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A new survey finds anxiety is a major reason people put off care and experts say there are simple ways to make healthcare visits feel less overwhelming

• One in three patients say theyve skipped, canceled, or rescheduled a healthcare appointment because they felt anxious or nervous about going.

• Missing care can have consequences, including running out of medication, worsening symptoms, or eventually needing urgent or emergency care.

• Making appointments easier to manage including offering text reminders, online scheduling and easy rescheduling could help reduce anxiety and keep patients connected to care.

Going to the doctor sounds simple enough, but for some people, making it through the front door can be the hardest part. Anxiety about an appointment, fear of bad news, discomfort with medical settings, or even the stress of making a phone call can all lead patients to put off care.

A new survey from Tebra found that 71% of Americans have missed, canceled, or rescheduled a healthcare appointment in the past year. Even more striking, 33% said they did so specifically because they felt anxious or nervous about going.

That hesitation can have real consequences. Among patients who skipped care, 59% said they experienced a negative outcome, including running out of medication, having a health condition worsen, or eventually needing emergency care.

So why does healthcare anxiety have such a strong hold on patients and what can people do when nervousness keeps them from getting the care they need? ConsumerAffairs spoke with Kristin Trick, MA, LCMHC-QS, LPC-S, RPT-S, to better understand why healthcare visits can feel so overwhelming and how patients can make them a little easier to manage.

Why are patients skipping appointments?

The survey identified which types of appointments patients are most likely to cancel:

• Dentist appointments (49%)

• Specialists (29%)

• Gynecology/urology (28%)

• Blood tests/medical imaging (28%

From this information, it would appear that the occurrence of anxiety may stem from fears of pain, uncertainties about results, or the sensitivity of particular forms of treatment, Dr. Trick said. In addition, the survey showed that 64% of respondents would not inform their provider of the actual reason for their absence.

The risks of canceling appointments

Dr. Trick explained that delayed treatment is the most prominent consequence of canceling doctors appointments.

Among the individuals who failed to make it for their scheduled visit, 36% had to wait for a long time, 22% had exhausted all their medicines, 15% reported deteriorating symptoms, and 8% even ended up in an urgent care facility or an emergency room, she said. Health facilities can avoid all these results by ensuring that rescheduling is not a difficult process and by following up with those who fail to show up for important visits.

Another factor to consider: Patients who use insurance run the risk of shortening their coverage length when they miss appointments, which delays treatment.

If a client misses their November session and cant be rescheduled until January, their deductible will be reset so theyll pay a much higher rate when they couldve applied significant coverage in the original appointment, Dr. Trick said.

Digital tools can help ease anxiety

The survey also found that some patients feel anxious when they have to call a doctors office and cancel or reschedule their appointment.

The solution? Adopting the latest technology to help ease some of those nerves.

What patients want more than anything else is ease and convenience, Dr. Trick said. SMS alerts turned out to be the most frequently chosen solution with 58% of people selecting it; then came the online appointment booking sites with 43%, followed by one-click cancel or re-scheduling options with 37%; and lastly, email alerts received 30% of votes.

Digital convenience is a must if healthcare practices want to retain patients. The ability to reschedule an appointment electronically promotes efficiency, as well as supports privacy. Ive had several clients cancel appointments over the years due to medical emergencies or sudden deaths of loved ones. No one in those situations wants to manage their calendar or make phone calls to revise plans. Enabling appointment changes through text or portal messages takes the burden off patients who need to cancel due to crisis.

Decreasing anxiety

To help patients feel less anxious and ensure they have the ability to cancel and reschedule their appointments to maintain continuity of care, Dr. Trick shared some strategies for healthcare organizations.

• Inform patients in advance about what to expect during their appointment.

• Train employees to react empathetically towards anxious patients.

• Provide the possibility for private communication for those patients.

• Use supportive messaging in cases of canceled visits rather than a punitive one.

• Be clear and direct with cancellation policies and rescheduling options.

Anxiety originates from and is perpetuated by fear of the unknown, Dr. Trick said. When facts and details are provided and repeated, both written and verbal, clients anxiety about appointments decreases.

The most important insight here is that no-shows do not necessarily indicate a lack of concern for one's own health by patients. Rather, they are more likely caused by various obstacles such as anxiety, work-related issues, cost problems, and difficult scheduling procedures. By concentrating on getting rid of such obstacles by demonstrating empathy and increasing accessibility, practices can positively influence attendance and patient relations in general.

Two more months data will determine the actual number

By Mark Huffman of ConsumerAffairs

• The Senior Citizens League projects a 3.6% Social Security cost-of-living adjustment for 2027, down from its 3.8% estimate in July.

• A 3.6% adjustment would add about $69.75 to the average monthly benefit used in the groups analysis, raising it from $1,937.53 to $2,007.28.

• The estimate remains preliminary, with August and September inflation figures still to be included before the official adjustment is announced in October.

Social Security recipients could receive a 3.6% cost-of-living adjustment in 2027, according to a new projection from The Senior Citizens League. However, two months of inflation data remain before the final figure is determined.

The nonpartisan seniors advocacy group lowered its forecast from 3.8% in July. Despite that decline, the projected adjustment would be 0.8 percentage points higher than the 2.8% increase beneficiaries received for 2026.

If a 3.6% adjustment took effect using the average benefit cited by the group, monthly payments would rise by approximately $69.75, from $1,937.53 to $2,007.28. The actual increase for each recipient would depend on the persons current benefit.

The forecast was updated after the release of July inflation figures, the first of three months used in calculating the annual Social Security adjustment. The official COLA is based on the average Consumer Price Index for Urban Wage Earners and Clerical Workers, or CPI-W, during July, August, and September, compared with the corresponding average from the previous year.

August and September prices are key

Because data for August and September are not yet available, the 3.6% figure remains subject to change. The Social Security Administration is expected to announce the official 2027 adjustment in October, with higher payments beginning in January.

The Senior Citizens League produces a new forecast each month using a statistical model that incorporates consumer prices, interest rates, and the national unemployment rate. Its estimates change as economic conditions and new inflation data emerge.

For beneficiaries, a larger COLA can help offset rising household expenses, but it does not necessarily translate into an equivalent improvement in purchasing power. Older Americans often devote a substantial share of their income to housing, healthcare, insurance, utilities, and food. Increases in Medicare premiums can also absorb part of the additional Social Security income received by beneficiaries enrolled in the program.

For some older adults, regular group activities may be linked to a lower risk of cognitive disability

• Older adults who joined community gathering places had a lower risk of cognitive disability if they did not already exercise regularly.

• Researchers followed more than 2,700 older adults in Japan for nearly four years.

• The findings suggest accessible community programs may offer another way for less-active older adults to stay engaged.

Staying connected to other people can mean more than simply having someone to chat with. New research suggests that community gathering places may also be associated with cognitive health among some older adults.

In Japan, community gathering places are designed to give residents opportunities to participate in group activities, including exercise and social interaction. These programs are part of efforts to help older adults maintain their health and independence.

Researchers from Osaka Metropolitan University wanted to find out whether taking part in these gatherings was associated with a lower risk of cognitive disability and whether a person's existing exercise habits made a difference.

How the study worked

The researchers analyzed data from 3,511 adults ages 65 and older living in Habikino City, Osaka Prefecture, who had not been certified as needing long-term care when the study began. Participants completed a self-administered questionnaire in early 2020, and their information was linked with long-term care insurance records.

After exclusions, 2,758 people were included in the primary analysis. Researchers tracked participants through January 2024, looking for new cases of cognitive disability. They also looked at whether participants regularly attended community gathering places and whether they had an established exercise habit.

For the study, regular exercise meant exercising enough to cause sweating for at least 30 minutes twice a week for more than a year. Community-gathering participants were people who attended at least once a week.

The researchers adjusted their analysis for factors including age, sex, health conditions, living arrangements, economic status, smoking and drinking, functional health, and depressive symptoms.

What the results mean

During a median follow-up of 3.9 years, 345 people developed cognitive disability. Among older adults who did not have regular exercise habits, those who participated in community gathering places had about half the risk of developing cognitive disability compared with those who did not participate.

The adjusted hazard ratio was 0.51, meaning the estimated risk was roughly 49% lower for participants in this group. However, researchers did not find a significant association among people who already exercised regularly.

That doesn't mean community gatherings prevent cognitive disability, since this was an observational study and cannot establish cause and effect. The researchers also noted that the study took place in one Japanese municipality, so the findings may not apply everywhere.

Still, the results point to a potentially useful role for accessible community programs particularly for older adults who aren't already physically active.

These findings support a growing direction in long-term care prevention policy, which creates opportunities for participation that are accessible to older adults who may find regular exercise difficult, researcher Kazuki Uemura said in a news release.

We hope this evidence will help inform community-based initiatives that support a wide range of older adults and contribute to policies aimed at reducing health inequalities.

A new study finds sleep quality may play a bigger role than screen time, exercise or diet when mental health symptoms affect adolescents daily lives

• Sleep stood out: Sleep quality was the strongest lifestyle factor connecting mental health symptoms with academic and social difficulties.

• Screen time mattered, too: Reducing screen time was the second-strongest factor for academic functioning, though its effects were smaller than sleep.

• Its not a cure-all: Researchers say better sleep may help, but it shouldnt replace professional mental health care when a child is struggling.

When a child or young teen is dealing with anxiety, depression, or other mental health symptoms, parents may focus on how those issues affect mood. But those challenges can also show up in everyday life, including school performance and relationships with friends.

A new study from researchers at UC Davis suggests that sleep quality may be an especially important piece of that puzzle. Researchers looked at four lifestyle factors sleep, screen time, physical activity, and diet and found that sleep was the strongest factor connecting mental health symptoms with academic and social functioning in early adolescence.

The findings don't mean that getting better sleep will solve mental health problems. Instead, they point to sleep as one potentially manageable factor that could help support young people who are already experiencing difficulties.

"This finding surprised us," researcher Jason Smucny, said in a news release. "We expected sleep to be important, but we didn't expect it to stand out so clearly above other lifestyle factors, particularly screen time.

How the researchers studied it

The researchers analyzed data from the Adolescent Brain Cognitive Development Study, following children across three waves when they were approximately 10 to 13 years old. The academic analysis included 6,754 participants, while the analysis of social problems included 7,550.

They examined whether four lifestyle factors sleep quality, weekend screen time, physical activity, and adherence to a Mediterranean-style diet helped explain relationships between mental health symptoms and later outcomes.

The researchers looked at symptoms including depression, anxiety, and distressing psychotic-like experiences. They then examined two outcomes measured later: school grades and social problems.

They also considered factors such as age, sex, and study site, along with environmental circumstances including financial adversity, family conflict, and the school environment.

What the results mean for families

Sleep consistently emerged as the standout factor.

For academic functioning, sleep quality accounted for 36.3% of the association between anxiety and later academic performance, 18.5% of the association involving depression, and 8.3% involving distressing psychotic-like experiences. Screen time was generally the second-strongest factor, while exercise and diet had smaller effects.

The connection was even more striking when researchers looked at social problems. Sleep was the only lifestyle factor that consistently showed a significant mediating effect across depression, anxiety, and distressing psychotic-like experiences, accounting for roughly 20% to 23% of those associations.

There was an important caveat, though: the study was observational, so it can't prove that poor sleep causes academic or social problems. The researchers also found that financial adversity and other environmental challenges could change these relationships.

For families, the takeaway is relatively simple: sleep is worth paying attention to when a young person is struggling but it's one piece of a much bigger picture, not a replacement for mental health care.

Sleep is something parents and families can address, researcher Tara Niendam said in the release. While it won't solve every mental health challenge, healthy sleep routines are a practical way to support a child's emotional well-being and day-to-day functioning."