Current Awareness in Aging Research (CAAR) Report No. 510 -- October 29, 2009

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 developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:


A. "Census Bureau Releases 2006-2008 American Community Survey Data" (CB09-CN.28, Oct. 27, 2009). The news release links to the data as provided by Census Bureau's American Factfinder.

Interactive Data is also available via Missouri Census Data Center:

B. "Federal, State, and Local Governments Finances of Selected State and Local Government Employee Retirement Systems" (October 2009, ASCII text format).



A. "New Wave VI data are available for Switzerland 2004" (Oct. 27, 2009).

B. "New Wave VI data are available for Italy 2004" (Oct. 28, 2009).

Data access:


II. Reports and articles:

3. US NATIONAL INSTITUTE ON AGING PRESS RELEASE: "NIA Extends Research on Health, Economics of Older Americans" (Oct. 29, 2009).



A. "Retirement Savings: Automatic Enrollment Shows Promise for Some Workers, but Proposals to Broaden Retirement Savings for Other Workers Could Face Challenges" (GAO-10-31, October 2009, .pdf format, 50p.).

B. "Medicare: Per Capita Method Can Be Used to Profile Physicians and Provide Feedback on Resource Use" (GAO-09-802, September 2009, HTML and .pdf format, 46p.).


5. US BUREAU OF LABOR STATISTICS ARTICLE: "The Employment Cost Index and the Impact on Medicare Reimbursements," by Jeffrey L. Schildkraut (October 2009).


6. US CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE AND MEDICAID STATISTICAL SUPPLEMENT UPDATES: The following tables were updated from Oct. 27-29, 2009 (all compressed and uncompressed .pdf format): "End Stage Renal Disease 2008: tables 11.1-11.2"; "Medicare Enrollment 2008" tables 2.1-2.8"; "Brief Summaries of Medicare & Medicaid 2008"; " Medicare SNF: Figures 6.1-6.4"; and Medicare Home Health Agency: Figures 7.1-7.3."


7. MORBIDITY AND MORTALITY WEEKLY REPORT QUICKSTATS: "Average Life Expectancy at Birth, by Race and Sex --- United States, 2000, 2006, and 2007" (US Centers for Disease Control, Vol. 58, No. 42, Oct. 30, 2009, HTML and .pdf format, p. 1185).




8. US DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF THE INSPECTOR GENERAL REPORT: "Beneficiary Appeals in Medicare Advantage" (OEI-01-08-00280, October 2009, .pdf format, 15p.).


We found that Medicare Advantage Organizations (MAO) decided the vast majority of organization determinations in favor of beneficiaries; they denied very few. Of those denials, beneficiaries appealed very few and, upon appeal, MAOs overturned more than half of their own denials.

MAOs must have a procedure to determine whether a beneficiary is entitled to receive health services and the amount, if any, a beneficiary is required to pay for these services. The outcome of this procedure, which must also allow for expedited reviews, is called an "organization determination." MAOs also must offer beneficiaries the right to appeal an adverse determination. Further, the Secretary of the Department of Health and Human Services must contract with an Independent Review Entity (IRE) to review second-level appeals in cases where an MAO has returned an adverse decision to a beneficiary's initial appeal. CMS oversees MAO compliance through audits.

We found that MAOs make the vast majority of organization determinations in favor of beneficiaries, and deny very few. Of these denials, called "adverse determinations," very few were appealed, and upon appeal, MAOs overturned more than half of their own denials. We also found that MAOs decided 23 percent of adverse expedited determinations, and 18 percent of appeals, late. At the second level of appeal, the IRE overturned about one in five adverse MAO decisions. It overturned 25 percent of adverse expedited service reconsiderations, compared with 16 percent of standard service reconsiderations. Finally, CMS identified many Medicare Advantage contracts that failed to meet appeals-related audit elements.

Our review raises questions and concerns. We found that beneficiaries appealed fewer than 1 in 10 adverse determinations. Although no rate of appeal is expected or correct, further study could examine factors that might explain this rate. Further study could also identify differences between denials that beneficiaries appeal and those that beneficiaries do not appeal. Particularly concerning are the problems with timeliness in processing adverse expedited determinations and the higher IRE overturn rate of expedited cases. Because expedited cases concern time-sensitive care, it is important that such care be delivered with minimal delays.


9. EUROPEAN COMMUNITY REPORT: Health Systems in Transition Country Profile: "Japan: Health system review," by Kozo Tatara and Etsuji Okamoto (Vol. 11, No. 5, 2009, .pdf format, 162p.).


10. FAMILY CAREGIVER ALLIANCE PERIODICAL: Caregiving PolicyDigest (Vol. 9, No. 21, Oct. 28, 2009).

More information about FCA:


11. ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT PERIODICAL: Pension Markets In Focus (No. 6, October 2009, .pdf format, 12p., with accompanying tables, Microsoft Excel format).,3343,en_2649_34853_36082019_1_1_1_1,00.html


12. AUSTRALIAN HOUSING AND URBAN RESEARCH INSTITUTE REPORT: "Reverse mortgages and older people: growth factors and implications for retirement decisions," by Catherine Bridge, Mark Mathews, Peter Phibbs, and Toni Adams (No. 123, October 2009, .pdf format, 89p.).



A. "Work-life balance of older workers," by Jorge Uriarte-Landa and Benoit-Paul Hebert (in Perspectives on Labour and Income, Vol. 10, No. 10, October 2009, HTML and .pdf format, p. 17-28).

B."Quick fact: Seniors have the lowest rates of police-reported violence," (in Juristat, Vol. 29, No. 4, October 2009).


14. INSTITUTE NATIONAL D'ETUDES DEMOGRAPHIQUE (INED) [PARIS, FRANCE] PERIODICAL: Population and Societies (No. 460, October 2009, .pdf format, 4p.). The topic of this issue is "The challenges of population ageing and migration in the French overseas departments," by Didier Breton, Sthanie Condon, Claude-Valentin Marie, and Franck Temporal.


15. PENSIONS REGULATOR [UK] REPORT: "A review of retirement information for DC (defined contribution) members," (October 2009, .pdf format, 27p.).



A. "The economic basis for the regulation of pensions," by David McCarthy and Anthony Neuberger (Research Report 603, 2009, .pdf format, 50p.).

B. "Defined contribution pension provision," by Chris Dobson and Sarah Horsfield (Research Report 608, 2009, .pdf format, 113p.).


17. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH ISSUE IN BRIEF: "The National Retirement Risk Index: After The Crash," by Alicia H. Munnell, Anthony Webb, and Francesca Golub-Sass (IB#9-22. October 2009, .pdf format, 9p.). Links to an introduction and full text are available at:


18. KAISER FAMILY FOUNDATION ISSUE BRIEF: "The Community Living Assistance Services and Supports (CLASS) Act" (October 2009, .pdf format, 2p.), with an accompanying presentation (.pdf format, 4p.).


19. METLIFE MATURE MARKET INSTITUTE REPORT: "The 2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs" (October 2009, .pdf format, 38p.).


20. NATIONAL COMMITTEE TO PRESERVE SOCIAL SECURITY AND MEDICARE DATA ANALYSIS BRIEF: "Price Negotiation for the Medicare Drug Program: It is Time to Lower Costs for Seniors" (October 2009, .pdf format, 8p.).

More information on NCPSCM:



A. "Public Policy, Financial Decisions, and the Health of Older Adults," by Marlene Lee (October 2009).

B. "Aging, Family Structure, and Health," by Marlene Lee (October 2009).


22. UNIVERSITY OF MICHIGAN RETIREMENT RESEARCH PERIODICAL: Newsletter (Vol. 10, No. 4, 2009, HTML and .pdf format, 7p.).


23. ROYAL COLLEGE OF PSYCHIATRISTS [UK] POSITION STATEMENT: "Age discrimination in mental health services: making equality a reality (Royal College of Psychiatrists position statement PS2/2009, October 2009, .pdf format, 6p.). The statement is linked from a RCP news release: "New College report reveals that tens of thousands of over-65s are at risk in mental health services" (October 2009). Link to full text as well as full text of an accompanying evidence document: "The need to tackle age discrimination in mental health" (October 2009, .pdf format, 33p.) is at the bottom of the news release.


24. TIME SPECIAL ARTICLES: "Planning For Retirement at Any Age" (October 2009).,29569,1930805,00.html


25. PUBLIC LIBRARY OF SCIENCE (PLoS) ONE ARTICLE: "Gain in Brain Immunity in the Oldest-Old Differentiates Cognitively Normal from Demented Individuals," by Pavel Katsel, Weilun Tan, and Vahram Haroutunian (PLoS ONE 4(10): e7642. doi:10.1371/journal.pone.0007642, HTML, XML, and .pdf format, 15p.).


26. NATURE NEUROSCIENCE BRIEF COMMUNICATIONS ABSTRACT: "Formation and maintenance of Alzheimer's disease bold beta-amyloid plaques in the absence of microglia," by Stefan A. Grathwohl, Roland E. Kalin, Tristan Bolmont, Stefan Prokop, Georg Winkelmann, Stephan A. Kaeser, Jorg Odenthal, Rebecca Radde, Therese Eldh, Sam Gandy, Adriano Aguzzi, Matthias Staufenbiel, Paul M. Mathews, Hartwig Wolburg, Frank L. Heppner, and Mathias Jucke (Vol. 12, No. 11, November 2009, p. 1361-1363).



A. "Age-associated increase in lifespan of naive CD4 T cells contributes to T-cell homeostasis but facilitates development of functional defects," by Hirotake Tsukamoto, Karen Clise-Dwyer, Gail E. Huston, Debra K. Duso, Amanda L. Buck, Lawrence L. Johnson, Laura Haynes, and Susan L. Swain (Vol. 106, No. 43, Oct. 27, 2009, HTML and .pdf format, p. 18333-18338). This article is available free of charge.

B. "Alzheimer's disease-like pathological features in transgenic mice expressing the APP intracellular domain," by Kaushik Ghosal, Daniel L. Vogt, Man Liang, Yong Shen, Bruce T. Lamb, and Sanjay W. Pimplikar (Vol. 106, No. 43, Oct. 27, 2009, HTML and .pdf format, p. 18367-18372). This article is available free of charge.


28. JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION PRELIMINARY COMMUNICATIONS ABSTRACT: "DNA {beta}-Amyloid1-42 Trimer Immunization for Alzheimer Disease in a Wild-Type Mouse Model," by Doris Lambracht-Washington, Bao-Xi Qu, Min Fu, Todd N. Eagar, Olaf Stuve, and Roger N. Rosenberg (Vol. 302, No. 16, October 28, 2009, p. 1796-1802).


III. Working Papers:

29. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH: "What Drives Health Care Spending? Can We Know Whether Population Aging Is A 'Red Herring'?" by Henry J. Aaron (WP#2009-18, October 2009, .pdf format, 29p.). Links to an abstract and full text are available at:


30. MICHIGAN RETIREMENT RESEARCH CENTER: "Mortality Contingent Claims: Impact of Capital Market, Income, and Interest Rate Risk," by Wolfram J. Horneff and Raimond H. Maurer (WP 2009-222, September 2009, .pdf format, 28p.). Links to an abstract and full text are available at:


31. NATIONAL BUREAU OF ECONOMIC RESEARCH: "What the Stock Market Decline Means for the Financial Security and Retirement Choices of the Near-Retirement Population," by Alan L. Gustman, Thomas L. Steinmeier, Nahid Tabatabai (w15435, October 2009, .pdf format, 34p.).


This paper investigates the effect of the current recession on the near-retirement age population. Data from the Health and Retirement Study suggest that those approaching retirement age (early boomers ages 53 to 58 in 2006) have only 15.2 percent of their wealth in stocks, held directly or in defined contribution plans or IRAs. Their vulnerability to a stock market decline is limited by the high value of their Social Security wealth, which represents over a quarter of the total household wealth of the early boomers. In addition, their defined contribution plans remain immature, so their defined benefit plans represent sixty five percent of their pension wealth. Simulations with a structural retirement model suggest the stock market decline will lead the early boomers to postpone their retirement by only 1.5 months on average. Health and Retirement Study data also show that those approaching retirement are not likely to be greatly or immediately affected by the decline in housing prices. We end with a discussion of important difficulties facing those who would use labor market policies to increase the employment of older workers.



A. "Chronic Health Conditions: Changing Prevalence in an Aging Population and Some Implications for the Delivery of Health Care Services," by Frank T. Denton and Byron G. Spencer (SEDAP Working Paper No. 259, October 2009, .pdf format, 35p.).


Since the prevalence of many chronic health conditions increases with age we might anticipate that as the population ages the proportion with one or more such conditions would rise, as would the cost of treatment. We ask three questions: How much would the overall prevalence of chronic conditions increase in a quarter century if age-specific rates of prevalence did not change? How much would the requirements for health care resources increase in those circumstances? How much difference would it make to those requirements if people had fewer chronic conditions? We conclude that the overall prevalence rates for almost all conditions associated mostly with old age would rise by more than 25 percent and that health care requirements would grow more rapidly than the population - more than twice as rapidly in the case of hospital stays - if the rates for each age group remained constant. We conclude also that even modest reductions in the average number of conditions at each age could result in substantial savings.

B. "Portfolio Allocation in the Face of a Means-Tested Public Pension," by Deborah A. Cobb-Clark and Vincent Hildebrand (SEDAP Working Paper No. 260, October 2009, .pdf format, 47p.).


Is there evidence that households adjust their asset portfolios just prior to retirement in response to a means-tested public pension? We address this question by estimating a system of asset equations constrained to add up to net worth. We find little evidence that in 2006 healthy households or couples responded to the incentives embedded in the means test determining pension eligibility by reallocating their assets. While there are some significant differences in asset portfolios associated with being near the income threshold, being of pensionable age, and being in poor health these differences are often only marginally significant, are not robust across time, and are not clearly consistent with the incentives inherent in the pension eligibility rules. In 2006, any behavioral response to the means test seems to occur among single pensioners in poor health. Comparison with 2002 results suggests the incentives to reallocate assets may have weakened over time.


33. NEP-AGE: Working papers in the Economics of Aging are available through the bibliographic database provided by Research Papers in Economics (RePEc). The latest compilation is for Oct. 17, 2009.


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

34. American Journal of Geriatric Psychiatry (Vol. 17, No. 11, November 2009).

Latest issue is at the bottom of the list.

35. International Social Security Review (Vol. 62, No. 4, October/December 2009). This is a special issue on "Policy learning and social protection."

36. Journal of the American Geriatrics Society (Vol. 57, No. 11, November 2009).

37. Journals of Gerontology (B) Psychological and Social Sciences (Vol. 64B No. 6, November 2009).

38. Omega: Journal of Death and Dying (Vol. 60, No. 1, 2009-10).

39. Public Health Reports (Vol. 124, No. 6, November/December 2009).

40. Public Policy and Aging Report (Vol. 19, No. 3, 2009).


41. 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 October 26, 2009:

B. Alzheimer's Disease: Literature for the week of October 26, 2009:

C. Parkinson's Disease: Literature for the week of October 26, 2009:

D. Prostate Cancer: Literature for the week of October 26, 2009:

E. Stem Cell Research: Literature for the week of October 26, 2009:

F. Ophthalmology: Literature for the week of October 26, 2009:

AMEDEO Literature Guide:


V. Funding Opportunities/Employment Opportunities:


A. "Roadmap Transformative Research Projects Program (R01)" (RFA-RM-09-022, reissue of RFA-RM-08-029, Oct. 23, 2009). For more information see:

B. "Development and Characterization of Animal Models for Aging Research (R01)" (PA-10-014, Oct. 28, 2009, National Institute on Aging). For more information see:

C. "Development and Characterization of Animal Models for Aging Research (R21)" (PA-10-015, Oct. 29, 2009, National Institute on Aging). For more information see:


43. ENCORE CAREERS PURPOSE PRIZE: For more information see:

More information about the Purpose Prize, click on "About" and "How it Works." Application deadline is Mar. 5, 2010.

More information about Encore Careers:


44. HUMAN DEVELOPMENT AND FAMILY STUDIES, SCHOOL OF HUMAN ECOLOGY, UNIVERSITY OF WISCONSIN-MADISON IS RECRUITING FOR A TENURE-TRACK ASSISTANT PROFESSOR POSITION TO BEGIN AUGUST, 2010. Adult Development/Adulthood and Aging Focus: Strong preference will be given to candidates with a substantive focus on adult development/adulthood and aging. For position information contact Professor Nadine Marks

Responsibilities: Develop a strong research program, compete for extramural funding, teach undergraduate and graduate courses, teach and mentor undergraduate, MS and PhD students, and provide service to the department, school, university, and public.

Qualifications: Candidates for the positions must have a PhD in Human Development and Family Studies, Psychology, Sociology, Education, Social Work or a related discipline by the time that the appointment begins. Evidence of the ability to achieve excellence in a program of scholarly research, a strong potential for external funding, and a commitment to interdisciplinary scholarship are required. Consistent with the emphasis of our department, we seek scholars with a life course or ecological orientation to the study of individuals, relationships, families, and/or communities, and an interest in application (e.g., program development and evaluation, intervention, prevention, policy, community-based research).

Application: Send a cover letter describing your qualifications for the position(s) you would like to be considered for, program of research, and teaching interests; curriculum vita; representative publications; and at least three letters of reference to: Dr. Linda Roberts, Chair, Human Development and Family Studies, 3rd Floor Middleton Building, 1305 Linden Drive., University of Wisconsin, Madison, WI 53706


telephone: 608.263.2381)

Deadline: Apply as soon as possible and to ensure consideration, no later than December 9, 2009. Review of applications will continue until the position(s) are closed.


45. AGEWORK.COM: Agework has updated its employment page with listings through Oct. 29, 2009.


VI. Conferences:

46.FAMILY CAREGIVER ALLIANCE: Caregiver University, a new initiative of the Family Caregiver Alliance, is a one-day crash course in skills for family caregivers.It is the first time Caregiver University is being offered in the Bay Area. Caregiver University is a selection of skill-building workshops that focus on the physical and emotional care of someone with dementia or other chronic illness.

"We are excited to be offering the Caregiver University, as family caregivers have long requested more hands-on training on caring of their loved ones," says Family Caregiver Alliance Executive Director, Kathleen Kelly. "Caregiver University is filling a gap to help family caregivers receive the education and training they require to care for a loved one."

Family or friends caring for someone who is frail, disabled, has a chronic illness or cognitive impairment will find the class an invaluable resource to manage their everyday challenges. Additionally, participants will walk away from class with caregiver tip cards for a quick reference to skills and information learned at Caregiver University.

Caregivers Gain Confidence

On a daily basis, FCA staff hear confusion, worry and overwhelming grief in the voices of family caregivers struggling with the day-to-day tasks of helping someone with a disabling chronic condition, especially someone with progressive memory loss. Caregiver University helps caregivers gain confidence by providing the necessary information and skills training needed to reduce stress.

"Caregivers do better when they feel more confident and competent in caring for a loved one," says FCA Program Director Donna Schempp. "This reduces their stress and frustration in being a good caregiver and helps them to keep their loved ones at home as long as possible."

FCA presents Caregiver University with support from The East Bay Foundation. Based in San Francisco, Family Caregiver Alliance offers programs to support and sustain the important work of families and friends caring for loved ones with chronic, disabling health conditions. FCA offers programs at national and local levels. FCA provides direct services for over 1400 caregivers in the Bay Area annually. A wealth of caregiving advice, resource listings, newsletters, fact sheets, research reports, policy updates and discussion groups are available free on our website. Visit

or call (800) 445-8106 for more information.


VII. Legislation Information Updates:

47. US SENATE SPECIAL COMMITTEE ON AGING HEARING TESTIMONY: "Default Nation: Are 401(k) Target Date Funds Missing The Mark?" a hearing held Oct. 28, 2009 (.pdf format). A video transcript of the hearing is available at the site (running time, about 1 hour, 20 minutes).


48. US SENATE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS HEARING TESTIMONY: "Pensions in Peril: Helping Workers Preserve Retirement Security Through a Recession," a hearing held October 29, 2009 (.pdf format). A video transcript of the hearing is available at the site (Adobe Flash format, running time, about 2 hours, 25 minutes).


It is not by muscle, speed, or physical dexterity that great things are achieved, but by reflection, force of character, and judgement; and in these qualities old age is usually not only not poorer, but is even richer

Cicero--106-43 B.C.


Jack Solock
Director--Data and Information Services Center
Social Sciences Research Services
3313 Social Science
University of Wisconsin-Madison
Madison, WI 53706