Current Awareness in Aging Research (CAAR) Report #455--September 18, 2008

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. Reports and articles:

1. AGINGSTATS.GOV CHARTBOOK: "Selected Indicators of Retirement Resources Among People Aged 55-64: 1984, 1994, and 2004," (2008, .pdf and HTML format, 45p.).



A. "Social Security Programs Throughout the World: Europe, 2008" (September 2008, .pdf and HTML format, 331p.).

B. "International Update, September 2008" (September 2008, HTML and .pdf format, 2p.).

C. "SSI Monthly Statistics: August 2008 (September 2008, HTML and .pdf format).



A. "Individual Retirement Accounts: Additional IRS Actions Could Help Taxpayers Facing Challenges in Complying with Key Tax Rules," (GAO-08-654, August 2008, .pdf format, 52p.).

B. "Pension Benefit Guaranty Corporation: Some Steps Have Been Taken to Improve Contracting, but a More Strategic Approach is Needed," (GAO-08-871 August 2008, .pdf format, 39p.).



A. "Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2005," (A-18-06-02600, August 2008, .pdf format, 38p.).


In a review of the Centers for Medicare and Medicaid Services' (CMS) Federal Information Security Management Act (FISMA) evaluations of information security programs at Medicare fiscal intermediaries and carriers for fiscal year (FY) 2005, we found that the scope and sufficiency of the evaluations adequately encompassed the eight FISMA requirements. CMS contracted with an outside firm to provide a comprehensive program to perform testing of security, but we could not determine the scope or sufficiency of the work for the data center technical assessments because we could not determine the extent of the contractor's work.

Each Medicare contractor must have its information security program evaluated annually by an independent entity. The Inspector General must submit to Congress annual reports on the results of these evaluations, as well as their scope and sufficiency. This report fulfills that responsibility for FY 2005.

We recommended that CMS review contractor documentation related to future data center technical assessments and ensure that contractor documentation complies with CMS contractual requirements. In written comments on our draft report, CMS concurred with our recommendation. CMS also provided clarifying information on technical issues that we used to modify our report where appropriate.

B. "Medicare Payments for Facet Joint Injection Services," (OEI-05-07-00200, September 2008, .pdf format, 31p.).


Sixty-three percent of facet joint injection services allowed by Medicare in 2006 did not meet Medicare program requirements, resulting in approximately $96 million in improper payments for physician services. Medicare allowed an additional $33 million in improper payments for associated facility claims.

Facet joint injections are an interventional pain management technique used to diagnose or treat back pain. Medicare Part B carriers are responsible for implementing program safeguards for these services. Services provided in an office were more likely to have an error than those provided in an ambulatory surgical center or a hospital outpatient department. We also found that in 2006, most carriers had policies and safeguards for facet joint injection services but they identified limits to using these safeguards.

Based on these findings, we recommend that CMS strengthen program safeguards to prevent improper payment for these services and clarify billing instructions for bilateral services. In addition, CMS should take appropriate action regarding the undocumented, medically unnecessary, and miscoded services identified in our review. CMS described steps that it will take to address our recommendation to strengthen program safeguards for facet joint injection services. CMS agreed with our recommendations to clarify billing instructions for bilateral services and to take appropriate action on services paid in error in our sample.


5. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY: "Survey Users Guide Nursing Home Survey on Patient Safety Culture," (No. 08-0060, September 2008, pdf format, 57p).


6. CENTERS FOR MEDICARE AND MEDICAID SERVICE PRESS RELEASE: "Medicare Issues New Rules to Enforce Marketing Requirements During Upcoming Health and Drug Plan Enrollment Period," (September 15, 2008).

More information about the new rules is available at:


7. NATIONAL INSTITUTES OF HEALTH PRESS RELEASE: "New NIH Research Initiative to Test Treatments for Menopausal Symptoms," (September 17, 2008).


8. US DEPARTMENT OF COMMERCE PRESS RELEASE: "Gutierrez Announces Nursing Homes Residents and P.O. Box Households Eligible to Receive Converter Box Coupons," (September 16, 2008).

A link to the coupon program ( can be found at the end of the press release.


9. NORTH DAKOTA STATE DATA CENTER PRESENTATION: "Regional Demographic Shifts and Their Implications for Hospice," (September 2008, PowerPoint format).



A. "Aged Care Planning Advisory Committees," (September 2008, .pdf and HTML format, 3p.).

B. "$150 million - 1,455 nursing home beds and community care packages for older Australians in areas of high need - election commitment," (September 2008, .pdf and HTML format, 2p.).


11. AGEING RESEARCH ONLINE [AUSTRALIA] PERIODICAL: Ageing Research Online Newsletter (Vol. 5, No. 3, September 2008, .pdf format, 12p.).



A. "Living and Caring? An Investigation of the Experiences of Older Carers," by Andy Ross, James Lloyd, Michael Weinhardt, and Hayley Cheshire (September 2008, .pdf format, 61p.).

B. "Living and Caring for All," by James Lloyd (September 2008, .pdf format, 26p.).


13. POPULATION REFERENCE BUREAU ARTICLE: "The 'Lucky Few' Reveal the Lifelong Impact of Generation," by Eric Zuehlke (September 2008).


14. CENTER FOR RETIREMENT RESEARCH AT BOSTON COLLEGE ISSUE BRIEF: "Do State Economics or Individual Characteristics Determine Whether Older Men Work?" by Alicia H. Munnell, Mauricio Soto, Robert K. Triest, and Natalia A. Zhivan (IB No. 8-13, September 2008, .pdf format, 12p.).



A. "Millions of Low-Income Americans Can't Get Medicaid: What Can Be Done?" by Stan Dorn (September 2008, .pdf format, 36p.).

B. "Determining Whether 401(k) Plan Fees are Reasonable: Are Disclosure Requirements Adequate?" by Sandy Mackenzie (September 2008, .pdf format, 9p.).

C. The following Prime Time Radio shows (RealPlayer format, running time, between 23 and 30 minutes) have been added to the PTR site:

An Owner's Guide to the Woman's Heart--Sep. 16, 2008

Blue Zones--Sep. 16, 2008

Note: this is a temporary address. When new PTR shows are released, these will be available at:



A. "Pitching Private Medicare Plans: An Analysis of Medicare Advantage and Prescription Drug Plan Advertising," by Xiaomei Cai, Gary Kreps, Jim McAuley, and Xiaoquan Zhao, Michelle Kitchman Strollo, Tricia Neuman, and Kim Boortz (September 2008, .pdf format, 29p.).

B. "The Federal Government's Authority To Regulate Advertising in Medicare," by Vicki Gottlich (September 2008, .pdf format, 12p.).


17. URBAN INSTITUTE REPORT: "Distributional Analysis of Pension and Social Security Reforms: Alternative Approaches and a Report on an Expert Panel Meeting," by Eric Toder (September 2008, .pdf format, 21p.).


18. CENTER ON BUDGET AND POLICY PRIORITIES REPORT: "Removing Barriers to Retirement Saving in Medicaid and Supplemental Security Income," (No. 2008-03, September 2008, .pdf format, 23p.).


19. TRANSAMERICA CENTER FOR RETIREMENT STUDIES REPORT: "Single Women in the U.S.A.: Retirement Dreams v. Financial Realities," (September 2008, .pdf format, 37p.).

More information about the Center:


20. FAMILY CAREGIVERS ALLIANCE PERIODICAL: Caregiving PolicyDigest (Vol. 8, No. 17, Aug. 20, 2008).

More information about NCA:



A. "FOXO3A genotype is strongly associated with human longevity," by Bradley J. Willcox, Timothy A. Donlon, Qimei He, Randi Chen, John S. Grove, Katsuhiko Yano, Kamal H. Masaki, D. Craig Willcox, Beatriz Rodriguez, and J. David Curb (Vol. 105, No. 37, September 16, 2008, p. 13987-13992).

B. "Peripheral A-{beta} subspecies as risk biomarkers of Alzheimer's disease," by Nicole Schupf, Ming X. Tang, Hide Fukuyama, Jennifer Manly, Howard Andrews, Pankaj Mehta, Jeffery Ravetch, and Richard Mayeux (Vol. 105, No. 37, September 16, 2008, p. 14052-14057).

C. "C-terminal peptides coassemble into A-{beta} 42 oligomers and protect neurons against A-{beta}42-induced neurotoxicity," by Erica A. Fradinger, Bernhard H. Monien, Brigita Urbanc, Aleksey Lomakin, Miao Tan, Huiyuan Li, Sean M. Spring, Margaret M. Condron, Luis Cruz, Cui-Wei Xie, George B. Benedek, and Gal Bitan (Vol. 105, No. 37, September 16, 2008, p. 14175-14180).


22. NATURE ARTICLE ABSTRACT: "An intrinsic mechanism of corticogenesis from embryonic stem cells," by Nicolas Gaspard, Tristan Bouschet, Raphael Hourez, Jordane Dimidschstein, Gilles Naeije, Jelle van den Ameele, Ira Espuny-Camacho, Ade Herpoel, Lara Passante, Serge N. Schiffmann, Afsaneh Gaillard & Pierre Vanderhaeghen (Vol. 455, No. 7211, September 18, 2008, p. 351-357).


23. SCIENCE REPORT ABSTRACT: "Clusters of Hyperactive Neurons Near Amyloid Plaques in a Mouse Model of Alzheimer's Disease," by Marc Aurel Busche, Gerhard Eichhoff, Helmuth Adelsberger, Dorothee Abramowski, Karl-Heinz Wiederhold, Christian Haass, Matthias Staufenbiel, Arthur Konnerth, and Olga Garaschuk (Vol. 321, No. 5896, September 19, 2008, p. 1686-1689).


24. BRITISH MEDICAL JOURNAL ARTICLE: "Exposure to antipsychotics and risk of stroke: self controlled case series study," by Ian J Douglas and Liam Smeeth (BMJ 2008;337:a1227, September 13, 2008, .pdf and HTML format).



A. "Estimating Long-Term Survival of Critically Ill Patients: The PREDICT Model," by Kwok M. Ho, Matthew Knuiman, Judith Finn, and Steven A. Webb (PLoS ONE 3(9): e3226. doi:10.1371/journal.pone.0003226, HTML, XML and .pdf format, 8p.).

B. "Imaging Mass Spectrometry Technology and Application on Ganglioside Study; Visualization of Age-Dependent Accumulation of C20-Ganglioside Molecular Species in the Mouse Hippocampus," by Yuki Sugiura, Shuichi Shimma, Yoshiyuki Konishi, Maki K. Yamada, and Mitsutoshi Setou (PLoS ONE 3(9): e3232. doi:10.1371/journal.pone.0003232, HTML, XML and .pdf format, 9p.).

C. "A{beta} Mediated Diminution of MTT Reduction-An Artefact of Single Cell Culture?" by Raik Ricke, Anja Klemm, Jessica Meinhardt, Ulrich H. Schrer, Marcus Fdrich, and Klaus G. Reymann (PLoS ONE 3(9): e3236. doi:10.1371/journal.pone.0003236, HTML, XML and .pdf format, 9p.).

D. "Amyloid Oligomer Conformation in a Group of Natively Folded Proteins," by Yuji Yoshiike, Ryoichi Minai, Yo Matsuo, Yun-Ru Chen, Tetsuya Kimura, and Akihiko Takashima (PLoS ONE 3(9): e3235. doi:10.1371/journal.pone.0003235, HTML, XML and .pdf format, 9p.).



A. "No Place Like Home - Testing a New Model of Care Delivery," by John K. Iglehart (Vol. 359, No. 12, September 18, 2008, p. 1200-1202).

B. "Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events," by Salim Yusuf, Hans-Christoph Diener, Ralph L. Sacco, Daniel Cotton, Stephanie npuu, William A. Lawton, Yuko Palesch, ReneH. Martin, Gregory W. Albers, Philip Bath, Natan Bornstein, Bernard P.L. Chan, Sien-Tsong Chen, Luis Cunha, Bjn Dahl, Jacques De Keyser, Geoffrey A. Donnan, Conrado Estol, Philip Gorelick, Vivian Gu, Karin Hermansson, Lutz Hilbrich, Markku Kaste, Chuanzhen Lu, Thomas Machnig, Prem Pais, Robin Roberts, Veronika Skvortsova, Philip Teal, Danilo Toni, Cam VanderMaelen, Thor Voigt, Michael Weber, and Byung-Woo Yoon, for the PRoFESS Study Group (Vol. 359, No. 12, September 18, 2008, p. 1225-1237).

C. "Aspirin and Extended-Release Dipyridamole versus Clopidogrel for Recurrent Stroke," by Ralph L. Sacco, Hans-Christoph Diener, Salim Yusuf, Daniel Cotton, Stephanie npuu, William A. Lawton, Yuko Palesch, ReneH. Martin, Gregory W. Albers, Philip Bath, Natan Bornstein,Bernard P.L. Chan, Sien-Tsong Chen, Luis Cunha, Bjn Dahl, Jacques De Keyser, Geoffrey A. Donnan, Conrado Estol, Philip Gorelick, Vivian Gu, Karin Hermansson, Lutz Hilbrich, Markku Kaste, Chuanzhen Lu, Thomas Machnig, Prem Pais, Robin Roberts, Veronika Skvortsova, Philip Teal, Danilo Toni, Cam VanderMaelen, Thor Voigt, Michael Weber, and Byung-Woo Yoon, for the PRoFESS Study Group (Vol. 359, No. 12, September 18, 2008, p. 1238-1251).


27. NEWSWEEK ARTICLE: "Invisible And Overlooked: A growing population of lesbian and gay senior citizens seeks recognition for their unique needs and challenges," by Jessica Bennett (September 18, 2008).


II. Working Papers:

28. UNIVERSITY OF MICHIGAN RETIREMENT RESEARCH CENTER: "Deferred Annuities and Strategic Asset Allocation," by Wolfram J. Horneff and Raimond H. Maurer (WP 2008-178, August 2008, .pdf format, 25p.). Links to the abstract and full-text can be found at:



A. "Health Indexes and Retirement Modeling in International Comparisons," by Erik Meijer, Arie Kapteyn, and Tatiana Andreyeva (WR614, August 2008, .pdf format, 64p.). Links to the abstract and full-text can be found at:

B. "Differential Mortality in Europe and the U.S.: Estimates Based on Subjective Probabilities of Survival," by Adeline Delavande and Susann Rohwedder (WR613, July 2008, .pdf format, 37p.). Links to the abstract and full-text can be found at:



A. "The Age Discrimination in Employment Act and the Challenge of Population Aging," by David Neumark (w14317, September 2008, .pdf format, 39p.).


This paper reviews evidence on age discrimination in U.S. labor markets and on the effects of the Age Discrimination in Employment Act (ADEA) in combating this discrimination. It focuses on the challenge of population aging facing the U.S. economy in coming decades. Combating age discrimination is likely to help in meeting this challenge by encouraging employment of older individuals. But the paper also explores how rapid aging of the population protected by the ADEA might inhibit the ADEA's effectiveness, and raises questions about possible changes in age discrimination policies and enforcement that could enhance the ability of the ADEA to mitigate some of the adverse consequences of population aging.

B. "Medicare Part D's Effects on Elderly Drug Costs and Utilization," by Jonathan D. Ketcham and Kosali Simon (w14326, September 2008, .pdf format, 19p.).


We analyze Medicare Part Ds net effect on elderly out-of-pocket (OOP) costs and use of prescription drugs using a dataset containing 1.4 billion prescription records from Wolters Kluwer Health (WKH). These data span the period December 2004-December 2007 and include pharmacy customers whose age as of 2007 is greater than 57 years. The outcomes we examine are OOP cost per days supply of a medication, the days of medication supplied per capita, and the number of individuals filling prescriptions. We compare outcomes before vs. after January 2006, for those over age 66 years vs. for those age 58-64 years, adjusting for the under-reporting of certain cash-only transactions in the WKH data. Our results indicate that from 2005-2007, Part D reduced elderly OOP costs per days supply of medication by 21.7%, and increased elderly use of prescription drugs by 4.7%, implying a price elasticity of demand of -0.22. These effects occurred primarily during the first year of the program. An age- and time-standardized comparison of our quantity results with previous estimates from Walgreens data shows that our findings are 2.6 times as large. We conclude that Part D lowered elderly patients OOP costs substantially and increased utilization modestly, and note that in comparing results across studies on this topic, magnitudes may vary substantially due to differences in data and methods.

C. "Long-Term Care of the Disabled Elderly: Do Children Increase Caregiving by Spouses?" by Liliana E. Pezzin, Robert A. Pollak, and Barbara S. Schone (w14328, September 2008, .pdf format, 26p.).


Do adult children affect the care elderly parents provide each other? We develop two models in which the anticipated behavior of adult children provides incentives for elderly parents to increase care for their disabled spouses. The "demonstration effect" postulates that adult children learn from a parent's example that family caregiving is appropriate behavior. The "punishment effect" postulates that adult children may punish parents who fail to provide spousal care by not providing future care for the nondisabled spouse when necessary. Thus, joint children act as a commitment mechanism, increasing the probability that elderly spouses will provide care for each other; stepchildren with weak attachments to their parents provide weaker incentives for spousal care than joint children. Using data from the HRS, we find evidence that spouses provide more care when they have children with strong parental attachment.

D. "Managing Contribution and Capital Market Risk in a Funded Public Defined Benefit Plan: Impact of CVaR Cost Constraints," by Raimond Maurer, Olivia S. Mitchell, and Ralph Rogalla (w14332, September 2008, .pdf format, 32p.).


Using a Monte Carlo framework, we analyze the risks and rewards of moving from an unfunded defined benefit pension system to a funded plan for German civil servants, allowing for alternative strategic contribution and investment patterns. In the process we integrate a Conditional Value at Risk (CVaR) restriction on overall plan costs into the pension manager's objective of controlling contribution rate volatility. After estimating the contribution rate that would fully fund future benefit promises for current and prospective employees, we identify the optimal contribution and investment strategy that minimizes contribution rate volatility while restricting worst-case plan costs. Finally, we analyze the time path of expected and worst-case contribution rates to assess the chances of reduced contribution rates for current and future generations. Our results show that moving toward a funded public pension system can be beneficial for both civil servants and taxpayers.

E. "Socioeconomic Status and Health: Dimensions and Mechanisms," by David M. Cutler, Adriana Lleras-Muney, and Tom Vogl (w14333, September 2008, .pdf format, 53p.).


This paper reviews the evidence on the well-known positive association between socioeconomic status and health. We focus on four dimensions of socioeconomic status -- education, financial resources, rank, and race and ethnicity -- paying particular attention to how the mechanisms linking health to each of these dimensions diverge and coincide. The extent to which socioeconomic advantage causes good health varies, both across these four dimensions and across the phases of the lifecycle. Circumstances in early life play a crucial role in determining the co-evolution of socioeconomic status and health throughout adulthood. In adulthood, a considerable part of the association runs from health to socioeconomic status, at least in the case of wealth. The diversity of pathways casts doubt upon theories that treat socioeconomic status as a unified concept.


31. CENTER FOR ECONOMIC STUDIES/Ifo INSTITUTE FOR ECONOMIC RESEARCH (CESifo) [MUNICH, GERMANY]: "On Myopia as Rationale for Social Security," by Torben Andersen and Joydeep Bhattacharya (CESifo Working Paper No. 2401, September 2008, .pdf format, 23p.). Links to the abstract and full-text can be found at:


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

32. Aging and Mental Health (Vol. 12, No. 4, September 2008).

33. Alzheimer's & Dementia: The Journal of the Alzheimer's Association (Vol. 4, No. 5, September 2008).

34. Health Economics, Policy and Law (Vol. 3, No. 4, October 2008).

35. Medical Care Research and Review (Vol. 65, No. 5, October 2008). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for the availability of this database and this issue.


36. 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 September 17, 2008:

B. Alzheimer's Disease: Literature for the week of September 17, 2008:

C. Parkinson's Disease: Literature for the week of September 17, 2008:

D. Prostate Cancer: Literature for the week of September 17, 2008:

E. Stem Cell Research: Literature for the week of September 17, 2008:

F. Ophthalmology: Literature for the week of September 17, 2008:

AMEDEO Literature Guide:


IV. Funding Opportunities:

37. RAND LABOR AND POPULATION PROGRAM: "RAND Postdoctoral Training Program in the Study of Aging," (the deadline for applications is February 9, 2009). "The RAND Postdoctoral Training Program in the Study of Aging enables outstanding junior scholars in demographic and aging research to sharpen their analytic skills, learn to communicate research results effectively, and advance their research agenda."


V. Conferences:

38. US DEPARTMENT OF HEALTH AND HUMAN SERVICES, ASSISTANT SECRETARY FOR PLANNING & EVALUATION/DISTRICT OF COLUMBIA SOCIOLOGICAL SOCIETY: "Retirement Resources Workshop: Exploring the implications of resource disparities among adults nearing retirement," (December 5, 2008, 1-4pm., Washington, DC).


VI. Legislation Information Updates:

39. US HOUSE COMMITTEE ON WAYS AND MEANS, SUBCOMMITTEE ON HEALTH HEARING TESTIMONY: "Hearing on Reforming Medicare's Physician Payment System," a hearing held September 11, 2008.

Testimony in HTML format:


40. US HOUSE COMMITTEE ON WAYS AND MEANS, SUBCOMMITTEE ON SOCIAL SECURITY HEARING TESTIMONY: "Hearing on the Performance of Social Security Administration Appeals Hearing Offices," a hearing held September 16, 2008).

Testimony in HTML format:


41. US SENATE SPECIAL COMMITTEE ON AGING HEARING TESTIMONY: "Marketing or Medicine: Are Direct-to-Consumer Medical Device Ads Playing Doctor?" a hearing held September 17, 2008.

Testimony in .pdf format:


42. US SENATE COMMITTEE ON FINANCE HEARING TESTIMONY: "Aligning Incentives: The Case for Delivery System Reform," a hearing held September 16, 2008 (statements are in .pdf format).


VII. Websites of Interest:

43. KAISEREDU.ORG: "Health Care and Long-Term Care Policy: Concerns Facing Older Women," is an online tutorial designed to "provide an overview of health coverage and cost challenges for women older than age 65." The slide show is narrated by Alina Salganicoff.



A. "Physician and Other Healthcare Professional Directory" (Sept. 18, 2008).

B. "Home Health Compare" (Sept. 18, 2008).

C. "Nursing Home Compare" (Sept. 18, 2008).

D. "Hospital Compare" (Sept. 18, 2008).

Scroll to "Data Updates".


45. CENTERS FOR MEDICARE AND MEDICAID SERVICES: Today, CMS announced the release of a new web site to provide caregivers with information about Medicare. The new site can be found at:

Related CMS Press Release:




Charlie Fiss
Information Manager
Data and Information Services Center
Rm. 3329 Social Science Bldg
1180 Observatory Drive
Madison, WI 53706-1393
Phone: (608) 265-9240
Fax: (608) 262-8400