk/shoulder conditions (74 percent)," says a press release from the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health, formerly the Health Foundation of Greater Cincinnati.

"This finding stresses the impact of environment on activity choices," Susan Zepeda, president and CEO of the foundation, said in the release.

Despite the relatively poor rating for sidewalks and shoulders, more than half of those surveyed said their neighborhoods are excellent or very good locations to walk, jog, or bike.

Of those whose incomes are at or below 200 percent of the federal poverty threshold, 74 percent said they feel somewhat or very safe being physically active outside in their neighborhoods, but only 45 percent reported walking, jogging, and biking conditions as excellent or very good.

Only 11.9 percent of Appalachian Kentuckians rated their sidewalks and shoulders as excellent or very good. The poll defines Appalachian Kentucky as the 46 counties in the Big Sandy, Buffalo Trace, Cumberland Valley, Fivco, Gateway, Kentucky River and Lake Cumberland area development districts. Just 18.9 percent of Western Kentucky residents rated their sidewalks and shoulders as excellent or very good.

To see the full geographic breakouts, click here.

With smoking ban dead for this year, its Senate sponsor holds a last-ditch discussion as she looks to another office

By Melissa Patrick
Kentucky Health News

Republican Sen. Julie Denton, sponsor of the Senate bill for a statewide smoking ban, held a last-ditch discussion Wednesday with the committee she chairs about why Kentucky needs such a law.

It was a discussion with no action possible because Senate President Robert Stivers, R-Manchester, who opposes Senate Bill 117, assigned it to the Judiciary Committee, of which he is a member, instead of the Health and Welfare Committee, headed by Denton, who is running for the Louisville Metro Council rather than re-election.

A frustrated Denton opened the discussion with personal stories about growing up with a grandfather who smoked heavily and the effects this has had on her father who has asthma and frequent respiratory infections. She said her daughter, who has asthma, cannot tolerate exposure to any smoke.

Denton (Legislative Research Commission photo)

"This is a public health issue, not about personal rights," Denton argued.

She said governments infringe on personal liberties "all the time" to support public health. She gave examples of speed-limit laws, seat-belt laws, laws that prohibit texting while driving, laws that prohibit drinking and driving, building codes and car-seat law requirements.

"To say this is different than all the others is disingenuous," she said.

As for the argument that non-smokers did not have to enter establishments that allow smoking, she said that is not an option for many who work in places that allow smoking: "People can't afford to just go to another job."

Denton said if the bill had been sent to her committee it would have been sent to the full Senate for a vote, but "Politics is standing in the way." Not only is Stivers against it, leaders of the House's Democratic majority blocked a vote on the House smoking-ban bill, citing members' concerns about political repercussions in the fall elections, when Republicans hope to take over the House.

Democratic Sen. Julian Carroll, a former governor, commended Denton, saying her comments were both "relevant and very important."

Carroll said "I am strongly in support of this bill" because of the cost Kentucky pays for people who smoke. He said the current state budget spends $9.5 billion on health care, and smoking is a strong contributor to that number.

Ashli Watts of the Kentucky Chamber of Commerce said smoking costs Kentucky $1.5 billion every year, creates work absenteeism, raises tax and insurance costs and is bankrupting the state. She said more than 90 percent of Chamber members in a 2013 survey supported a ban, and it is time to join the other 24 states with such laws.

Dr. Sylvia Cerel-Suhl of the American Heart Association gave a long list of reasons to support the bill. "There is no longer any debate that second hand smoke causes death," she said, adding later, "Just in Kentucky, we are losing 1,000 people a year to secondhand smoke." Sherri Irwin of the Kentucky Rural Health Association cited the same number.

Smoke-Free Kentucky map; click on it for larger version

As a parting suggestion, Denton said Kentucky might consider allowing local governments to opt out of a statewide ban. Dozens of localities have bans, thought some have significant exemptions.

Denton acknowledged a collective frustration in the committee and said, "I won't be here next year; hopefully, you all will push through."

Sen. Reginald Thomas, D-Lexington said, "Perseverance does pay off. We will make this bill law one of these days."

Senate OKs bill to fund pediatric cancer and autism research

With the backing of Republican Leader Mitch McConnell, the U.S. Senate has passed a bill designed to assist in funding research of pediatric cancer and autism, funded by money now used to pay for presidential campaigns and party conventions.

The proposed Gabriella Miller Kids First Research Act authorizes $12.6 million a year for 10 years, McConnell press secretary Robert Steurer said in an email.

McConnell's likely Democratic opponent in the November election, Secretary of State Alison Lundergan Grimes, said he delayed passage of the bill, but McConnell's office blamed Democratic objections.

McConnell said in a floor speech, "As a survivor of polio as a child, I have always empathized with children battling life-threatening or disabling disorders," and it is "about time" this bill passed. It goes to President Barack Obama for his signature, reports Joseph Gerth of The Courier-Journal.

Grimes found fault with McConnell's written reply to an inquiry about the bill, telling the constituent he would "keep your support in mind." Gerth reports,  "McConnell's Senate office on Tuesday said that the Senate Republican Caucus had agreed to unanimously support the measure on Jan. 7."

Students in 2 Appalachian Ohio high schools help reduce classmates' consumption of sugary drinks, a bane in the region

In a region where sweet-tea and soda is more popular than water, student-led groups in Appalachian Ohio were successful in reducing the amount of sugary drinks students consumed, reports The Ohio State University's Center for Clinical and Translational Science.

As part of the study, student-led teen advisory councils in the two Southern Ohio high schools implemented a 30-day intervention called "Sodabriety" to reduce the amount of sugary drinks students consumed. Results of the study were published in the March issue of the Journal of School Health.

The councils informed students about the risks of sugary drinks, put green ribbons on students' cars to remind them of the dangers, offered daily "sugar facts" during the morning announcements, performed soda-themed rap songs at student events and gave away water bottles with a "What's in your cup?" slogan.

The efforts paid off. Not only did some teens completely give up sugared drinks, but water consumption nearly doubled. Some students even reported weight loss, less acne and increased energy, Smith said.

A typical 20-ounce soda contains 15 to 18 teaspoons of sugar and upwards of 240 calories. A 64-ounce fountain cola drink could have up to 700 calories, says a fact sheet from the Harvard School of Public Health.

Kentucky high-school students rank third in the U.S. in obesity, with 33.4 percent overweight or obese, according to the federal Centers for Disease Control and Prevention. Consumption of sugary beverages is a problem in Appalachia, where obesity contributes heavily to the region's health issues.

“Teens who grow up in this region are ultimately more likely to die from cancer, diabetes and heart disease than any other place in the nation, and obesity is the common risk factor for all of those illnesses,” said nurse Laureen Smith, one of the researchers. “A child’s odds of becoming obese increases almost two times with each additional daily serving of a sugar sweetened drink, and Appalachian kids drink more of these types of beverages than kids in other parts of the country.”

Smith added, “Sugar sweetened beverages are the largest source of sugar in the American diet. For some teens, they account for almost one-third of daily caloric intake, and that amount is even higher among Appalachian adolescents. If we can help teens reduce sugared-beverage intake now, we might be able to help them avoid obesity and other diseases later in life.”

Kentucky does well in national comparison of premiums and tax credits in new health-insurance system

Under the Patient Protection and Affordable Care Act, health-insurance costs vary from region to region and state to state, and federal subsidies won't remove all of the differences, Christopher Snowbeck and MaryJo Webster write for the St. Paul Pioneer Press. According to data from the U.S. Department of Health and Human Services and state-run health insurance exchanges, Kentucky's cost of coverage compares favorably; most areas in the state have prices that are between 2.63 and 8.68 percent of annual income. Of course, the lower prices in Kentucky—and in other states—might be correlated to narrower networks of health-care providers, which insurers are using to limit costs. Here's a screen grab of an interactive map showing costs of coverage for different ages and incomes; for the actual interactive map, click here.

In more urbanized areas, where insurance competition is greater and prices are lower, smaller tax credits are needed, but more subsidy is needed in places with higher premiums—such as rural areas of the South. "Because there is so much geographic variation in cost, the government does have to pitch in a larger portion of premium in higher-cost areas to make coverage affordable," said Cynthia Cox, a researcher at the California-based Kaiser Family Foundation.

Though some people feel that the law is unfair and that they don't receive the tax credits as high as in other areas, the PPACA exists to ensure that "people at certain income levels pay no more than a set share of income to buy the midlevel 'benchmark' health plan where they live," Snowbeck and Webster write. Some variation in price disappeared, though, because insurance companies can no longer refuse to cover people who have pre-existing health conditions, said Jonathan Gruber, a Massachusetts Institute of Technology economist who helped craft the law.

Coverage prices differ because of factors such as health status, cost of living and competition among insurance companies. However, though the same plan sells for $170 per month in Pittsburgh and $450 in areas of Georgia, federal subsidies based on income brign the latter cost below $300. "The tax credits can help us bring that premium cost down and say to people: 'It's now in the achievable range,'" said Tracy Brosius of the Wyoming Institute of Population Health.

Sometimes the tax-credit system actually allows people in higher-cost cities to pay less than those from lower-cost cities. "Assessing which consumers wind up with the 'better deals' can be complicated, policy experts say, because the lowest-cost silver plans available in different regions likely have different coverage details, such as deductibles and networks of doctors and hospitals," Snowbeck and Webster write. Though some argue that the new system doesn't offer incentives for regions that more provide more effective health care, Cox said "Insurers still have a financial incentive to keep premiums low to attract enrollees, particularly young enrollees who might not be tax-credit eligible." (Read more)

Family dinners promote healthier eating, often with fewer calories, as part of an achievable strategy to battle child obesity

In celebration of National Nutrition Month, there is no better time to make a commitment to eat more meals together as a family.

Family meals offer a great opportunity to not only spend time together and strengthen family relationships, they are also a great time for parents to be good role models for health eating, Angel Ginn, a registered dietitian-nutritionist in the Academy of Nutrition and Dietetics, said in a news release distributed by Newswise, a research-reporting service.

“Research shows that family meals promote healthier eating – more fruits, vegetables and fiber; less fried food; and often fewer calories,” Ginn said.

Kentucky high-school students rank third in the U.S. in obesity, with 33.4 percent overweight or obese. Elementary and middle school students rank eighth, and pre-kindergarteners rank sixth. Only 11.6 percent of adolescents in Kentucky eat fruits and vegetables three or more times in an average week, according to the federal Centers for Disease Control and Prevention.

Suggestions to add more family meals to the household routine include:

• Start slowly. Add one more family meal a week to your family's normal schedule. This can be added on the weekends if the weekly schedule is too busy.
• Plan meals together; make sure everyone has something they like at the meal.
• Make a  ritual out of setting the table in a special way; for example, using candles or colored napkins.
• Talk to each other, choosing topics that are positive.
• No electronics at the table, and turn off the television. Playing background music is a nice way to create a relaxing atmosphere and also signals that it is time to eat.

Ginn also suggested the website Kids Eat Right ( www.KidsEatRight.org) as a resource to help families get on the path of shopping smart, cooking healthy and eating right.

Todd County weekly's editor-publisher wonders why so many uninsured locals haven't signed up for health insurance

With open enrollment in the new health-insurance exchanges ending March 31, at least one country editor is wondering why most people in his community who lack coverage haven't take advantage of the historic opportunity. And since he's in Kentucky, he used the state's next-to-last ranking in the latest Gallup-Healthways Well-Being Index as the point of departure for an article that took up most of his editorial page.

"Kentucky is its own worst enemy . . . and if you think this is just an Eastern Kentucky problem, you aren't paying attention," Editor-Publisher Ryan Craig, right, wrote in last week's Todd County Standard, in Western Kentucky. "Our numbers suggest we are as miserable as anywhere in the state, i.e., the nation." Craig then listed statistics for poverty, income, education and health insurance and said bluntly, "We are near the bottom in all of these categories, which are the same categories that cause Kentucky to have such a dismal ranking in the Miserable Test year after year."

Craig says Todd County, "it, seems, is among the bottom of counties who signed up for the Affordable Care Act," and wonders why only 533 of the estimated 2,455 people in his county without health insurance have signed up for it: "Is it because of fear of the unknown? Politics? The prevailing answer people tell me is that they would rather pay the tax penalty and not have the insurance. What would happen if that person or someone in their family was in a car wreck? They readily admit that they are taking a big chance, but don't see how they can afford the insurance even when it is cheaper now, especially those who are very sick and couldn't get insurance before." One man told him he would have to declare bankruptcy.

"The deadline to apply for health insurance through the exchange is March 31," Craig writes. "If you don't have insurance, at least consider the process." The Standard has been judged Kentucky's best small weekly newspaper seven years in a row, but doesn't put news or editorials online. For a scan of the editorial as a PDF, click here.

New research argues that Alzheimer's disease should rank as third most common cause of death in the U.S.

Alzheimer's disease may contribute to almost as many deaths in the U.S. as heart disease or cancer, says a recent study published in Neurology.

Alzheimer's is listed as the nation's sixth leading cause of death, far behind the leading causes of death, heart disease and cancer, according to the federal Centers for Disease Control and Prevention. But the study says it should rank third.

Because death certificates provide the information used for these statistics, the overall picture of what causes death is often not told, especially in the elderly. This creates a system of under-reporting the complete reason for the death, lead author of the study Bryan D. James of Rush University Medical Center in Chicago said in Newswise, a research-reporting service.

“The estimates generated by our analysis suggest that deaths from Alzheimer’s disease far exceed the numbers reported by the CDC and those listed on death certificates,”James said.

The study supports contentions of the Alzheimer's Association, which estimates that the disease causes about a third of the deaths in Kentucky. In 2010, 8 percent of Kentuckians age 65 and older, or 80,000, had Alzheimer's, with a projected number of 97,000 in 2025.

The study did annual testing for dementia on 2,566 people ages 65 and older. It found that 559 participants without dementia at the start of the study developed Alzheimer’s. Within eight years of the study, 1,090 participants died. Those diagnosed with Alzheimer's between ages 75 to 84 had a death rate more than four times higher after the diagnosis and people 85 and older nearly three times higher than the whole.

Researchers concluded that More than one-third of all deaths in those 75 and older were caused by Alzheimer's, and that an estimated 503,400 Americans over age 75 in 2010 died from it. That's five to six times higher than the 83,494 number reported by the CDC. That would move the disease from the sixth leading cause of death and to the third; chronic lung disease, stroke and accidents now rank third, fourth and fifth.