The New Old Age Blog: Hospital Alarms Fail to Prevent Injury, Study Finds

When it comes to protecting older people from falls, it can take a long time to figure out what helps and sometimes an even longer time to take action against things that were supposed to help but don’t.

A case in point: the so-called safety rails on hospital and nursing home beds. Their hazards, as The New Old Age reported more than two years ago, are well documented. They are intended to keep sick, drugged or confused people from climbing or falling out of bed. What they actually do is make falls more dangerous; they also trap patients between the rails and the mattress until they asphyxiate, causing hundreds of deaths annually.

The Consumer Product Safety Commission is finally investigating these hazards, with findings due soon.

Alarms — sensors that alert aides or nurses when someone at risk of falling attempts to get out of bed or up from a chair or toilet — sound better, right? Lots of health care facilities thought so.

Use of these alarms has increased “over the past 10 or 15 years as the problems of physical restraints and bed rails became better known,” said Ronald Shorr, who directs geriatric research at the V.A. Medical Center in Gainesville, Fla. “This was the next wave in fall prevention.”

The trouble is, hospital bed alarms don’t appear to reduce falls, according to the study that Dr. Shorr just published in The Annals of Internal Medicine.

Lots of patients, of all ages, fall in hospitals, and about a quarter of those falls cause injuries. They also cost hospitals money, because Medicare will no longer reimburse facilities for treating injuries from falls that in theory shouldn’t have happened.

Though there aren’t statistics on the number of systems, it is rare these days to find a large hospital that doesn’t use alarms, in some cases built right into the beds.

Yet “their efficacy hadn’t been established,” Dr. Shorr told me in an interview. The few studies that reported reduced falls from alarms were small, lacked control groups, or didn’t continue for very long. Dr. Shorr and his colleagues set out to remedy those shortcomings.

Over 18 months, they documented falls among patients in 16 medical and surgical units, with a combined 349 beds, at Methodist Healthcare-University Hospital in Memphis, Tenn. Half those units were randomly designated “usual care.” In the other eight, the “intervention” units, Dr. Shorr and study coordinator Michelle Chandler held repeated education sessions to explain the alarms — in this case, flexible pads made by Bed-Ex and widely-used — and demonstrate their use in beds and on chairs and commode seats.

Ms. Chandler visited the intervention units daily — the staff started calling her “Mrs. Falls” — and even brought fresh alarm pads and help set them up to encourage their use.

The intervention worked, in that those units used the alarms far more often. But when the researchers tallied up the falls among the 27,672 patients (half of them over age 63) in these units — controlling for many variables, including not only demographic factors but staffing levels and psychotropic drug regimens — they found the alarms had no significant effect.

Patients in the units that used alarms more heavily fell just as often as patients in the control units that used alarms much less frequently. (The numbers: 5.62 falls per 1,000 patient-days, a measure of how many people spent how long in the hospital, versus 4.56 falls in the control units, not a statistically significant difference.)

There were no fewer injuries in the more-alarmed units, nor any less use of physical restraints.

There were likely higher costs, though. A Bed-Ex monitor and cables cost about $350 at the time, and each disposable sensor pad cost $23.

Why didn’t the alarms help? Dr. Shorr hypothesized that the staff developed what he called alarm fatigue. “How many times a week do you hear a car alarm go off?” he asked. “You become desensitized.”

But it is also possible, he said, that when the alarms sounded and the nurses scampered, “the patients who weren’t alarmed fell more often.”

My own 2 cents: If an alarm sounds when someone stirs, is any hospital or nursing home so well-staffed that someone can materialize within seconds? Does a staff become less vigilant when patients have alarms and are presumed – wrongly, it seems – to be safer?

Nursing homes also frequently use alarms, and while this hospital data might not apply in another setting, Dr. Shorr said his findings made him skeptical about their effectiveness there, too.

So we probably shouldn’t feel reassured about our elders’ safety when they are in a hospital, alarms or no alarms. Even younger people, recovering from surgery and feeling the effects of anesthesia or sedatives, can and do fall.

“The more eyes on your loved one, the better,” said Dr. Shorr. “And it’s best if they’re your eyes.”

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Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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Push for minimum wage hike intensifies

NEW YORK — Before the recession, Amie Crawford was an interior designer, earning $50,000 a year patterning baths and cabinets for architectural firms.

Now, she's a "team member" at the Protein Bar in Chicago, where she makes $8.50 an hour, slightly more than minimum wage. It was the only job she could find after months of looking. Crawford, now 56, says she needed to take the job to stop the hemorrhaging of her retirement accounts.

In her spare time, Crawford works with a Chicago group called Action Now, which is staging protests to raise the minimum wage in a state where it hasn't been raised since 2006.

"Thousands of workers in Chicago, let alone in the rest of the country, deserve to have a livable wage, and I truly believe that when someone is given a livable wage, that is going to bolster growth in communities," she said.

If it seems that workers such as Crawford are more prevalent these days, protesting outside stores including Wal-Mart, McDonald's and Wendy's to call for higher wages, it may be because there are more workers in these jobs than there were a few years ago.

Quiz: How much do you know about the 'fiscal cliff'?

Of the 1.9 million jobs created during the recovery, 43% of them have been in the low-wage industries of retail, food services and employment services, whose workforces include temporary employees who often work part time and without benefits or health insurance, according to a study by Annette Bernhardt, policy co-director of the National Employment Law Project in New York.

At the same time, many workers such as Crawford who have been displaced from their jobs are experiencing significant earnings losses after getting a new job. About one-third of the 3 million workers displaced from their jobs from 2009 to 2011 and then reemployed said their earnings had dropped 20% or more, according to the Bureau of Labor Statistics.

"What these protests are signaling are that working families are at breaking point after three decades of rising inequality and stagnant wages," Bernhardt said.

The rise of low-paying jobs in the recovery, experts said, has cut the spending power of workers who once worked in middle-class occupations. Construction workers who made $30 an hour, for example, during the housing boom may now find themselves working on a temporary basis.

"You see workers trading down their living standards," said Joseph Brusuelas, a senior economist for Bloomberg who studies the U.S. economy.

Now, Brusuelas said, there's an oversupply of workers and they're willing to take any job in a sluggish economy, even if they're overqualified. That includes temporary jobs without benefits, and minimum wage positions such as the one Crawford took.

Although the 2012 election might have brought the idea of income inequality to the forefront of voters' minds, efforts to increase wages for these workers are sputtering in an era of austerity when businesses say they are barely hiring, much less paying workers more.

The New Jersey state legislature handed Gov. Chris Christie a bill to raise the state's minimum wage to $8.50 an hour from the federal minimum of $7.25 this month, but he hasn't signed it and has signaled he might not. An earlier effort in New Jersey to tie the minimum wage to the consumer price index was vetoed by the governor.

Democratic lawmakers in Illinois are also trying to push a bill that would increase the minimum wage — an earlier effort this year failed. The Legislature last voted to raise its minimum wage in 2006, before the recession, and the governor agreed.

"A higher minimum wage means a person has to pay more for each worker," said Ted Dabrowski, vice president of policy at the Illinois Policy Institute, which opposes raising the minimum wage. "Companies have a few choices — increase prices, reduce the number of people they hire, cut employee hours or reduce benefits. When employees become too expensive, they have no choice but to reduce the number of workers."

The Center for Economic and Policy Research in Washington, D.C., however, says there is little indication from economic research that increases in the minimum wage lead to lower employment, and, because higher wages mean workers have more money to spend, employment can actually increase.

A bill to raise the federal minimum wage was introduced to the U.S. Senate by Tom Harkin (D-Iowa) in July and referred to committee, where it has sat ever since.

"Business lobbyists are aware of the campaign and are aggressively working to stop it," said Madeline Talbott, the former lead organizer of Chicago's Action Now. "We've had a hard time getting our legislature to approve it."

But Talbott and other advocates say that the protests that have spread throughout Illinois and the country in recent weeks might force the issue to its head.

"You saw it happening 18 months ago when Occupy started — workers are now realizing that they have rights too in the workplace," said Camille Rivera, executive director of United NY, one of the groups working to raise the minimum wage in New York. "It's a good time for us to be fighting these issues, when companies are making millions of dollars in profits."

The protests are bringing out people who might not usually participate, including Marcus Rose, 33. Rose, who has worked the grill at a Wendy's for 21/2 months, was marching outside that Wendy's in Brooklyn recently on a day of protests, responding as organizers shouted lines such as "Wendy's, Wendy's, can't you see, $7.25 is not for me."

"If you don't stand up for nothing, you can't fall for anything," he said.

Talbott, the Action Now organizer, says that people such as Rose may make a difference in whether lawmakers at the state and national level will listen to the protests. The Obama victory energized the working class to believe that they could fight against big-money interests and win, she said.

"It comes down to the traditional situation — whether the power is in the hands of organized money or of organized people," she said. "The organized money side tends to win, but it doesn't have to win. The more people you are, the more chance you have against money."

alana.semuels@latimes.com

ricardo.lopez2@latimes.com

Semuels reported from New York and Lopez from Los Angeles

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Man dies after falling from Mag Mile hotel while taking photos

A man trying to take a photo from the top of the Intercontinental Hotel on Michigan Avenue fell 22 feet down a smokestack and died, according to authorities.

The 23-year-old man, from Minnesota, was pronounced dead at Northwestern Memorial Hospital, a spokesman for the Cook County medical examiner's office said.

He was wheeled into an ambulance inside the basement garage of the Intercontinental Hotel, at 505 N. Michigan Ave., about 5:05 a.m. and taken to Northwestern Memorial Hospital in "extremely critical" condition, according to the fire department. A white sheet had been draped over him.

The man fell 22 feet into an angled portion of the 6-foot wide smokestack and was wedged in, Fire Department Spokeswoman Meg Ahlheim said. After the angle, the chimney is vertical for about 42 floors.

Fire crews had cut into the wall adjacent to the angled portion and used wood boards to block the man's fall, in case his position adjusted at all, Ahlheim said.

"We had to send members from the top down on ropes to assess his condition, the whole time we’re monitirong the situation for toxic gases," said Special Operations Chief Michael Fox. " We found the best way to get out him was to go about two floors below and we had to cut the ductwork for the chimeny, which was made out of steel. And eventually we ended up sliding the victim down into the hole and removing him from the building"

The man was able to communicate with his girlfriend, either with phone calls or text messages, Ahlheim said, but firefighters lost contact with him about 3:15 a.m.

The Chicago Fire Department had responded to the hotel about 1:10 a.m. after someone called and reported a person threatening to jump.

Firefighters later learned the man fell into a smokestack, Ahlheim said. A "confined space" rescue, bringing 30 department companies and about 100 firefighters and paramedics, was called about 2 a.m.

More than two dozen department vehicles, including two department rescue squads, a hazardous materials truck, at least two ambulances and a department command van lined Michigan Avenue during the rescue.

A spokesperson for the hotel wasn't immediately available and employees at the hotel hung up twice when reached by phone for comment. 

pnickeas@tribune.com
Twitter: @peternickeas

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“The Voice” finale taps Rihanna, Kelly Clarkson, Bruno Mars and the Killers

LOS ANGELES (TheWrap.com) – The season finale of “The Voice” has enlisted some high-profile talent to help send the show’s third cycle off with a bang.

Rihanna, Kelly Clarkson, Bruno Mars and The Killers have been tapped to perform on the two-hour extravaganza, which will culminate with the crowning of a new champion, NBC said Wednesday.

An additional special guest will be named at a later date, the network added.

Rihanna will perform her song “Diamonds,” while “American Idol” alum Clarkson – who has served as a guest mentor on the show, as well as hosting the rival singing competition “Duets” – is set to sing “Catch My Breath.”

The Killers, meanwhile, will play their single “Runaways,” and Mars will debut the song “When I Was Your Man” from his sophomore album “Unorthodox Jukebox,” which was released Tuesday.

The season finale of “The Voice” will air live on December 18 at 8 p.m.

Music News Headlines – Yahoo! News

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Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

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Illinois foreclosures up for 11th month

Foreclosure activity in Illinois posted the 11th straight year-over-year increase in November, but compared with a month earlier, filings are trending in the right direction, according to new data released Thursday.

RealtyTrac said the 13,520 properties within the state that received a foreclosure notice last month was a decrease of 9 percent from October but up 9 percent from November 2011. last month's activity, which equated to one out of every 392 homes in the state receiving a notice, gave Illinois the nation's third-highest state foreclosure rate, surpassed by only Florida and Nevada.

In the Chicago-area counties of Cook, DuPage, Kane, Kendall, Lake and Will, almost 11,000 homes received a foreclosure notice in November, a decrease of 10.5 percent from October's level of activity but up 1.6 percent from November 2011

Most of that activity was in Cook County, where about 2,299 homes received initial notices of default, another 2,651 homes were scheduled for court-ordered sales and 2,086 homes were repossessed by lenders.

Among the nation's metropolitan areas, Rockford and Chicago ranked 11th and 13th, respectively, in terms of their foreclosure rates.

Nationally, the number of homes that were repossessed by lenders and became bank-owned rose on a year-over-year basis for the first time  since October 2010, the company said. In November, more than 59,000 homes across the country were repossessed, an increase of 11 percent from October and 5 percent from November 2011.

"The drop in overall foreclosure activity in November was caused largely by a 71-month low in foreclosure starts for the month, more evidence that we are past the worst of the foreclosure problem brought about by the housing bubble bursting six years ago," said Daren Blomquist, a company vice president. "But foreclosures are continuing to hobble the U.S. housing market as lenders finally seize properties that started the process a year or two ago, and much longer in some cases."

mepodmolik@tribune.com | Twitter @mepodmolik

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3 dead after masked gunman opens fire at Portland mall

HAPPY VALLEY, Oregon -- A gunman opened fire inside an Oregon shopping mall on Tuesday in the middle of the busy holiday season, killing two people, critically wounding a young woman and terrorizing shoppers before shooting himself to death, police said.

The afternoon shooting rampage at the crowded Clackamas Town Center in the Portland suburb of Happy Valley touched off panic inside the mall, sending thousands of shoppers streaming out as police and fire crews arrived on the scene.

Clackamas County Sheriff Craig Roberts said the lone gunman died from a self-inflicted gunshot wound and that law enforcement officers who descended on the scene had not fired a single shot inside the mall. A single weapon was recovered.

"The mall is supposed to be a place where we can take our families. He took the lives of two people and a young lady is at the hospital fighting for her life right now," Roberts said.

The wounded victim was taken by helicopter to a hospital where a spokeswoman said she was in serious condition.

The shooting started around 3:30 p.m. It was not clear how long it lasted, but some shoppers and employees hid in fear for at least two hours as teams of police checked to see whether there might be another shooter.

Police and SWAT teams established a perimeter around the scene and worked to evacuate the mall as they searched for the gunman. Video footage from inside the mall, aired on CNN, showed shoppers heading toward exits with their arms raised above their heads.

Roberts said that police, assisted by agents from the FBI and U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives were still combing through the mall for evidence late on Tuesday night.

A mall spokeswoman directed calls to law enforcement authorities. Clackamas Town Center is one of the Portland area's biggest and busiest malls, with 185 stores and a 20-screen movie theater.

"My thoughts and prayers are with the victims and their families," Oregon Governor John Kitzhaber said in a statement released by his office. "I appreciate the work of the first responders and their quick reaction to this tragic shooting."

Man in Santa suit: 'Hit the floor'

The mall Santa was waiting for the next child's Christmas wish when shots rang out, causing the shopping mall to erupt into chaos.

About to invite a child to hop onto his lap, Brance Wilson instead dove for the floor and kept his head down as he heard shots being fired upstairs in the mall Tuesday afternoon.

"I heard two shots and got out of the chair. I thought a red suit was a pretty good target," said the 68-year-old Wilson. Families waiting for Santa scattered. More shots followed, and Wilson crept away for better cover.

Wilson was among hundreds of horrified people who ducked or ran for cover when a gunman, dressed in camouflage and a mask and possibly wearing body armor, fired dozens of rounds.

Kayla Sprint, 18, was interviewing for a job at a clothing store when she heard shots.

"We heard people running back here screaming, yelling '911,'" she told the AP.

Sprint barricaded herself in the store's back room until the coast was clear.

Jason DeCosta is a manager of a window-tinting company that has a display on the mall's ground floor. When he arrived to relieve his coworker, he heard shots ring out upstairs.

DeCosta ran up an escalator, past people who had dropped for cover and glass littering the floor.

"I figure if he's shooting a gun, he's gonna run out of bullets," DeCosta said, "and I'm gonna take him."

DeCosta said when he got to the food court, "I saw a gentleman face down, obviously shot in the head."

"A lot of blood," DeCosta said. "You could tell there was nothing you could do for him."

He said he also saw a woman on the floor who had been shot in the chest.

Austin Patty, 20, who works at Macy's, said he saw a man in a white mask carrying a rifle and wearing a bulletproof vest. There was a series of rapid-fire shots in short succession as Christmas music played. Patty said he dove for the floor and then ran.

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Pope Benedict offers blessings with his first tweet

VATICAN CITY (Reuters) – After weeks of anticipation, Pope Benedict sent his first tweet on Wednesday.

“Dear friends, I am pleased to get in touch with you through Twitter. Thank you for your generous response. I bless all of you from my heart.”

The tweet was sent when the 85-year-old pope tapped on a touch screen at the end of his weekly general audience in the Vatican before thousands of people.

(Reporting By Philip Pullella, editing by Paul Casciato)

Internet News Headlines – Yahoo! News

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Anthony Jeselnik, Amy Schumer, Nick Kroll Shows get Comedy Central premiere dates

NEW YORK (TheWrap.com) – Comedy Central has set premiere dates for new series starring comedians Anthony Jeselnik, Amy Schumer, Nick Kroll, Ben Hoffman and Nathan Fielder.

The biting Jeselnik and Schumer are familiar to fans of Comedy Centrals celebrity roasts: They reliably deliver some of the most scathing and best-assembled insults. Nick Kroll stars on FX’s “The League.” And Hoffman and Fielder will both lure unassuming, regular people into their shows, airing together on Thursdays.

Comedy Central made the announcements as it released its midseason schedule Tuesday.

The sketch series “Kroll Show” premieres Wednesday, January 16 at 10:30 p.m. “The Jeselnik Offensive” debuts Tuesday, February 19 at 10:30 p.m., and will take on the week’s train wrecks in the news.

The sketch/man on the street series “The Ben Show,” starring Hoffman, premieres Thursday, February 28 at 10 p.m. It will be followed at 10:30 by Fielder’s “Nathan For You,” which “draws real people into an experience far beyond what they signed up for, according to Comedy Central.

Schumer looks at “sex, relationships, and the general clusterf— that is life” in “Inside Amy Schumer,” beginning Tuesday, April 30 at 10:30 p.m.

The network also announced standup specials for Jeselnik on Sunday, January 13, Kristen Schaal on Friday, January 18, and Katt Williams on Saturday, February 23. (Williams has popped up lately for a string of run-ins with the law, but he’s also famous for telling jokes.)

Comedy Central also set several return dates. Roastmaster Jeff Ross is back for season 2 of “The Burn With Jeff Ross” on Tuesday, January 8 at 10:30 p.m. “Workaholics” clocks in again on Wednesday, January 16 at 10 p.m., and the fifth season of “Tosh.0″ premieres Tuesday, February 5 at 10 p.m.

TV News Headlines – Yahoo! News

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The New Old Age Blog: The Gift of Reading

This is the year of the tablet, David Pogue of The Times has told us, and that may be good news for seniors who open holiday wrappings to find one tucked inside. They see better with tablets’ adjustable type size, new research shows. Reading becomes easier again.

This may seem obvious — find me someone over 40 who doesn’t see better when fonts are larger — but it’s the business of science to test our assumptions.

Dr. Daniel Roth, an eye specialist and clinical associate professor at the Robert Wood Johnson Medical School in New Brunswick, N.J., offered new evidence of tablets’ potential benefits last month at the annual meeting of the American Academy of Ophthalmology.

His findings, based on tests conducted with 66 adults age 50 and over: older people read faster (a mean reading speed of 128 words per minute) when using an iPad, compared to a newspaper with the same 10-point font size (114 words per minute).

When the font was increased to 18 points — easy to do on an iPad — reading speed increased to 137 words per minute.

“If you read more slowly, it’s tedious,” Dr. Roth said, explaining why reading speed is important. “If you can read more fluidly, it’s more comfortable.”

What makes the real difference, Dr. Roth theorizes, is tablets’ illuminated screen, which heightens contrast between words and the background on which they sit.

Contrast sensitivity — the visual ability to differentiate between foreground and background information — becomes poorer as we age, as does the ability to discriminate fine visual detail, notes Dr. Kevin Paterson, a psychologist at the University of Leicester, who recently published a separate study on why older people struggle to read fine print.

“There are several explanations for the loss of sensitivity to fine detail that occurs with older age,” Dr. Paterson explained in an e-mail. “This may be due to greater opacity of the fluid in the eye, which will scatter incoming light and reduce the quality of the projection of light onto the retina. It’s also hypothesized that changes in neural transmission affect the processing of fine visual detail.”

Combine these changes with a greater prevalence of eye conditions like macular degeneration and diabetic retinopathy in older adults, and you get millions of people who cannot easily do what they have done all their lives — read and stay connected to the world of ideas, imagination and human experience.

“The No. 1 complaint I get from older patients is that they love to read but can’t, and this really bothers them,” Dr. Roth said. The main option has been magnifying glasses, which many people find cumbersome and inconvenient.

Some words of caution are in order. First, Dr. Roth’s study has not been published yet; it was presented as a poster at the scientific meeting and publicized by the academy, but it has not yet gone through comprehensive, rigorous peer review.

Second, Dr. Roth’s study was completed before the newest wave of tablets from Microsoft, Google, Samsung and others became available. The doctor made no attempt to compare different products, with one exception. In the second part of his study, he compared results for the iPad with those for a Kindle. But it was not an apples to apples comparison, because the Kindle did not have a back-lit screen.

This section of his study involved 100 adults age 50 and older who read materials in a book, on an iPad and on the Kindle. Book readers recorded a mean reading speed of 187 words per minute when the font size was set at 12; Kindle readers clocked in at 196 words per minute and iPad readers at 224 words per minute at the same type size. Reading speed improved even more drastically for a subset of adults with the poorest vision.

Again, Apple’s product came out on top, but that should not be taken as evidence that it is superior to other tablets with back-lit screens and adjustable font sizes. Both the eye academy and Dr. Roth assert that they have no financial relationship with Apple. My attempts to get in touch with the company were not successful.

A final cautionary note should be sounded. Some older adults find digital technology baffling and simply do not feel comfortable using it. For them, a tablet may sit on a shelf and get little if any use.

Others, however, find the technology fascinating. If you want to see an example that went viral on YouTube, watch this video from 2010 of Virginia Campbell, then 99 years old, and today still going strong at the Mary’s Woods Retirement Community in Lake Oswego, Ore.

Ms. Campbell’s glaucoma made it difficult for her to read, and for her the iPad was a blessing, as she wrote in this tribute quoted in an article in The Oregonian newspaper:

To this technology-ninny it’s clear
In my compromised 100th year,
That to read and to write
Are again within sight
Of this Apple iPad pioneer

Caregivers might be delighted — as Ms. Campbell’s daughter was — by older relatives’ response to this new technology, a potential source of entertainment and engagement for those who can negotiate its demands. Or, they might find that old habits die hard and that their relatives continue to prefer a book or newspaper they can hold in their hands to one that appears on a screen.

Which reading enhancement products have you used, and what experiences have you had?

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