Older adults may be even more vulnerable to fraud and scams than previously thought, according to an NIA-funded study that mimicked a real-world government imposter scam. The results suggest that a sizable minority of older adults, including those without cognitive impairment, are vulnerable to fraud and scams. The study results were published in JAMA Network Open.

Previous research on the vulnerability of older adults to financial fraud and scams has largely relied on self-reported data. To assess a more real-world response, researchers from the Rush Alzheimer’s Disease Center in Chicago, in collaboration with the Financial Industry Regulatory Authority Investor Education Foundation, conducted an experiment that mimicked imposter scams. The participants — 644 older adults (on average, age 85) in the Rush Memory and Aging Project — were contacted by a fictitious government agency about unusual activity on their Social Security and Medicare accounts that required verification.

Researchers classified how the older adults responded to the scam into three groups: no engagement (did not answer the phone or call in), engagement (answered or called in but raised skepticism and did not provide personal information), and conversion (answered or called in without skepticism or provided personal information). Most of the participants did not engage (68.5%). However, when they answered or called in, more of the participants engaged without skepticism (16.4%) than with skepticism (15.1%), and 12% of the participants even provided personal information.

The researchers also compared key characteristics across the engagement groups and found differences in cognition, financial literacy, and scam awareness. Older adults who engaged but raised skepticism scored the highest of all three groups on cognitive and financial literacy tests. This group also had the fewest number of people with dementia.

Those in the conversion group had the lowest scam awareness. When participants with dementia were excluded from analysis, cognition and financial literacy differences were no longer statistically significant, but those in the conversion group still scored lowest in scam awareness.

The generalizability of these findings to the general aging population may be limited, as participants were majority White, women, and highly educated. Because of the high levels of education among participants and the use of less intensive tactics than actual scammers, there is likely even more conversion among older adults in real-world scenarios. Increasing scam awareness and further exploring factors associated with vulnerability are important steps to decrease the risk of fraud victimization for this population.

To learn more, please visit https://www.nia.nih.gov/news/high-vulnerability-government-impersonation-scams-among-older-adults

Dementia — a loss of thinking, remembering, and reasoning skills that affects everyday life — is a growing concern. It’s often preceded years in advance by memory and thinking problems, including cognitive decline and mild cognitive impairment. Interventions that prevent or delay these problems might help to reduce the risk of dementia.

Some studies have linked healthy eating patterns to improved cognitive function. Examples include the Mediterranean diet, which emphasizes fruits, vegetables, and lean proteins, and the DASH eating plan, designed to treat or prevent hypertension.

The MIND diet merges key features of the Mediterranean and the DASH diets. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It aims to protect brain health. The diet features green leafy vegetables and other vegetables, prefers berries over other fruit, and endorses whole grains, beans, nuts, and at least one weekly serving of fish. It limits red meat, sweets, cheese, fast food, and fried foods.

A research team led by Dr. Russell P. Sawyer of the University of Cincinnati studied whether the MIND diet is linked to cognitive health. They also looked for potential differences between Black and White Americans and between genders. Many earlier studies of diet and cognitive health have underrepresented Black participants.

The researchers drew on data from a large ongoing NIH-supported study called REGARDS (REasons for Geographic and Racial Differences in Stroke). REGARDS is designed to assess why Black Americans and others have increased rates of stroke and related conditions that affect brain health. Of the 30,000 REGARDS participants, about 14,000 had sufficient data on their cognitive status and eating patterns to be included in the new analysis. Their average age was about 64 at the start of the study. About 57% were female, 70% were White, and 30% were Black. They were followed for about 10 years.

The research team created a score for each participant based on how closely their self-reported eating patterns adhered to MIND diet recommendations. Cognitive health was measured at the beginning and end of the study. Results were reported in Neurology on Sept. 18, 2024.

Overall, the researchers found that, after adjusting for demographic and other factors, closer adherence to the MIND diet was linked to lower cognitive impairment and slower rates of cognitive decline. Participants with greatest adherence to the MIND diet had a 4% reduced risk of cognitive impairment compared to those with lowest adherence.

The team also found that closer following of the MIND diet was associated with an 8% lower risk of cognitive decline in female participants but no difference in males. And greater adherence to the diet was a better predictor of cognitive decline in Black than in White participants.

The researchers note that their findings generally align with earlier studies that examined associations between cognitive health and MIND and similar diets. But additional studies are needed to better understand the role that healthy eating may play in cognitive health.

“With the number of people with dementia increasing with the aging population, it’s critical to find changes that we can make to delay or slow down the development of cognitive problems,” Sawyer says. “These findings warrant further study, especially to examine these varying impacts among men and women and Black and White people.”

To learn more, please visit https://www.nia.nih.gov/news/healthful-diet-linked-reduced-risk-cognitive-decline.

Medicines are intended to help us live longer and healthier, but taking medicines the wrong way or mixing certain drugs and supplements can be dangerous. Older adults often have multiple medical conditions and may take many medicines, which puts them at additional risk for negative side effects. Read on to learn how to safely take and keep track of all your medicines.

What are medicines?

Medicines, often referred to as drugs, are used to prevent or treat diseases and other health conditions. Medicines can be obtained by a prescription or over the counter (OTC). Prescription drugs are medicines that you can get only with a doctor’s order; for example, pills to lower your cholesterol or an asthma inhaler. OTC medications can be purchased without a prescription; for example, aspirin or lubricating eye drops.

Dietary supplements are not considered drugs because they are not intended to prevent or treat diseases. Rather, these products are intended to maintain or improve health, and they may help you meet your daily requirements for essential vitamins and minerals. For example, calcium and vitamin D can help build strong bones. Learn more about taking supplements safely in the NIA article, Dietary Supplements for Older Adults.

It can be dangerous to combine certain prescription drugs, OTC medicines, dietary supplements, or other remedies. For example, you should not take aspirin if you take warfarin for heart problems. To avoid potentially serious health issues, talk to your doctor about all medicines you take, including those prescribed by other doctors, and any OTC drugs, vitamins, supplements, and herbal remedies. Mention everything, even ones you use infrequently.

Starting a new medicine

Talk with your health care provider before starting any new prescription, OTC medicine, or supplement, and ensure that your provider knows everything else you are taking. Discuss any allergies or problems you have experienced with other medicines. These might include rashes, trouble breathing, indigestion, dizziness, or mood changes. Make sure your doctor and pharmacist have an up-to-date list of your allergies so they don’t give you a medicine that contains something that could cause an allergic reaction.

You will also want to find out whether you’ll need to change or stop taking any of your other prescriptions, OTC medicines, or supplements while using this new medicine. Mixing a new drug with medicines or supplements you are already taking might cause unpleasant and sometimes serious problems. For example, mixing a drug you take to help you sleep (a sedative) and a drug you take for allergies (an antihistamine) can slow your reactions and make driving a car or operating machinery dangerous.

When starting a new medication, be sure to write down the name of the drug, the dose, and why it’s being prescribed for you. Also, make note of any special instructions for how to take the medicine. For many drugs, this information is included on the bottle or prescription label.

Filling your prescription

When you get your prescriptions filled, the pharmacist can answer many of your questions about prescription drugs, OTC medicines, and supplements. Try to have all your prescriptions filled at the same pharmacy so your records are in one place. This will help alert the pharmacist if a new drug might cause a problem with something else you’re taking. If you’re unable to use just one pharmacy, share your list of medicines and supplements with the pharmacist at each location when you drop off your prescription.

When you have a prescription filled:

• Ask your pharmacist if there is a patient profile you can fill out, so the pharmacy is aware of all drugs and OTC medications, vitamins, and supplements you take.
• Tell the pharmacist if you have trouble swallowing pills. There may be liquid medicine available. Do not chew, break, or crush tablets without first asking if this will change the way the drug works.
• Make sure you can read and understand the name of the medicine as well as the directions on the container and on the color-coded warning stickers on the bottle. If the label is hard to read, ask your pharmacist to use larger type.
• Read all the information about your medication carefully. Many prescription medicines come with paper handouts, called medication guides, that contain information to help patients avoid serious side effects.
• Check that you can open the container. If not, ask the pharmacist to put your medicines in bottles that are easier to open.
• Ask about special instructions on where to store a medicine. For example, should it be kept in the refrigerator or in another climate-controlled place?
• Check the label on your medicine before leaving the pharmacy. It should have your name on it and the directions provided by your doctor. If it doesn’t, don’t take it, and talk with the pharmacist.

The image below points out information typically present on a prescription label. Please note that your prescription label may have a different format than the one shown. The prescription number is usually printed in the upper left corner of the label.

Talk with your doctor or pharmacist if you have questions about the written information that comes with your prescription.

Medication side effects

Unwanted or unexpected symptoms or feelings that occur when you take medicine are called side effects. Side effects can be relatively minor, such as a headache or a dry mouth. They can also be life-threatening, such as severe bleeding or damage to the liver or kidneys. The side effects of some medications can also affect your driving.

Some side effects may appear when you start taking a medicine but get better with time. Others occur once in a while. But some side effects may be ongoing while you’re on the medication. If you have uncomfortable side effects, don’t stop taking your medicine before you talk with a health care provider. Write them down so you can report them to your doctor or pharmacist accurately. Call your doctor right away if you have any problems with your medicines or if you are worried that the medicine might be doing more harm than good. Your health care provider may be able to prescribe a different medicine or help you deal with side effects in other ways.

Keeping track of your medicines

Many older people take multiple medications, and it can be challenging to keep track of everything. Here are some tips that can help:

• Make a list. Write down all medicines you take, including OTC drugs. Also include any vitamins or dietary supplements. The list should include the name of each medicine or supplement, the amount you take, and time(s) you take it. If it’s a prescription drug, also note the doctor who prescribed it and the reason it was prescribed. Show the list to all your health care providers, including physical therapists and dentists. Keep one copy in a safe place at home and one in your wallet or purse.
• Get familiar with your medicines. If you take more than one medicine, make sure you can tell them apart by size, shape, color, or the number imprinted on the pill.
• Create a file. Save all the written information that comes with your medicines and keep it somewhere you can easily refer to it. Keep these guides for as long as you’re taking the medication.
• Check expiration dates on bottles. Don’t take medicines that are past their expiration date. Your doctor can tell you if you need a refill.
• Secure your medicines. Keep your medicines out of the reach of children and pets. If you take any prescription pain medicines (for example, morphine, other opioids, or codeine), keep them in a locked cabinet or drawer. If your medicines are kept in bottles without safety caps because those are hard for you to open, be extra careful about where you store them.
• Dispose of your medicines safely. Check the expiration dates on your medication bottles and discard any unused or expired medicines as soon as possible. Timely disposal of medicines can reduce the risk of others taking them accidentally or misusing the medications on purpose. Check with your doctor or pharmacist about how to safely discard expired or unneeded medications, or review the FDA’s guidance on Where and How To Dispose of Unused Medicines.

Taking medicines safely

Here are some tips to help you take your medicines safely:

• Follow instructions. Read all medicine labels and be sure to follow instructions. Don’t take a larger dose of a medicine, thinking it will help you more. This could be very dangerous and even deadly. And don’t skip or take half doses of a prescription drug to save money.
• Take medicine on time. Some people use meals or bedtime as reminders to take their medicine. Other people use charts, calendars, or weekly pill boxes. You can also set timers and write reminders to take your medication. Medication reminder apps for smartphones are becoming more popular; these apps can help you remember when and how to take your medications each day.
• Turn on a light. Don’t take medicine in the dark; you might make a mistake.
• Report problems. Call your doctor right away if you have any trouble with your prescriptions, OTC medicines, or supplements. There may be something else you can take.
• Tell your doctor about alcohol, tobacco, and drug use. Alcohol, tobacco, and other drugs can affect how well your medicines work. Be honest with your doctor about how much you use.
• Ask your loved ones for help. Take a friend or relative with you to your doctor’s appointments if you think you may need help understanding or remembering what the doctor tells you.
• Check before stopping. Take prescription medicine until it’s finished, or your doctor says it’s all right to stop. Note that some medicines are supposed to be taken only “as needed.”
• Don’t share. Do not take medicines prescribed for another person or give yours to someone else.

To learn more, please visit Taking Medicines Safely as You Age | National Institute on Aging (nih.gov)

Many people enjoy an alcoholic beverage or two on occasion with friends or family, but alcohol can be addictive. As we age, alcohol consumption can also make existing health problems worse and have dangerous interactions with some medications. Anyone at any age can develop an unhealthy reliance on alcohol.

Sometimes, families, friends, and health care workers may overlook the concerns about older people drinking. This can be the case because the side effects of drinking in older adults are mistaken for other conditions related to aging, for example, a problem with balance. But how the body handles alcohol changes with age.

The effects of alcohol change as we age

As you grow older, health problems or prescribed medicines may require that you drink less alcohol or avoid it completely. You may also notice that your body’s reaction to alcohol is different than before. Some older people feel the effects of alcohol more strongly without increasing the amount they drink. This can make them more likely to have accidents such as falls, fractures, and car crashes. Also, older women are more sensitive than men to the effects of alcohol.

Other people develop a harmful reliance on alcohol later in life. Sometimes this is a result of major life changes, such as the death of a spouse or other loved one, moving to a new home, or failing health. These kinds of changes can cause loneliness, boredom, anxiety, or depression. In fact, depression in older adults often aligns with drinking too much.

People who drink daily do not necessarily have alcohol use disorder. And not all who misuse alcohol or have alcohol use disorder drink every day. But heavy drinking, even occasionally, can have harmful effects.

How does drinking damage the body?

Drinking too much at one time or on any given day, or having too many drinks over the course of a week, increases the risk of harmful consequences, including injuries and health problems. People who consistently misuse alcohol over time are also at greater risk of developing alcohol use disorder.

Drinking too much alcohol over a long time can:

• Lead to some kinds of cancer, liver damage, immune system disorders, and brain damage
• Worsen some health conditions such as osteoporosis, diabetes, high blood pressure, stroke, ulcers, memory loss, and mood disorders
• Make some medical conditions hard for doctors to accurately diagnose and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack.
• Cause some older people to be forgetful and confused — symptoms that could be mistaken for signs of Alzheimer’s disease or a related dementia.

Cautions about mixing alcohol and medicines

Many medicines — prescription, over the counter, or herbal remedies — can be dangerous or even deadly when mixed with alcohol. Many older people take medications every day, making this a particular concern.

Before taking any medicine, ask your doctor or pharmacist if you can safely drink alcohol.

Here are some examples of potential dangers caused by mixing alcohol with some medicines:

• If you take aspirin and drink, your risk of stomach or intestinal bleeding increases.
• When combined with alcohol, cold and allergy medicines (antihistamines) may make you feel very sleepy.
• Alcohol used with large doses of acetaminophen, a common painkiller, may cause liver damage.
• Some medicines, such as cough syrups and laxatives, have a high alcohol content. If you simultaneously drink alcohol, that will add to the effects.
• Alcohol used with some sleeping pills, pain pills, or anxiety/anti-depression medicine can be deadly.

Learn more about mixing alcohol with medicines.

How alcohol affects safety

Drinking even a small amount of alcohol can lead to dangerous or even deadly situations because it can impair a person’s judgment, coordination, and reaction time. This increases the risk of falls, car crashes, and other accidents.

Alcohol is a factor in about 30% of suicides and fatal motor vehicle crashes, 40% of fatal burn injuries, 50% of fatal drownings and homicides, and 65% of fatal falls. People should not drink alcohol if they plan to drive, use machinery, or perform other activities that require attention, skill, or coordination.

In older adults, especially, too much alcohol can lead to balance problems and falls, which can result in hip or arm fractures and other injuries. Older people have thinner bones than younger people, so their bones break more easily. Studies show that the rate of various types of fractures in older adults increases with heavy alcohol use.

Adults of all ages who drink alcohol and drive are at higher risk of traffic accidents than those who do not drink. Drinking slows reaction times and coordination, and interferes with eye movement and information processing. People who drink even a moderate amount are at higher risk for traffic accidents, possibly resulting in injury or death to themselves and others. (Note that even without alcohol, the risk of a car accident goes up starting at age 55.) Also, older drivers tend to be more seriously hurt in crashes than younger drivers. Alcohol adds to these age-related risks.

In addition, alcohol misuse or alcohol use disorder can strain relationships with family members, friends, and others. At the extreme, heavy drinking can contribute to domestic violence and child abuse or neglect. Alcohol use is often involved when people become violent, as well as when they are violently attacked. If you feel that alcohol is endangering you or someone else, call 911 or obtain similar help right away.

What are signs of alcohol misuse or alcohol use disorder?

Alcohol misuse or alcohol use disorder is a pattern of drinking that can cause harm to a person’s health and social relationships. Drinking too much at one time or on any given day or having too many drinks over the course of a week increases the risk of harmful consequences, including injuries and health problems. Men should not have more than two drinks a day and women only one. Drinking less alcohol is better for health than drinking more.

The definition of “one drink” means:

• One 12-ounce can or bottle of regular beer, ale, or hard seltzer
• One 8- or 9-ounce can or bottle of malt liquor
• One 5-ounce glass of red or white wine
• One 1.5-ounce shot glass of 80-proof distilled spirits like gin, rum, tequila, vodka, or whiskey.

Understanding these “standard” drink sizes can make it easier to follow health guidelines. Another thing to keep in mind is that drinks may be stronger than you think they are if the actual serving sizes are larger than the standard sizes. In addition, drinks within the same beverage category, such as beer, can contain different percentages of alcohol. It’s important to read the label to understand and be aware of how much you’re actually drinking.

Getting the help you need for alcohol misuse or alcohol use disorder

Some people have no trouble cutting back on their drinking. But others will need to stop drinking completely. Alcohol problems can happen to people from all walks of life at any age, and, each year, millions of people seek help for alcohol problems.

If you or someone you love is thinking of changing their habits around alcohol, the “Rethinking Drinking” website, hosted by NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), provides information on signs of a problem and tools that can help lead to better health.

Making a change in your drinking habits can be hard. Don’t give up! If you don’t reach your goal the first time, try again. The good news is you’re not in this alone. Don’t be afraid to talk with a doctor and ask your family and friends for help.

Here are some approaches to try to get started:

• Ask your doctor about advances in medication that might help you stick with alcohol abstinence longer or reduce cravings. Your health care professional may also be able to give you advice about treatment.
• Talk to a trained counselor who knows about alcohol problems in older people.
• Find a support group for older people with alcohol problems. Many people find group counseling sessions or meetings helpful.
• Choose individual, family, or group therapy, depending on what works for you.
• Check out an organization such as Alcoholics Anonymous that offers support and programs for people who want to stop drinking.
• Consider websites or mobile applications that can help you track your alcohol intake and offer positive support as you make progress toward your goals.

Strategies to help cut back or quit drinking

Many older adults decide to quit drinking in later life. You can do it, too. Here are some ways to cut back or stop drinking:

• Count how many ounces of alcohol you are getting in each drink.
• Keep track of the number of drinks you have each day.
• Decide how many days a week you want to drink. Plan some days that are free of alcohol.
• In place of alcohol, try drinking water, juice, or soda. You could also try nonalcoholic “mocktails” or low-alcohol beer.
• Remove alcohol from your home.
• Ask for support from your family and advice from your health care provider. Get the help you need to cut back or quit.

Learn your patterns and plan ahead

As you evaluate your alcohol use, you may find that you drink more often in particular settings or in reaction to certain emotions, such as stress or boredom. Take time to learn about your habits and plan ahead on ways to make a change. Here are some ideas:

• Develop interests that don’t involve alcohol.
• Avoid people, places, and situations that may trigger your drinking.
• Avoid drinking when you’re angry or upset or if you’ve had a bad day.
• Plan what you will do if you have an urge to drink.
• Learn to say “no, thanks” when you’re offered an alcoholic drink.
• Remember to stay healthy for the fun things in life, such as the birth of a grandchild, a long-anticipated trip, or a holiday party.

Your body changes as you get older and that can affect daily routines. Be alert to these changes and think about adjusting your alcohol use so you can enjoy your life to the fullest.

Learn more about available types of alcohol treatment. To find alcohol treatment for yourself or a loved one, visit the NIAAA Alcohol Treatment Navigator.

Other than skin cancer, breast cancer is the most common cancer among American women. For many women, mammograms are the best way to find breast cancer early, when it is easier to treat. Mammograms can find cancer before it is big enough to feel or cause symptoms.

Symptoms

There are different symptoms of breast cancer, and some people have no symptoms at all. Symptoms can include:

• Any change in the size or the shape of the breast.
• Pain in any area of the breast.
• Nipple discharge other than breast milk (including blood).
• A new lump in the breast or underarm.

If you have any signs that worry you, see your doctor right away.

Risk factors

Some main factors that affect your chance of getting breast cancer include:

• Being a woman.
• Being older. Most breast cancers are found in women who are 50 or older.
• Having changes in your BRCA1 or BRCA2 genes.

How to lower your risk

You can do things to help lower your breast cancer risk.

• Keep a healthy weight and be physically active.
• Choose not to drink alcohol, or drink alcohol in moderation.
• If you are taking hormone replacement therapy or birth control pills, ask your doctor about the risks.
• Breastfeed your children, if possible.

Fast facts

• Each year in the United States, about 270,000 women get breast cancer and 42,000 women die from the disease.
• Men also get breast cancer, but it is not very common. About 1 out of every 100 breast cancers diagnosed in the United States is found in a man.
• Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women.

To learn more, please visit https://www.cdc.gov/cancer/features/breast-cancer.html.