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Longevity is the Next Disruption in the Field of Wellness PowerPoint Presentation

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Description : This medical presentation on "Longevity is the Next Disruptor in the Field of Wellness" was delivered during Global Wellness Summit.

Tags : wellness, medical, healthcare, Longevity, Disruption

Published on : Jul 19, 2020 | Views : 1821 | Downloads : 1

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Wellness :The Cleveland Experience: Vitality: Improve Health, Save Big $ For Social Programs, Ed & Research Dr. Michael Roizen Chief Wellness Officer J Gorman & Family Chair, Wellness Institute Part of The Legacy of Toby Cosgrove
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DISCLOSURE OF INTERESTS:
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www.Sharecare.com www.RealAge.com
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BE HALF AS OLD AS YOU ARE!! KEEP YOUR EXPERIENCE KEEP Your KNOWLEDGE, Your ACCEPTANCE, Your EXPERIENCES & REGAIN Your VIGOR, Your ENERGY, Your PASSION Albert B. Ratner, PhD Peter Linneman, PhD Michael F. Roizen MD The RealAge Revolution Gets Serious: Longevity is the Next Disruptor, Enjoy It
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Outline For GWAS Why Health/Care Needs To Be Fixed If Social Disruption Is To Be Avoided & How CC Has Shown It Can Be Done 9 or 10 Steps You Can Do To Keep YOU & Your Brain Healthy/Younger How To Plan for The Next Disruptor: A Lot More Healthy Longevity Or Ability to Easily Make Your RealAge A Lot Lot Younger
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AGING Deaths & Complications After Surgery Arthritis Cataracts & Macular Degen- eration Frailty Heart Disease & Stroke Type II Diabetes Cancer Neurodegeneration & Mental Dysfunction Aging is largest driving force in CHRONIC disease : So Make Your RealAge Younger
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Aging is KEY For GWAS From Horrendous LDL Cholesterol (260mg/ dL) to Ideal (<70 or <30) = 3 Fold Decrease in Risk of Heart Disease From Horrible BP (260/165) to ideal (115/75) = 5 Fold Decrease in Risk of H/Vasc Disease From Chronologic Age of 65 & RealAge of 75 to Ideal RealAge (30 Yrs Younger) = 27 Fold Decrease in Risk of All Diseases Aging Is The Greatest Risk & Is Very Modifiable
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Outline For GWAS Why Health/Care Needs To Be Fixed If Social Disruption Is To Be Avoided & How CC Has Shown It Can Be Done
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With Influx of Chronic Diseases With NO Change In Chronic Disease Rates
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Type2Diabetic Prevalence In USA 1974: 2.2 million of 211 million = 11/1000 1983: 4.6 million of 235 m = 24/1000 1994: 6.8 m of 260 m = 30/1000 2004: 15.0 m of 292 m = 55/1000 2014: 29.0 m of 320 m = 91/1000 2050: Predicted 120-180 m (CDC incr predictn for 2050 to 220 m on 9 15 15 = 500/1000 Total Hip & Knee Arthroplasties in USA 1974: 0.067million of 211 million= 0.003/1000 1990: 0.327 million of 235 m = 0.13/1000 2006: 0.675 m of 292 m = 0.02/1000 2010: 1.05 m of 320 m = 0.03/1000 2050: Predicted 6.33 m (4.17 K & 1.86 H) = 0.2/1000
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Why Is H/C in USA More Expensive: One Of Biggest Reasons -- As of Now We Treat More Chronic Disease Type2Diabetic Prevalence In USA 2014: 29.0 m of 320 m = 91/1000 (16.9 million were treated & use 1.5% of GDP) Type2Diabetes & Prediabetes in China Total in 2010 = 607.3 million people (20 fold more than in USA) 2010: Diabetics: Treated = 11.6 million with OK Glycemic control (0.11% of GDP—14 fold less than in USA)
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Chronic Disease Management Causes 84% of all Costs & 67% of Costs are in under 65 Year Olds (2012 data) Tobacco Food Choices & Portion Size Physical Inactivity Unmanaged Stress
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Calories Consumed Increased 2% Compounded Annually From 1983 To 2000 then down a little (250-350 More Calories A Day) Physical Activity Decreased To Zero (ZERO!!) In 47.5% In 2010 From 17% In 1988!!!
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Net Result: USA’s Costs Increased From 11.7 to 17.6% of GDP (50%+ Increase) As Body Mass Index Increased By 0.37% Per Year In Both Women & Men From 1988 To 2010..
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Care Cost w/9.5%/yr Inc At CC For Employees + 2008: $305 pmpm 2009: $334 projected num here & below 2010: $366 2011: $401 2012: $439 2013: $481 2014: $526 2015: $576 2016: $631 An additional $395 million
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If Do 5 Behaviors Have Only 10-20 % of Risk of All Others For CV & Cancer -- Only 4% Did 5 Behaviors (88+K Nurses Health Study, NEJM, 2000 & 2015) Swedish Men: Same Result 1% did 5 (35+K EHPJ, 2014) What Really Matters to Chronic Disease
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Med Diet (Walnuts + Olive Oil) Substantially Reduces Invasive Breast Cancer By 38-62% Toledo E et al, JAMAIM 2015 4828; 9 14
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Pierce JP et al.: J Clin Oncol, 25:2345-2351, 2007 Women’s Healthy Eating and Living (WHEL) Study More Vegetables, Fruits & Physical Activity = Improved Breast Cancer Patients’ Survival
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If Do 5 Behaviors Have Only 10-20 % of Risk of All Others For CV & Cancer -- Only 4% Did 5 Behaviors (88+K Nurses Health Study, NEJM, 2000 & 2015) Swedish Men: Same Result 1% did 5 (35+K EHPJ, 2014) In USA in 2010-16, Only 2.7% Had Healthy Diet, Body Fat, 30 min Phys Activity 5 days a week & Didn’t Smoke(4754 NHANES;MCP,16) How Do We Get Many More To Do 5 Healthy Behaviors ???? The Biggest & Most Important Question in Health Today. What Really Matters to Chronic Disease
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Reduction in Body Mass (BMI) by Year Employee Health Plan – Employees in Weight Management Only Source: COACH Sample includes 4,713 members with BMI data each year from 2011 through 2013 26
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We Think Cleveland Clinic Helped It’s Typical Employee Get About 5.3 Years Younger in Last 8 Years For Example: Smoking Rates Decreased 10+% from 15.4 to 5.3% = 1.2 yrs younger for Avg BMI down 0.5% per yr = 0.4 yrs younger Immuniz Rates from 51 to 90+% = 0.2 yrs younger
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Annual Trend 2004 - 2009 = 7.5% Annual Trend 1Q2010 - 1Q2015 = 2.8% $220 $270 $320 $370 $420 $470 Q1 04 Q2 04 Q3 04 Q4 04 Q1 05 Q2 05 Q3 05 Q4 05 Q1 06 Q2 06 Q3 06 Q4 06 Q1 07 Q2 07 Q3 07 Q4 07 Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09 Q4 09 Q1 10 Q2 10 Q3 10 Q4 10 Q1 11 Q2 11 Q3 11 Q4 11 Q1 12 Q2 12 Q3 12 Q4 12 Q1 13 Q2 13 Q3 13 Q4 13 Q1 14 Q2 14 Q3 14 Q4 14 Q1 15 Q1 04 to Q4 09 PMPM Expon. (Q1 04 to Q4 09 PMPM) Q1 10 to Q1 15 PMPM Expon. (Q1 10 to Q1 15 PMPM) Trended EHP Paid PMPM by Quarter (Medical and Pharmacy Claims) EHP primary members only ; claims paid through 6/30/15; Data Sources: EHP Warehouse, HCTA, EHP Financial Summary PMPM normalized for ASC Grouper, PBB , 09/01/2010 rate change and rate exception (April 2012 – March 2013) Includes pharmacy CMS subsidy, rebates, internal savings and error adjustment PBB = Provider Based Billing ASC = Ambulatory Surgery Center 28 $159 m = Population Health Dividend in 2015
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Care Cost Include Wellness & Admin w/ 9.5% / yr Inc At CC For Employees + = 101,000 2008: $305 pmpm 2009: $334 but became 328 2010: $366 but became 346 2012: $439 but became 368 2013: $481 but became 395 2014: $526 but became 397 2015: $576 but became 392 2016 1st half 625 became 388 Saving $241 million/y (or $156 m/y @ 6.8%)
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Estimated Cumulative Savings by “Bending the Trend” Since 2010 30 $235,000,000 Source: EHP Financial Summary; claims paid through May, 2017
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2010-2014 - Cleveland Clinic Financial Modeling – Client: Lafarge eCoaching Cumulative Savings: Direct $9.43M + Indirect $9.56 Return on Investment: $1.68 $37m this year= Population Health Dividend
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32 Programs by Geography -- LafargeHolcim And Spread to The Many Communities of That Company
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With Influx of Chronic Diseases With NO Change In Chronic Disease Rates WITH Rewards For Healthy Choice Plan
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Aging 2017 Why Are Medical Costs Per Employee Rising, But Not For Cleveland Clinic or Lafarge-Holcim & a Few Other Cos You Can Slow Your Aging & Become AgeProof The Largest Cause of Aging is Stress—The Greatest Way of Reducing Usual Aging Is Managing Stress
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Make Your RealAge Younger
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With Proper Repair & Maintenance Calendar Age 77; RealAge 77; Life Expectancy 80 RealAge 53; Life Expectancy 80
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Very High Mild High Moderate Stress Free Now 0-16 wks p<0.05 p<0.01 * ** *** p<0.001 -10.0 0.0 10.0 20.0 30.0 Control Grp Online Program Only Online Program + Peer Group Online Program + Prof-led Grp. Perceived Stress Score
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Perceived Stress Scale PRE % of Participants N=275 Popu7la5ti%onhsihgihft ftroomvevryerhyighihghpetorcmeaivneadgesatrbelessstress Measure of how unpredictable, uncontrollable, and overloaded respondents find their lives Mean Score: 19.4 Sample Items How often have you felt difficulties were piling up so high that you could not overcome them? How often have you felt that you were unable to control the important things in your life? How often have you found that you could not cope with all the things that you had to do?
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Perceived Stress Scale % of Participants N=275 PRE POST 44% decrease in perceived stress Measure of how unpredictable, uncontrollable, and overloaded respondents find their lives 48% Mean Score: 19.4 Mean Score: 10.9 39%
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N=275 % of Participants PRE Emotional Exhaustion (Maslach Burnout Inventory) Po4p4ul%atiornesphoifrt ttohaigcthiveblyurennogaugted Depletion of emotional energy, distinct from physical exhaustion or mental fatigue. Emotional exhaustion is a clear signal of distress in emotionally demanding work. Mean Score: 24.6 Sample Items I can effectively solve the problems that arise in my work. I feel used up at the end of the workday. I feel emotionally drained from my work.
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31% 34% N=275 % of Participants 38% decrease in burnout PRE POST Emotional Exhaustion (Maslach Burnout Inventory) Depletion of emotional energy, distinct from physical exhaustion or mental fatigue. Emotional exhaustion is a clear signal of distress in emotionally demanding work. Mean Score: 24.6 Mean Score: 15.3
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Outline For GWAS Why Health/Care Needs To Be Fixed If Social Disruption Is To Be Avoided & How CC Has Shown It Can Be Done 9 or 10 Steps You Can Do To Keep YOU & Your Brain Healthy/Younger
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Preventing Brain Dysfunction: Manage Stress Do 4 Components of Phys Activity
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Step 3: Move Your Body Best documented for younger memory Increase in Size of Hippocampus with 3 Months of Aerobic Exercise
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Do Minimum Physical Activity For Maximum Health Benefit General = 100 min a day of movement 10,000 Steps A Day Resistance Exercise = 30 min a week Cardio = 21 min Three X a Week at 80% of Max HR…With 2 mins At End at Maximum Intensity (If MD Allows) 40 Jumps a Day
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Preventing Brain Dysfunction: Manage Stress Do 4 Components of Phys Activity Do “Speed Of Processing Games”
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S of P Games PREVENTED 48% OF DEMENTIA: Multisite, randomized controlled trial: 3 cognitive training programs to 2,832;average age 73.6 years 1. strategy-based memory or 2. reasoning training; 3 computerized, process-based speed of processing training, or no-contact controls. Dementia incidence after 10 yrs in controls was 14%. & the same in 2 of test groups; but Dementia incidence was 12.1% among those completing 10 or fewer sessions of speed of process training & 8.2% if completed more than 10 hrs of speed of processing training
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With Proper Repair & Maintenance 1970-’s Last 70,000 miles 2017 Lasts 200,000 miles Calendar Age 77; RealAge 77; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 120
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Preventing Brain Dysfunction: Manage Stress Do 4 Components of Phys Activity Do “Speed Of Processing Games” Eat Salmon/Ocean Trout or 900 mg DHA: Avoid SSSSnake oil Foods Give Sleep Respect Avoid Toxins Drink Coffee-No Additives Please Take the Fab 8+
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The Fab 8+ Or Are They?: 1. ½ Multi 2x a day
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Insurance Policy Against Imperfect Diet Of 26 million people who took detailed RA nutrition analysis test, it was possible to get all nutrients needed from diet: 96,000 of 26 million (about 1/3rd of 1%) did so ½ Multi Twice a day
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Prenatal Multivitamins + DHA Decrease congenital birth defects (major) by 80% Decrease childhood cancers by 65%+ Decrease Autism & Autistic spectrum disorders by 40%+ (if taken for 3 months prior to conception) Improve IQ outcomes
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MultiVitamins & Cancer in Health Professionals 14,461 men—avg age 64.3 No Change in CV risks 12% reduction in non-prostate cancers in all men 18% reduction in non-prostate cancers in men over age 70 27% reduction in total cancers in men with prior cancers WilliamsPT & PD Thmpson Atheroscler Thromb Vasc Biol 2013;33: 1085-91
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MultiVitamins & Cardiovascular Disease in Health Professionals 18,530 men—avg age 52.8 (14,700) vs 52.2 (3790) After 10 in RCT and after 12.2 in Prospective Yrs, no signif CV benefit or risk, save 39% dec in fatal MI’s in RCT After 20 Yrs, a 43% reduction in heart attacks or strokes (lifestyle,age, diet adj) 55% reduced need of CV revascularization 27% reduction in CV deaths Rautianen S et al (Sesso HD) J Nutrit 2016; 146:1235-40 Sesso HD et al JAMA 2012; 308:1751-60
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The Fab 8+: ½ Multi 2x a day Vit D2/3 to level of 35-80 Calcium Citrate with Mg++ DHA: 900 mg a day Aspirin 2 babies with half a glass of warm water before & after A statin –atorvastatin or rosuva- CoQ10 200mg a day Probiotic Consider Omega-7 420mg a day
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Preventing Brain Dysfunction: Manage Stress Do 4 Components of Phys Activity Do “Speed Of Processing Games” Eat Salmon/Ocean Trout or 900 mg DHA: Avoid SSSSnake oil Foods Give Sleep Respect Avoid Toxins Drink Coffee-No Additives Please Take the Fab 8+ Enjoy An Infrared Sauna for 20 min 4 Times Each Week
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10. Enjoy An Infrared SAUNA For 20 Minutes 4 TIMES Each Week Not-sweating In An Infrared Sauna (Much Cooler Than A Radiant Heat Sauna) For 20 Minutes 4 Times/Week Reduces The Chance You’ll Have Sudden Death By More Than 50% Reduces Your Risk Of Dementia And Stroke By More Than 60%. Get A Two Person Version For Your Home & Help Your Spouse Enjoy A Younger Heart &
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Outline For GWAS Why Health/Care Needs To Be Fixed If Social Disruption Is To Be Avoided & How CC Has Shown It Can Be Done 9 Steps You Can Do To Keep YOU & Your Brain Healthy/Younger How To Plan for The Next Disruptor: A Lot More Healthy Longevity Or Ability to Easily Make Your RealAge A Lot Lot Younger
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14 Areas of “Hot” Research Into Why You Age Some, Like Mitochondrial Errors & Wear & Tear may Be Able to Be Reduced But The Key Is Having A Great Repair/ Replacement System: Pluripotent Stem Cells Example of Sunburn/ Heartburn Example of Heart Attack & Stroke The Holy Grail Of Aging Is Repair
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Calorie Restriction in 21/23 Species Extends Median & Max Life Span 5 days a Month Seems To Be Almost As Good, Maybe Better in 2 Species (Longo et al) 1000 calories 1st day, Followed By Four 750 calorie days; Then Medit Diet Reduced Biomarkers of Aging, Inflammation & Lengthened Telomeres on Stem Cells 5 Day a Month Modified Calorie Restriction May Rejeuvenate Your Pluripotent Stem Cells
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Metformin - A Retrospective Study
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When Your RealAge Approaches Life Expectancy You Lack Energy= Frailty Your NAD+ = Much Lower, As Used Up By Chronic Inflammation & Acute Inflammation NAD+ Key For SIRT’s (Sweet-16) Effects & For Energy Prod in Your Mitochondria Maybe You Can Rejevenate By Giving SIRT stimulant & NADr Animal Studies & DMD Pts = Big Benefits=10+ yrs Younger Real Age Human Studies Show Dose & Safety Huge % of Aging Researches Taking Human Outcome Studies Lacking
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Life Expectancy At Birth & At Age 65
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Life Expectancy At Birth & At Age 65 Conservative Prediction About 2 yrs/10 yrs 2030 = 84 & 23 yrs Best MFR Prediction 2030 = 120 & 45 yrs About 1.5yrs/ 1 yr We & YOU Have Entered Age Of Exponential Gains in Longevity After Exponential $ in Aging Research
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With Proper Repair & Maintenance 1970-’s Last 70,000 miles 2017 Lasts 200,000 miles Calendar Age 77; RealAge 77; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 120
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The Cleveland Clinic Personalized Approach to Health, Well-Being & Longevity Revolution: The Premier Program- PEP Whatever It Takes To Keep You Healthy & Younger No Matter What
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HEALTHY LONGEVITY 2nd & 3rd Careers Better Sex No Pain, Acceptance Vigor More Energy, Less Stress More Play Experience For More Productivity Mental Creativity The Next Disruptor: A Lot More Healthy Longevity Or Ability to Easily Make Your RealAge A Lot Lot Younger
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With Proper Repair & Maintenance 1970-’s Last 70,000 miles 2017 Lasts 200,000 miles Calendar Age 77; RealAge 77; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 80 RealAge 53; Life Expectancy 120
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` Every Life Deserves World Class Care
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