Stopping smoking as early as possible is important, but cessation at any age provides meaningful life extensions.

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The direct costs of the disease reflect a small portion of the burden. The hidden costs, in the form of lost wages, informal care, and changing roles are substantial. Their magnitude is even more important when we consider that the family generally lives on a fixed income, and the caregiver is an older aged spouse. Medical practitioners will best be able to intervene if they look holistically at the patient with this disease. When treating symptoms themselves, practitioners need to be aware of the high level of pain, fatigue, and depression associated with PD, even in the early stages. The results demonstrate clearly that family relationships are affected early, indicating the importance of providing early referrals to services such as home health, social workers/counseling, and well as PD support groups.

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Medicaid requires that physicians who accept Medicaid reimbursement for treating a patient agree to accept its payment as payment in full. Policy instruments under Medicaid's control are both levels of reimbursement and various administrative burdens imposed on physicians by the program. A model depicting the physician's participation decision is developed, and predictions from the comparative statics analysis are discussed. Data came from a 1975--76 survey of fee-for-service physicians. The results indicate that high fee schedules and low administrative burdens are ways to stimulate physician involvement with Medicaid patients. Results on the Medicaid policy instruments and other explanatory variables on the whole lend support to the model of physician behavior proposed earlier in the paper.

Objective This study determines effects of elevated body mass index (BMI) on type 2 diabetes mellitus (DM) onset and its complications among U.S. elderly. Design and Methods Data came from the Medicare Current Beneficiary Survey (MCBS), 1991-2010. A Cox proportional hazard model was used to assess effects of elevated BMI at the first MCBS interview on DM diagnosis, complications, and insulin dependence onset among Medicare beneficiaries with no prior DM diagnosis and not enrolled in Medicare Advantage (N=14,657). Results Among DM-diagnosed individuals, elevated BMIs were associated with progressively higher risk of adverse outcomes. For women, hazard ratio (HR) of insulin dependence ranged from a 1.77 at 25 ≤ BMI ≤ 27.49 to 3.57 at BMI ≥ 40. A similar pattern was observed in risk for cardiovascular (HR=1.34 to HR=2.45), cerebrovascular (HR=1.30 to HR=2.00), renal (HR=1.31 to HR=2.23), and lower extremity complications (HR=1.41 to HR=2.95). In men, increased risks for DM complications occurred at higher BMI (27.5 ≤ BMI ≤ 29.99) levels than in women. Ocular complications occurred at higher BMI levels than other complication types in both genders. Conclusions Having even moderately elevated BMI is associated with increased risk of developing DM complications.

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ABSTRACT. Objective: This study examined changes in drinking behavior after age 50 and baseline personal characteristics and subsequent life events associated with different alcohol-consumption trajectories during a 14-year follow-up period. Method: Data were taken from the Health and Retirement Study. The study sample included individuals ages 51-61 in 1992 who survived the sample period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) and had at least fi ve interviews with alcohol consumption information, yielding an analysis sample of 6,787 (3,760 women). We employed linear regression to determine drinking trajectories over 1992-2006. Based on these fi ndings, each sample person was classifi ed into one of fi ve drinking categories. We used multinomial logit analysis to assess the relationship between personal demographic, income, health, and attitudinal characteristics as well as life events and drinking-trajectory category. Results:Overall, alcohol consumption declined. However, rates of decline differed appreciably among sample persons, and for a minority, alcohol consumption increased. Persons with increasing consumption over time were more likely to be affl uent (relative-risk ratio [RRR] = 1.09, 95% CI [1.05, 1.12]), highly educated (RRR = 1.20, 95% CI [1.09, 1.31]), male, White (RRR = 3.54, 95% CI [1.01, 12.39]), unmarried, less religious, and in excellent to good health. A history of problem drinking before baseline was associated with increases in alcohol use, whereas the reverse was true for persons with histories of few or no drinking problems. Conclusions: There are substantial differences in drinking trajectories at the individual level in midlife and late life. A problem-drinking history is predictive of alcohol consumption patterns in later life. (J. Stud. Alcohol Drugs, 71, 169-179, 2010)