Current Awareness in Aging Research (CAAR) Report #317--December 15, 2005


CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:

1. NATIONAL CENTER FOR HEALTH STATISTICS: "NHANES [National Health and Nutrition Examination Survey] 2003-2004," (December 2005). Demographics and Body Measurement files (SAS Transport format (.xpt), along with documentation (.pdf format) have been added to the files available for download.

Click on "What's New" and see the items under November 2005.

2. INTER-UNIVERSITY CONSORTIUM FOR POLITICAL AND SOCIAL RESEARCH: ICPSR at the University of Michigan has recently released the following datasets, which may be of interest to demography researchers. Note: Some ICPSR studies are available only to ICPSR member institutions. To find out whether your organization is a member, and whether or not it supports ICPSR Direct downloading, see:

American Community Survey (ACS): Public Use Microdata Sample (PUMS), 2001 (#3890)

American Community Survey (ACS): Public Use Microdata Sample (PUMS), 2000 (#3889)


II. Reports and articles:


A. "Public Housing: Distressed Conditions in Developments for the Elderly and Persons with Disabilities and Strategies Used for Improvement," (GAO-06-163, December 2005, .pdf format, 47p.).

B. "Survey of Public Housing Agencies on Housing for the Elderly and Non-Elderly Persons with Disabilities," (GAO-06-205SP, 2005, .pdf format, 13p.).

Note: This is a temporary address. GAO reports are always available at:

4. CONGRESSIONAL BUDGET OFFICE REPORT: "Global Population Aging in the 21st Century and Its Economic Implications," (December 2005, .pdf format, 34p.).

5. NATIONAL CENTER FOR HEALTH STATISTICS REPORT: "National Hospital Ambulatory Medical Care Survey: 2003 Outpatient Department Summary," by Kimberly Middleton and Esther Hing (_Advance Data from Vital and Health Statistics_, No. 366, December 14, 2005, .pdf format, 36p.).

6. US CENSUS BUREAU FACTS FOR FEATURES: "Oldest Baby Boomers Turn 60!," (December 12, 2005).

7. CENTERS FOR MEDICARE AND MEDICAID SERVICES DECISION MEMORANDUM: "Addition of ICD-9-CM 790.4, Nonspecific Elevation of Levels of Transaminase or Lactic Acid Dehydrogenase, as a Covered Indication for the Hepatitis Panel/Acute Hepatitis Panel National Coverage Determination (NCD)," (December 14, 2005).


A. "Use of Modifier 59 to Bypass Medicare's National Correct Coding Initiative Edits," (OEI-03-02-00771, November 2005, .pdf format, 20p.).


Modifier 59 is used to indicate that a provider performed a distinct procedure or service for a beneficiary on the same day as another procedure or service. This modifier would allow the code pair to bypass the edit and both services would be paid. This inspection found that 40 percent of code pairs billed with modifier 59 in fiscal year 2003 did not meet program requirements, resulting in an estimated $59 million in improper payments. Specifically, modifier 59 was used inappropriately with 15 percent of code pairs because the services were not distinct from each other and with 25 percent of code pairs because the services were not adequately documented. This inspection also found that 11 percent of code pairs billed with modifier 59 in fiscal year 2003 were paid when modifier 59 was billed with the incorrect code. This billing error represented $27 million in Medicare paid claims. In addition, OIG found that most carriers did not conduct reviews of modifier 59 but those carriers that did found providers who were using modifier 59 inappropriately.

OIG recommended that CMS: (1) encourage carriers to conduct prepayment and postpayment reviews of the use of modifier 59 and (2) ensure that carriers' claims processing systems only pay claims with modifier 59 when the modifier is billed with the correct code. CMS concurred with these recommendations.

B. "Use of Modifier 25," (OEI-07-03-00470, November 2005, .pdf format, 17p.)


OIG conducted this study to assess the extent to which use of modifier 25 meets program requirements. Modifier 25 is used to allow additional payment for evaluation and management (E/M) services performed by a provider on the same day as a procedure, as long as the E/M services are significant, separately identifiable, and above and beyond the usual preoperative and postoperative care associated with the procedure. OIG found that 35 percent of claims for E/M services allowed by Medicare in 2002 did not meet program requirements, resulting in $538 million in improper payments. Modifier 25 was also used unnecessarily on a large number of claims, and while such use may not lead to improper payments, it fails to meet program requirements. OIG recommends that CMS work with carriers to reduce the number of claims submitted using modifier 25 that do not meet program requirements, emphasize that providers must maintain appropriate documentation of both the E/M services and procedures, and remind providers that modifier 25 should only be used on claims for E/M services. CMS concurred with OIG's recommendations.

9. PEW RESEARCH CENTER REPORT: "Social Trends Reports Baby Boomers Approach 60: From the Age of Aquarius to the Age of Responsibility," (December 2005, .pdf format, 43p.).

Follow link to "Complete Report".


A. "The Business Case for Workers Age 50+: Planning for Tomorrow's Talent Needs in Today's Competitive Environment," (December 2005, .pdf format, 24p.).

B. "Baby Boomers to Help Seniors Rebuild Lives After Hurricane Disasters," (December 12, 2005).


A. "Distributional Effects of Reforming Social Security through Benefit Reductions," by Gordon Mermin (December 12, 2005, .pdf format, 21p.).

B. "Reforming Social Security through Price and Progressive Price Indexing," by Gordon Mermin (_Older Americans' Economic Security_, Brief #6, December 12, 2005, .pdf format, 2p.).

C. "Women and Social Security," by Melissa Favreault (_Older Americans' Economic Security_, Brief #7, December 12, 2005, .pdf format, 2p.).

D. "Incentives for Older Workers to Remain in the Workforce," by Rudolph G. Penner (December 2005, HTML format).

E. "Employer Motivations for Hiring and Retaining Older Workers," by C. Eugene Steuerle (December 2005, HTML format).


A. "The Diverse Employment Experiences of Older Men and Women in the Workforce," by James T. Bond and Ellen M. Galinsky (Issue 2, November 2005, .pdf format, 19p.).

B. "Context Matters: Insights About Older Workers from the National Study of the Changing Workforce," by James T. Bond and Ellen M. Galinsky (Issue 1, November 2005, .pdf format, 19p.).

For more information about the Families and Work Institute:

13. EMPLOYEE BENEFIT RESEARCH INSTITUTE NEWSLETTER: _Notes_ (Vol. 26, No. 12, December 2005, .pdf format, 18p.).

14. NATIONAL CENTRE FOR SOCIAL RESEARCH [UK] PRESS RELEASE: "British Social Attitudes: the 22nd Report," (December 2005, .pdf format, 17p.). Note: The Survey includes data on attitudes towards retirement saving in the UK.

To order the full report go to:


A. "Activity Implementation Report: National Palliative Care Strategy (October 2005, .pdf and .rtf format, 180p.).

B. "Scoping the Needs of Individuals Living Alone for Palliative Care," (October 2005, .pdf and .rtf format, 44p.).

C. "Building an age-friendly multicultural future for Victoria," (December 9, 2005).

16. _SCIENCE_ BREVIA ABSTRACT: "Increase in Activity During Calorie Restriction Requires Sirt1," by Danica Chen, Andrew D. Steele, Susan Lindquist, and Leonard Guarente (Vol. 310, No. 5754, December 9, 2005, .pdf and HTML format, p. 1641).


A. "Protease nexin-2/amyloid {beta}-protein precursor limits cerebral thrombosis," by Feng Xu, Judianne Davis, Jianting Miao, Mary Lou Previti, Galina Romanov, Kelly Ziegler, and William E. Van Nostrand (Vol. 102, No. 50, December 13, 2005, .pdf and HTML format, p. 18135-18140).

B. "Somatic mtDNA mutations cause aging phenotypes without affecting reactive oxygen species production," by Aleksandra Trifunovic, Anna Hansson, Anna Wredenberg, Anja T. Rovio, Eric Dufour, Ivan Khvorostov, Johannes N. Spelbrink, Rolf Wibom, Howard T. Jacobs, and Nils-Göran Larsson (Vol. 102, No. 50, December 13, 2005, .pdf and HTML format, p. 17993-17998).

18. _LANCET_ ARTICLE ABSTRACT: Note: _Lancet_ requires free registration before providing access. "Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomised, controlled clinical trial," by Bradi B. Granger, Karl Swedberg, Inger Ekman, Christopher B. Granger, Bertil Olofsson, John J.V. McMurray, Salim Yusuf, Eric L. Michelson, and Marc A. Pfeffer, for the CHARM investigators (Vol. 366, No. 9502, December 10, 2005, .pdf and HTML format, p. 2005-2011). Note: As of 5pm CST the _Lancet_ web site is having technical problems and is not available.


A. "Recognising heart failure in elderly patients with stable chronic obstructive pulmonary disease in primary care: cross sectional diagnostic study," by Frans H. Rutten, Karel G. M. Moons, Maarten-Jan M. Cramer, Diederick E. Grobbee, Nicolaas P. A. Zuithoff, Jan-Willem J. Lammers, and Arno W. Hoes (Vol. 331, No. 7529, December 10, 2005, .pdf and HTML format, p. 1379-1381).

B. "Functional limitation in long standing illness and quality of life: evidence from a national survey," by Gopalakrishnan Netuveli, Richard D. Wiggins, Zoe Hildon, Scott M. Montgomery, David Blane (Vol. 331, No. 7529, December 10, 2005, .pdf and HTML format, p. 1382-1383).

C. "Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study," by J. J. W. Roche, R. T. Wenn, O. Sahota, and C. G. Moran (Vol. 331, No. 7529, December 10, 2005, .pdf and HTML format, p. 1374-1376).

D. "The ageing population of the United Kingdom and cardiovascular disease," by Azeem Majeed and Paul Aylin (Vol. 331, No. 7529, December 10, 2005, .pdf and HTML format, p. 1362).

20. _JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION_ ARTICLE ASTRACT: "Dietary Fiber Intake and Risk of Colorectal Cancer: A Pooled Analysis of Prospective Cohort Studies," by Yikyung Park, David J. Hunter, Donna Spiegelman, Leif Bergkvist, Franco Berrino, Piet A. van den Brandt, Julie E. Buring, Graham A. Colditz, Jo L. Freudenheim, Charles S. Fuchs, Edward Giovannucci, R. Alexandra Goldbohm, Saxon Graham, Lisa Harnack, Anne M. Hartman, David R. Jacobs Jr, Ikuko Kato, Vittorio Krogh, Michael F. Leitzmann, Marjorie L. McCullough, Anthony B. Miller, Pirjo Pietinen, Thomas E. Rohan, Arthur Schatzkin, Walter C. Willett, Alicja Wolk, Anne Zeleniuch-Jacquotte, Shumin M. Zhang, and Stephanie A. Smith-Warner (Vol. 294, No. 22, December 14, 2005, .pdf and HTML format, p. 2849-2857).

21. COMMUNITY PARTNERSHIPS FOR OLDER ADULTS NEWSLETTER: _Community View_ (Vol. 2, No. 4, December 2005).


III. Working Papers:


A. "Who's Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," by Laurence Kotlikoff and Christian Hagist (w11833, December 2005, .pdf format, 39p.).


Government healthcare expenditures have been growing much more rapidly than GDP in OECD countries. For example, between 1970 and 2002 these expenditures grew 2.3 times faster than GDP in the U.S., 2.0 times faster than GDP in Germany, and 1.4 times faster than GDP in Japan.

How much of government healthcare expenditure growth is due to demographic change and how much is due to increases in benefit levels; i.e., in healthcare expenditures per beneficiary at a given age? This paper answers this question for ten OECD countries -- Australia, Austria, Canada, Germany, Japan, Norway, Spain, Sweden, the UK, and the U.S. Specifically, the paper decomposes the 1970 - 2002 growth in each countrys healthcare expenditures into growth in benefit levels and changes in demographics.

Growth in real benefit levels has been remarkably high and explains the lions share - 89 percent - of overall healthcare spending growth in the ten countries. Norway, Spain, and the U.S. recorded the highest annual benefit growth rates. Norways rate averaged 5.04 percent per year. Spain and the U.S. were close behind with rates of 4.63 percent and 4.61 percent, respectively.

Allowing benefit levels to continue to grow at historic rates is fraught with danger given the impending retirement of the baby boom generation. In Japan, for example, maintaining its 1970-2002 benefit growth rate of 3.57 percent for the next 40 years and letting benefits grow thereafter only with labor productivity entails present value healthcare expenditures close to 12 percent of the present value of GDP. By comparison, Japans government is now spending only 6.7 percent of Japans current output on healthcare.

In the U.S., government healthcare spending now totals 6.6 percent of GDP. But if the U.S. lets benefits grow for the next four decades at past rates, it will end up spending almost 18 percent of its future GDP on healthcare. The difference between the Japanese 12 percent and U.S. 18 percent figures is remarkable given that Japan is already much older than the U.S. and will age more rapidly in the coming decades.

Although healthcare spending is growing at unsustainable rates in most, if not all, OECD countries, the U.S. appears least able to control its benefit growth due to the nature of its fee-for-service healthcare payment system. Consequently, the U.S. may well be in the worst long-term fiscal shape of any OECD country even though it is now and will remain very young compared to the majority of its fellow OECD members.

B. "Aging, Pension Reform, and Capital Flows: A Multi-Country Simulation Model," by Axel Boersch-Supan, Alexander Ludwig, and Joachim Winter (w11850, December 2005, .pdf format, 43p.).


Population aging and pension reform will have profound effects on international capital markets. First, demographic change alters the time path of aggregate savings within each country. Second this process may be amplified when a pension reform shifts old-age provision towards more pre-funding. Third, while the patterns of population aging are similar in most countries, timing and initial conditions differ substantially. Hence, to the extent that capital is internationally mobile, population aging will induce capital flows between countries. All three effects influence the rate of return to capital and interact with the demand for capital in production and with labor supply. In order to quantify these effects, we develop a computational general equilibrium model. We feed this multi-country overlapping generations model with detailed long-term demographic projections for seven world regions. Our simulations indicate that capital flows from fast-aging regions to the rest of the world will initially be substantial but that trends are reversed when households decumulate savings. We also conclude that closed-economy models of pension reform miss quantitatively important effects of international capital mobility.


A. "Developing New Strategies to Support Future Caregivers of the Aged in Canada: Projections of Need and their Policy Implications," by Janice Keefe, Jacques Légaré, and Yves Carrière (SEDAP Research Paper No. 140, November 2005, .pdf format, 25p.).


Projections of future need for Canadian continuing care services typically uses current utilization patterns and population aging. Accurately assessing this need is much more complex since disability patterns among the elderly are changing and availability of caregivers is affected by changes in family structure. This paper projects annual growth rates between 2001-2031 in the need for informal and formal support among elderly Canadians and discusses the policy implications of the increasing demand for informal caregivers. Using Statistics Canada's LifePaths micro-simulation model, these projections incorporate disability rates and the potential availability of informal caregivers. The authors conclude that continued focus on family to meet the needs of elderly Canadians without increased support is not sustainable in the long term. New strategies to support Canadian caregivers are proposed and their economic feasibility in the public and private markets are evaluated.

B. "Welfare Restructuring without Partisan Cooperation: The Role of Party Collusion in Blame Avoidance," by Martin Hering (SEDAP Research Paper No. 141, November 2005, .pdf format, 41p.).


This article argues that welfare state restructuring, which is highly unpopular among voters, is politically feasible if government and opposition parties collude informally with each other. Contrary to key arguments made in the literature, restructuring does not require the formation of a formal grand coalition which diffuses blame from voters. Party collusion is a distinctive blame-avoiding strategy that differs not only from other party-oriented strategies such as building a grand coalition, but also from voter-oriented ones. By analyzing the politics of pension reform in Germany from 1995 to 2004, this article shows that party collusion, which emerges through repeated signaling and informal agreements, enables political parties to restructure the welfare state without running the risk of electoral failure. Finally, it suggests that collusion likely explains recent successes of Austrian, French and Italian governments in legislating unpopular welfare cutbacks.

24. INSTITUTE FOR THE STUDY OF LABOR (IZA) [University of Bonn, Germany]:

A. "Demographic Alternatives for Aging Industrial Countries: Increased Total Fertility Rate, Labor Force Participation, or Immigration," by Robert Holzmann (Discussion Paper No. 1885, December 2005, .pdf format, 30p.).


The paper investigates the demographic alternatives for dealing with the projected population aging and low or negative growth of the population and labor force in the North. Without further immigration, the total labor force in Europe and Russia, the high-income countries of East Asia and the Pacific, China, and, to a lesser extent, North America is projected to be reduced by 29 million by 2025 and by 244 million by 2050. In contrast, the labor force in the South is projected to add some 1.55 billion, predominantly in South and Central Asia and in Sub-Saharan Africa. The demographic policy scenarios to deal with the projected shrinking of the labor forth in the North include moving the total fertility rate back to replacement levels, increasing labor force participation of the existing population through a variety of measures, and filling the demographic gaps through enhanced immigration. The estimations indicate that each of these policy scenarios may partially or even fully compensate for the projected labor force gap by 2050. But a review of the policy measures to make these demographic scenarios happen also suggests that governments may not be able to initiate or accommodate the required change.

B. "Labour Force Participation of the Elderly in Europe: The Importance of Being Healthy," by Adriaan Kalwij and Frederic Vermeulen (Discussion Paper No. 1887, December 2005, .pdf format, 30p.).


In this paper we study labour force participation behaviour of individuals aged 50-64 in 11 European countries. The data are drawn from the new Survey of Health, Ageing and Retirement in Europe (SHARE). The empirical analysis shows that health is multi-dimensional, in the sense that different health indicators have their own significant impact on individuals' participation decisions. Health effects differ markedly between countries. A counterfactual exercise shows that improved health conditions may yield over 10 percentage points higher participation rates for men in countries like Austria, Germany and Spain, and for females in the Netherlands and Sweden. Moreover, we show that the declining health condition with age accounts considerably for the decline in participation rates with age.

25. ECONOMIC WORKING PAPER ARCHIVE [WASHINGTON UNIVERSITY AT ST. LOUIS]: "Long-Term Labour Force Projections for the 25 EU Member States: A set of data for assessing the economic impact of ageing," by Giuseppe Carone (European Economy Working Paper No. 235, November 2005, .pdf format, 214p.).


This paper presents the methodology and results of labour force projections over the long term (until 2050) for each of the 25 EU Member States. These projections were undertaken in order to provide the background technical inputs for the assessment of the potential economic and fiscal impact of an ageing population. The projections presented in this paper show the outcome for the labour force of extrapolating recent trends in labour market behaviour (entry and exit rates from the labour market). These base case projections reflect the working assumption of -no policy change- and are neither forecasts nor predictions in that they are not based on any assessment of more or less likely future changes in working patterns or economic conditions. To summarise the outcome of projections, the baseline scenario indicates that, notwithstanding the projected increase in the participation rates and the reduction in unemployment rates, the pace of labour force and employment growth in the EU25 will be weakly positive over the next 15 years and will turn negative over the period 2018 to 2050. These is mainly the outcome of projected declining trends for the working-age population and a shift in the age structure of the population towards older, less participating groups - a consequence of the baby-boom generation approaching retirement and the succeeding lower-birth-rate cohorts reaching working age.


IV. Journal Tables of Contents (check your library for availability):

26. American Economic Review (No. 95, No. 5, December 2005). Note: Full electronic text of this journal is available in the ProQuest Research Library and the EBSCO Host Academic Search Elite Database. Check your library for the availability of these databases and this issue.

27. Gerontechnology (Vol. 4, No. 2, October 2005).

28. Research on Aging (Vol. 28, No. 1, January 2006). Note: Full electronic text of this journal is available in the ProQuest Research Library and the EBSCO Host Academic Search Elite Database. Check your library for the availability of these databases and this issue.

29. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "advanced search"
C. Type in your publication name and click "Exact title" radio button
D. Under "Show", click the "fax/ariel" radio button.
E. View the table of contents for the issue noted.

Journal of Adult Development (Vol. 12, No. 2-3, August 2005).

Journal of the American Geriatrics Society (Vol. 53, No. 12, 2005).


30. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of December 14, 2005:

B. Alzheimer's Disease: Literature for the week of December 14, 2005:

C. Parkinson's Disease: Literature for the week of December 14, 2005:

D. Prostate Cancer: Literature for the week of December 14, 2005:

E. Stem Cell Research: Literature for the week of December 14, 2005:

F. Ophthalmology: Literature for the week of December 14, 2005:

AMEDEO Literature Guide:


VI. Conferences:

32. CONFERENCEALERTS.COM: has recently updated its gerontology conferences page.

33. NATIONAL INSTITUTES OF HEALTH: Summer Institute on Aging Research, Aspen Wye River, Queenstown, Maryland, July 8-14, 2006.

"The Summer Institute on Aging Research program includes lectures, seminars, and small group discussions in research design relative to aging, including issues relevant to aging of ethnic and racial minorities. Lectures will cover topics in research on aging, including: the biology of aging; genetics and Alzheimer's disease; and health, behavior, and aging. Discussion sessions will focus on methodological approaches and interventions. The program also will include consultation on the development of research interests and advice on preparing and submitting research grant applications to NIA."

For more information:

34. UNIVERSITY OF FLORIDA/AMERICAN OCCUPATIONAL THERAPY ASSOCIATION: "2006 Internations Conference on Aging, Disability and Independent," a conference to be held February 1-5, 2005 (St. Petersburg, FL). "Maintaining independence and active participation in society in later life is something we all hope to attain. Faced with chronic health conditions or life-long or late-onset disabilities, the ability to socialize, to continue working, to enjoy recreation and leisure activities, and to carry out the activities of daily life can be compromised."

35. POPULATION RESEARCH CENTER (AT NORC AND UNIVERSITY OF CHICAGO): Demography Workshop: "January 5, 2006: Martha K. McClintock, David Lee Shillinglaw Distinguished Service Professor, Department of Psychology, will present "Social Isolation and Mammary Cancer: The Psychosocial Regulation of Gene Expression during Aging.""

For abstract:

For more information:


VII. Legislation Information Updates:

36. US HOUSE COMMITTEE ON ENERGY AND COMMERCE, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATION HEARING TESTIMONY: "Safety of Imported Pharmaceuticals: Strengthening Efforts to Combat the Sales of Controlled Substances Over the Internet," a hearing held December 13, 2005.

Hearing testimony:


VIII. Websites of Interest:

37. KAISER FAMILY FOUNDATION: "" KFF has added "Medicare Drug Benefit Low-Income Subsidy Applications as of 11/29/05," to its interactive web extractor.

See the entry "Medicare Drug Benefit Low-Income Subsidy Applications as of 11/29/05," listed on "12/06/05".

For more on see:

38. WHITE HOUSE CONFERENCE ON AGING: The 2005 White House Conference on Aging is being held December 11-14, 2005. Links to coverage of the conference (via C-Span and Kaiser Family Foundation) are available. For more information go to:




Charlie Fiss
Information Manager
Center for Demography and Ecology and
Center for Demography of Health and Aging
Rm. 4470A Social Science Bldg
1180 Observatory Drive
Madison, WI 53706-1393
Phone: (608) 265-9240
Fax: (608) 262-8400