HealthDay (4/5, Dotinga) reports that two studies published online April 4 in the journal Neurology offer “insights into the mysterious phenomenon of rapid cognitive decline in the two or three years before death, and [confirm] that intellectually challenging activities can help keep your mind sharp.” The first study “suggests that while Alzheimer’s disease may nudge the mental decline early on, other causes seem to be at play when the decline speeds up in the years just before death.” HealthDay adds, “Can people do anything to prevent the mind from declining in old age? A second study suggests that’s a possibility — through activities such as reading, playing board games, and doing crossword puzzles.”

An accompanying editorial observed, “The research on declining mental abilities represents an important advance in the science of aging,” MedPage Today (4/5, Smith) reports. The editorial argued that “the controversial issue of de-differentiation’ may hold clues to the biology of aging and is thus ‘an important research topic whose study deepens our understanding of both disease-based and normal biological aging.’

Related Links:

— “Brain Falters Near End of Life, but Games, Puzzles Might Slow Decline,”Randy Dotinga , HealthDay, April 4, 2012.

The Los Angeles Times (4/5, Khan) reports that research “involving more than six million Swedes reveals that the risk of suicide and cardiovascular death increases immediately after a cancer diagnosis.”

HealthDay (4/5, Esposito) reports, “Using nationwide census and death registry data that covered more than six million people over a 15-year period ending in 2006, Swedish researchers tabulated the suicides and cardiovascular fatalities among people with new cancer diagnoses and compared them to similar deaths in those without cancer.”

MedPage Today (4/5, Neale) reports, “In the first week after receiving the diagnosis, patients had a greater risk of committing suicide (RR 12.6, 95% CI 8.6 to 17.8) and of dying from a cardiovascular cause (RR 5.6, 95% CI 5.2 to 5.9) compared with cancer-free people.” The researchers found that “the elevated risk extended up to one year and beyond for suicide, and up to about six months for cardiovascular death.” The study was published April 5 in the New England Journal of Medicine.

Related Links:

— “Cancer diagnosis raises risk of heart attack and suicide, study says,”Amina Khan, Los Angeles Times, April 4, 2012.

In a video commentary for Medscape (4/5), psychiatrist Jeffrey A. Lieberman, MD, of Columbia University, asserts, “What we are seeing in the context of this great recession that we are experiencing, the deficits that are occurring at the state level, and the changes in healthcare delivery that financial pressures are occasioning is a retreat from the mission of mental healthcare.” He adds, “This creates a vicious cycle where the state cuts back, putting more pressure on the nonpublic healthcare” clinicians who are “also under financial pressure. They are also looking for ways to reduce their financial vulnerability, and so they cut services. All of this leaves psychiatry and patients who need psychiatric services in the lurch and out in the cold.”

USA Today (4/5, Zoroya) reports, “As thousands of additional veterans seek mental health care every month, the Department of Veterans Affairs is short of psychiatrists, with 20% vacancy rates in much of the country served by VA hospitals, according to department data.” What’s more, “the vacancies occur at a time when the number of veterans with post-traumatic stress disorder is increasing by about 10,000 every three months, what experts say is the cumulative effect of a decade of war, VA data show.” According to internal data, “the VA has about a 20% shortfall in psychiatrists at hospitals throughout the Northwest, Deep South, and Southern California,” particularly in rural areas with smaller populations.

Sen. Murray Raises Question Whether Cost Factors Into PTSD Diagnosis Decision. In continuing coverage, the AP (4/5) reports that US Sen. Patty Murray (D-WA) “is questioning military and Veterans’ Affairs officials over concerns that cost has been a factor in reversing diagnoses of soldiers found to suffer” from post-traumatic stress disorder (PTSD). Murray’s “questioning came Wednesday at a Tacoma field hearing of the Senate Veterans’ Affairs Committee, which she chairs.” While the AP did not mention what VA officials had to say in response to the questioning, it did report that “military officials pointed out that it is not US policy to deny soldiers and veterans necessary medical care or benefits for financial reasons.” However, some soldiers who have PTSD challenged that claim at Wednesday’s hearing.

Related Links:

— “VA sees shortfall of mental health specialists,”Gregg Zoroya, USA Today, April 5, 2012.

The Washington Post (4/3, Andrews) reports that “depression often goes undiagnosed in the elderly, who feel the stigma of mental illness more acutely than younger people and are often less likely to seek help,” but “the situation may be changing,” because “in October, Medicare began to cover annual depression screening in primary-care settings with no cost sharing for beneficiaries.” The piece notes that “the landscape should change as policymakers and insurers increasingly offer incentives to primary care physicians to transform their practices into medical homes for their patients and reward [clinicians] for better disease control rather than simply running tests and doing procedures.”

Related Links:

— “Depression often goes undiagnosed, but new Medicare benefit may change that,”Michelle Andrews, The Washington Post, April 2, 2012.