• Provide agents with the most current medical information they need to package and present their cases

• Provide agents with the most current medical information that will be of interest to their clients

• Provide agents with the most current medical information to improve their own health awareness

All baby boomers need to read this book!
Robert W. Griffith, MD
Editor, HealthandAge.com 

This book is a great gift for a financial advisor to give to all clients with senior parents.
Dick Bell, CLU, ChFC, President 2004 Society of Financial Service Professionals

Learn more and Order here

Late-onset Alzheimer disease is the most common form and accounts for 90% of the cases. There is no clear genetic predisposition to late-onset Alzheimer disease.

The strongest risk factor for late-onset Alzheimer disease is age. At age 65 the incidence is 3% per 1000 persons. At age 90 it is 50% per 1000 persons.

Midlife "heart health status" is emerging as another major risk factor in the development of Alzheimer disease. Elevated cholesterol, high blood pressure, obesity, and elevated C-reactive protein in middle age have all been associated with the development of Alzheimer disease.

The diagnosis of Alzheimer disease is made clinically. It can only be confirmed at autopsy. The current criteria for the diagnosis includes:

1. Multiple Cognitive Deficits

This includes memory impairment in which the person has trouble learning new information or to recall previous information.

Learning disturbances such as language problems (called aphasia), movement problems even though there is no impairment in motor skills (called apraxia), recognition problems even though there is no impairment in sensory system (called agnosia), and "executive functioning" problems in planning, organizing, sequencing, and abstracting.

2. Deficit Impairment

The deficits must cause a significant impairment in the individual functioning compared to a previous level of function.

3. Gradual onset and continuing cognitive decline.

4. The are no other explanations for the cognitive decline.

The management of Alzheimer disease requires a comprehensive, multidisciplinary team approach to assist in:

1. Presenting the diagnosis
2. Medical therapy
3. Behavioral management
4. Social support network
5. Caregiver and patient education
6. Safety measures

Bottom Line: The epidemic of Alzheimer disease appears to have its basis in risk factors that start well before the individual reaches old age. These middle age  risk factors will become a primary focus for both heart health and brain health. It is also important to remember that Alzheimer disease is not an automatic decline for individual life insurance. There is a small group of carriers who are willing to offer coverage to older applicants (i.e. age 80 and up) who are in the early stages of the disease. This is an important step in properly pricing a risk that will come to have a major impact on the life insurance world in the next twenty years.

Abdominal Aortic Aneurysm (AAA) is defined as a dilatation of 3.0 cm or more in the wall of the abdominal aorta.   

“Clinically relevant” AAAs are those larger that 4.0 cm.

AAAs can rupture and cause sudden death and do in about one-third of the cases.

Rupture is “unlikely” as long at the diameter of the AAA is less than 5.5 cm.

The problem is that expansion of an AAA appears to accelerate the larger the aneurysm.

If the person lives long enough, the question becomes “when” they will need surgery to repair the aneurysm.

Because AAAs are asymptomatic, even when they approach the danger point, their discovery poses a clinical challenge. In most cases they are found by accident through testing for other medical issues

Bottom Line: Applicants with an AAA may not be insurable.  You will need to know its size, growth pattern, and other risk factors (especially smoking and high blood pressure) to even get a tentative quote.

Aggrenox (aspirin/extended-release dipyridamole or Persantine) is a “combination” medication that was created to offer protection against recurrent stroke.  Its RiskTutor classification is Yellow (underwriting concerns).

Bottom Line: If an applicant is taking Aggrenox, it is important to determine the “event” that promoted its use.  Not all applicants on Aggrenox have had a stroke.  Some may have had a TIA (pre-stroke or mini-stroke).  See these RiskTutor newsletters for more information on TIAs and strokes:

TIA:
RiskTutor TIA Newsletter

Stroke:
RiskTutor Stroke Newsletter

Female, 77, Non-smoker, $6,000,000 Individual Coverage
Height 5’ 2”, Weight 143 lbs
Current Medications: ASA, Lipitor, and Tenormin

The applicant was discovered to have a low reading on a pulmonary function study (FEV-1 or 43%) and initially declined for life insurance.  The agent insisted that the applicant was a vibrant, active person with no apparent respiratory problems.  She did have a history of asthma but it was mild.  The pulmonary function test was taken during a bout of bronchitis.

Discussion: The applicant returned to her doctor to discuss the reason for being declined for life insurance.  Her physician noted that she was due for her annual physical and decided to include a new pulmonary function test and an exercise treadmill.  Her FEV-1 upon retesting was 71% and she went over 9 minutes on her treadmill test.  She was subsequently offered standard rates from more than one carrier.  Make sure the music and the words match in your field underwriting assessment.  The art of underwriting is based on the “whole” picture and not a single test.