THURSDAY, Aug. 14 (HealthDay News) -- The average monthly premium for Medicare's prescription drug plan will increase to an estimated $28 in 2009, three dollars more than this year's monthly premium, Medicare officials announced Thursday.

That 2009 figure is 37 percent lower than originally projected when Medicare's so-called Part D drug coverage was introduced in 2003, the officials added. The Part D program offers prescription drug benefits to Medicare beneficiaries.

"Part D continues to come in under budget, achieve consistently high satisfaction rates, and with it millions of Americans are living healthier, better lives," Kerry Weems, acting administrator of the U.S. Centers for Medicare and Medicaid Services, said during an afternoon teleconference.

But, he added, "most beneficiaries will see a premium increase in their current plan. There will be some significant increases."

There are three reasons behind the premium increase, Weems said.

"First, there is a trend in prescription drug cost growth generally -- prices tend to increase because of price increases for existing drugs, the growth in the average number of prescriptions per person, and the introduction of new drugs," he said.

Second, the 2008 premiums were calculated as part of a demonstration project that has now expired. This project resulted in premiums being 50 cents less in 2008 than had been projected.

"That change is now reflected in the 2009 premium," Weems said.

Third, drug distributors participating in Part D have found coverage for catastrophic care to be higher than expected. "So they have adjusted their 2009 bids to reflect those higher-than-anticipated costs," Weems said.

There are steps Medicare beneficiaries can take to reduce the impact of premium increases, Weems added.

In 2009, Medicare beneficiaries will continue to have access to what's known as enhanced drug coverage, which allows people to pay additional premiums to cover gaps in their drug coverage. Some low-income beneficiaries will be able to have their gap coverage at minimal or no cost, Weems said.

"In addition, 97 percent of people in stand-alone prescription drug plans will have access to a 2009 plan with equal or lower-cost premiums than their 2008 plan," Weems said. "Moreover, many Medicare beneficiaries will have access to a Medicare Advantage plan that offers lower prescription drug premiums than a stand-alone plan."

Currently, 24.4 million Medicare beneficiaries are enrolled in the Part D drug plan.

In a related development, Medicare officials announced Thursday that 10 doctors-group practices participating in Medicare's Physician Group Practice Demonstration project showed improved quality of care for patients with congestive heart failure, coronary artery disease and diabetes.

Based on these improvements, the 10 groups involved in the project are being paid $16.7 million in incentives designed to reward health-care providers for improving results and coordinating the health care needs of Medicare patients.

"We are paying for better outcomes and we are getting higher quality and more value for the Medicare dollar," Weems said in a prepared statement. "And these results show that by working in collaboration with the physician groups on new and innovative ways to reimburse for high quality care, we are on the right track to find a better way to pay physicians."

More information

To learn more, visit the U.S. Centers for Medicare and Medicaid Services.

THURSDAY, Aug. 14 (HealthDay News) -- When elderly patients complain they have a lack of energy, doctors shouldn't dismiss it as a normal part of aging, say researchers who found that lack of energy (anergia) is associated with several health problems and higher rates of hospitalization and death.

The study of more than 2,100 New York City residents, ages 65 to 104, found that almost one in five reported so little energy, they spent most of the day sitting on the sofa.

"When elderly people complain they're tired, most doctors say, 'Yeah, well, you're old.' They tell their patients that feeling listless is an expected part of aging, but there are reasons people are tired, and they need to be investigated. For clinicians, the message from our study is that a lack of energy is widespread in the elderly, but it's not normal," senior author Dr. Mathew Maurer, associate professor of clinical medicine at Columbia University Medical Center, said in a news release.

In this study, participants were classified as anergic if they said they sat around due to lack of energy and agreed with two of the six following statements: "I recently have not had enough energy;" "I felt slowed physically in the past month;" "I did less than usual in the past month;" "My slowness is worse in the morning;" "I wake up feeling tired;" "I nap more than two hours a day."

The researchers found that the 18 percent of study participants classified as anergic reported more arthritis, sleep disorders, cardiovascular symptoms and other health issues. They also reported twice as many overnight hospitalizations, emergency department visits and home care services. In addition, anergia was associated with a 60 percent greater rate of death in the six years after participants were surveyed, the study said.

The findings were published in the Journal of Gerontology.

Heart and kidney dysfunction, arthritis, lung disease, anemia, and depression are among the many conditions that may cause anergia.

"I believe anergia is the universal language by which the elderly talk about their health problems," Maurer said. "Instead of noting symptoms of pain or a depressed mood, many older adults feel more comfortable telling their physicians that they are tired. As health care providers, we need to start learning how to further identify the underlying causes of this lack of vigor and address them."

Maurer and his colleagues wrote that anergia needs to be regarded as a geriatric condition similar to common age-related syndromes such as memory impairment and increased risk of falling.

In an extension of this initial study, the Columbia researchers found that anergia occurred in 39 percent of older adults with heart failure. They also found demonstrable differences in physical activity levels and circadian rhythm between those with anergia and those without anergia.

"As our population ages, it has become paramount to the health of our nation to accurately describe the health problems associated with age," Dr. Linda P. Fried, dean of the Mailman School of Public Health at Columbia University Medical Center, said in the medical center news release.

"A central feature of the frailty phenotype that we described years ago is self-reported exhaustion. The current study suggests that this concern expressed by patients or their caregivers is important and may be a very useful question in identifying older adults susceptible to functional decline and poor health outcomes," Fried said.

More information

The U.S. Centers for Disease Control and Prevention explains healthy aging for older adults.

WEDNESDAY, Aug. 13 (HealthDay News) -- A satisfying sex life is possible as you age into your 70s and 80s, new research suggests.

Many older Americans are apparently taking advantage of that fact, because 68 percent of men between 57 and 85 reported having sex last year, as did 42 percent of women, according to the study's lead author, Edward Laumann, the George Herbert Mead Distinguished Service Professor of Sociology at the University of Chicago. And, Laumann added, more older women might have wanted to have sex, but there just aren't as many available older men for them to partner with.

"Healthy people can have reasonably satisfying sexual health for most of their lives," said Laumann. "There are challenges that arise, but it's not aging, per se, that's the issue. A decline in sexuality may be the canary in the mineshaft. Sexual problems may manifest before diabetes and high blood pressure."

The study findings were published in the current issue of The Journal of Sexual Medicine.

"It's definitely whether you're elderly or "wellderly" that makes a difference," said Dr. Virginia Sadock, director of the program of human sexuality at New York University Langone Medical Center in New York City. "Illness and medications make a difference in sex lives."

Other factors that can get in the way of a satisfying sex life later in life include having had a sexually transmitted disease, and having physical problems, mental health issues or relationship difficulties, the study found.

The study included information from 1,550 women and 1,455 men between the ages of 57 and 85. All participated in the National Social Life, Health and Aging Project.

Some highlights of the study include:

• Having had a sexually transmitted disease (STD) in the past nearly quadrupled a woman's odds of having sexual pain, and it tripled the odds a woman would have lubrication problems.
• In men, a history of STD was associated with five times the risk of finding sex unpleasant.
• In both older men and women, a common factor in sexual dysfunction and a decreased interest in sex was urinary tract syndrome.
• Both older men and older women reported that mental health issues affected their interest in sex.
• For men, relationship troubles also contributed to a lack of interest in sex and the inability to achieve orgasm.
• Drinking alcohol daily improved a women interest in and pleasure from sex. Alcohol didn't have that effect on men.
• Hispanic women were twice as likely to report pain during intercourse.
• Black men were twice as likely to say they weren't interested in sex and were more likely to report climaxing early.

"Sexual health is a harbinger of physical and mental health, and it plays an important role in the quality of life," Laumann said. "Older people don't just drop out of the picture. In general, if you're healthy, you can be sexually active."

Sadock added: "Don't assume that because you're older, your sex life has to be gone. If you're healthy and connected to someone, and you've had a pretty good sex life when you're younger, then you can have a pretty good sex life in old age."

More information

To read more about sex as you age, visit the U.S. National Women's Health Information Center.