Some Common Drugs May Increase Risk of Dementia

Some common drugs may cause increased risk of dementia.
Some common drugs may cause increased risk of dementia.

Research conducted in 2019 has strengthened the connection between the risk of dementia and a common class of drugs used to treat a variety of symptoms.

Anticholinergics are a type of medication that blocks the action of acetylcholine. That’s a chemical messenger (or “neurotransmitter”) in the brain that help coordinate breathing, digestion, urination and other functions.

Anticholinergics can treat a variety of ailments, including urinary incontinence.

Considerable’s recent article entitled “These common prescription drugs could boost your risk of dementia” reports that anticholinergics include a roster of drugs for depression (such as Paxil), psychosis (such as Thorazine), Parkinson’s disease (such as Cogentin) and bladder disorders (such as Ditropan).

The 2019 study found a nearly 50% increase in chances of dementia in those people who received more than 1,095 daily doses of these drugs in a 10-year period.

The research was published in JAMA Internal Medicine.

The study, sponsored by the University of Nottingham, monitored 284,343 patients age 55 and older between 2004 and 2016. The researchers examined the total standardized daily doses (TSDDs) of anticholinergic drugs during that time period.

The researchers said that this was the equivalent to a senior taking a strong anticholinergic medication daily for at least three years.

Researchers looked at each person’s anticholinergic exposure and found the most frequently prescribed anticholinergic drugs were antidepressants, drugs to treat vertigo, motion sickness or vomiting and an overactive bladder.

The researchers at the University of Nottingham discovered that some other anticholinergic antihistamines and gastrointestinal drugs failed to correspond to a higher incidence of dementia.

The UK study shows a correlation between these specific anticholinergic drugs and increased chances of dementia. However, the researchers cautioned that seniors shouldn’t stop taking any medications without talking with their doctor.

Reference: Considerable (July 1, 2020) “These common prescription drugs could boost your risk of dementia”

 

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Estate Planning with a Business

Estate planning with a business addresses owner succession, protecting assets and the smooth operation of the business.

Estate planning with a business is different. If you have children, ownership shares in a business, or even in more than one business, a desire to protect your family and business if you became disabled, or charitable giving goals, then you need an estate plan attuned to those needs. The recent article “Estate planning for business owners and executives” from The Wealth Advisor explains why business owners, parents and executives need estate plans.

An estate plan is more than a way to distribute wealth. It can also:

  • Establish a Power of Attorney, if you can’t make decisions due to an illness or injury.
  • Identify a guardianship plan for minor children, naming a caregiver of your choice.
  • Coordinating beneficiary designations with your estate plan. This includes retirement plans, life insurance, annuities and some jointly owned property.
  • Create trusts for beneficiaries to afford them asset or divorce protection.
  • Identify professional management for assets in those trusts if appropriate.
  • Minimize taxes and maximize privacy through the use of planning techniques.
  • Create a structure for your philanthropic goals.

An estate plan ensures that fiduciaries are identified to oversee and distribute assets as you want. Estate planning with a business especially focuses on managing ownership assets, which requires more sophisticated planning. Ideally, you have a management and ownership succession plan for your business, and both should be well-documented and integrated with your overall estate plan.   See here for a deeper dive into business succession planning.  https://www.galliganmanning.com/business-succession-planning-in-your-estate-plan/

Some business owners choose to separate their Power of Attorney documents, so one person or more who know their business well, as well as the POA holder or co-POA, are able to make decisions about the business, while family members are appointed POA for non-business decisions.

Depending on how your business is structured, the post-death transfer of the business may need to be a part of your estate planning with a business. A current buy-sell agreement may be needed, especially if there are more than two owners of the business.

An estate plan, like a succession plan, is not a set-it-and-forget it document. Regular reviews will ensure that any changes are documented, from the size of your overall estate to the people you choose to make key decisions.

Reference: The Wealth Advisor (July 28, 2020) “Estate planning for business owners and executives”

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Estate Planning after Divorce

Divorce changes your estate plan, so make sure to update it and your beneficiary designations after the divorce.

Estate planning after divorce takes careful consideration.  Without a spouse as the center of an estate plan, the executors, trustees, guardians or agents under a power of attorney and health care proxies will have to be chosen from a more diverse pool of those that are connected to you.

Wealth Advisor’s recent article entitled “How to Revise Your Estate Plan After Divorce” explains that beneficiary forms tied to an IRA, 401(k), 403(b) and life insurance will need to be updated to show the dissolution of the marriage.

There are usually estate planning terms that are included in agreements created during the separation and divorce. These may call for the removal of both spouses from each other’s estate planning documents, assets, bank and retirement accounts. For example, in Texas, bequests to an ex-spouse in a will prepared during the marriage are voided after the divorce. Even though the old will is still valid, a new will has the benefit of realigning the estate assets with the intended recipients and avoiding difficulties in probating the will.

However, any trust created while married is treated differently. Revocable trusts can be revoked, and the assets held by those trusts can be part of the divorce. Irrevocable trusts involving marital property are less likely to be dissolved, and after the death of the grantor, distributions may be made to an ex-spouse as directed by the trust.

A big task in the post-divorce estate planning process is changing beneficiaries. Ask for change of beneficiary forms for all retirement accounts. Without a stipulation in the divorce decree ending their interest, an ex-spouse still listed as beneficiary of an IRA or life insurance policy may still receive the proceeds at your death.  Sometimes beneficiary designations or retitling of assets occur during the divorce process, but often they occur after resolving the divorce and aren’t complete by the time an estate planning attorney needs to be involved.

Divorce makes children assume responsibility at an earlier age. Adult children in their 20s or early 30s typically assume the place of the ex-spouse as fiduciaries and health care proxies, as well as agents under powers of attorney, executors and trustees.  Many clients often try to coordinate their estate plans with their ex-spouses to ensure their mutual children are provided for.

If the divorcing parents have minor children, they must choose a guardian to care for the children, in the event that both parents pass away.  This was always true, but the need for it is heightened if parents aren’t on the same page.

Ask an experienced estate planning attorney to help you with the issues that are involved in estate planning after a divorce.

Reference: Wealth Advisor (July 7, 2020) “How to Revise Your Estate Plan After Divorce”

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