April 2019 Briefing - Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for April 2019. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Poor Olfaction Tied to Elevated Long-Term Mortality in Seniors

MONDAY, April 29, 2019 (HealthDay News) -- Among older adults, poor olfaction is associated with elevated long-term mortality, according to a study published online April 30 in the Annals of Internal Medicine.

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Healthy Diet Tied to Lower Odds of Physical Impairment in Men

MONDAY, April 29, 2019 (HealthDay News) -- Better overall diet quality is significantly associated with lower odds of impairment in physical function among older men, according to a study recently published in the Journal of Nutrition, Health & Aging.

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Gender Differences Seen in Adverse Drug Reactions

FRIDAY, April 26, 2019 (HealthDay News) -- The risk for adverse drug reactions (ADRs) may be higher for women, even when accounting for gender differences in drug use, according to a study published online April 2 in the British Journal of Clinical Pharmacology.

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Interdisciplinary Care Pathway Helps Manage Frail, Elderly Trauma Patients

THURSDAY, April 25, 2019 (HealthDay News) -- An interdisciplinary care protocol for frail geriatric trauma patients significantly reduces the risk for delirium and 30-day readmission, according to a study published online April 5 in the Journal of the American College of Surgeons.

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Many Seniors Will Be Unable to Afford Care They Need by 2029

WEDNESDAY, April 24, 2019 (HealthDay News) -- The number of middle-income seniors is projected to almost double by 2029, and many will have inadequate financial resources to afford the level of care they need, according to a report published online April 24 in Health Affairs.

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Over Half of Seniors Initiating Dialysis Die Within One Year

WEDNESDAY, April 24, 2019 (HealthDay News) -- More than half of Medicare beneficiaries initiating dialysis die within one year, according to a research letter published online April 22 in JAMA Internal Medicine.

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Low Socioeconomic Position Linked to Poor End-of-Life Care

WEDNESDAY, April 24, 2019 (HealthDay News) -- Low socioeconomic position (SEP) is a risk factor for potentially poor-quality end-of-life care, including hospital death, according to research published online April 23 in PLOS Medicine.

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PCI Beneficial for All Categories of Older AMI Patients

WEDNESDAY, April 24, 2019 (HealthDay News) -- For older patients with acute myocardial infarction (AMI), percutaneous coronary intervention (PCI) is beneficial across age strata, according to a research letter published online April 23 in Circulation: Cardiovascular Interventions.

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Sleeping Pill Use Tied to Greater Need for BP Meds in Older Adults

WEDNESDAY, April 24, 2019 (HealthDay News) -- Consumption of sleeping pills is linked to a subsequent increase in the number of antihypertensive drugs taken among older adults, according to a study published online March 25 in Geriatrics & Gerontology International.

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Prevalence of TV, Video Watching High, Stable 2001 to 2016 in U.S.

TUESDAY, April 23, 2019 (HealthDay News) -- From 2001 to 2016, the estimated prevalence of watching television or videos for at least two hours/day remained high and stable, while the prevalence of computer use increased, according to a study published in the April 23/30 issue of the Journal of the American Medical Association.

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Risk Model Developed for Readmission After AMI in Seniors

TUESDAY, April 23, 2019 (HealthDay News) -- A risk model has been developed and validated for hospital readmission within 30 days after acute myocardial infarction (AMI) in older patients and has demonstrated moderate performance, according to a study published online April 23 in Circulation: Cardiovascular Quality and Outcomes.

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Risks, Benefits of Long-Term Drug Therapy for Osteoporosis Reviewed

TUESDAY, April 23, 2019 (HealthDay News) -- Long-term osteoporosis drug therapy (ODT) reduces fracture risk in women but may increase risk for rare adverse events, and research gaps surround use of long-term drug therapies for osteoporotic fracture prevention, according to a review and position paper published online April 23 in the Annals of Internal Medicine.

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Measures May Predict Metabolic Syndrome in Older Adults

MONDAY, April 22, 2019 (HealthDay News) -- Three simple measurements may predict metabolic syndrome (MetS) in older patients, according to a study recently published in Metabolic Syndrome and Related Disorders.

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Acetaminophen Safe as First-Line Analgesic for Most Older Adults

FRIDAY, April 19, 2019 (HealthDay News) -- Despite a potential increased risk for stroke in patients with diabetes, acetaminophen is a safe first-line analgesic for most older adults living in nursing homes, according to a study published online March 26 in the Journal of the American Geriatrics Society.

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Loan Forgiveness, Educational Debt May Affect Practice Patterns

FRIDAY, April 19, 2019 (HealthDay News) -- Increased educational debt appears to directly influence physician practice choice, according to a study published in the April issue of the Journal of the American Osteopathic Association.

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National Hand Hygiene Initiative Successful in Australia

FRIDAY, April 19, 2019 (HealthDay News) -- The National Hand Hygiene Initiative (NHHI) has successfully sustained improvement in hand hygiene compliance, according to a study recently published in The Lancet Infectious Diseases and presented at the European Congress of Clinical Microbiology & Infectious Diseases, held from April 13 to 16 in Amsterdam.

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Sixty People Charged in Massive Opioid Painkiller Investigation

THURSDAY, April 18, 2019 (HealthDay News) -- Fifty-three medical professionals, including 31 doctors, are among the 60 people charged by U.S. authorities for their alleged involvement in the illegal prescribing and distribution of opioid painkillers.

AP News Article

Stroke Hospitalizations Down in Black, White Medicare Enrollees

WEDNESDAY, April 17, 2019 (HealthDay News) -- Rates of hospitalization for stroke have fallen since 1988 for both black and white Medicare enrollees, while black men and women have had greater improvements in 30-day mortality after stroke, according to a study published in the April issue of Medical Care.

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iADL Dependency May Up Mortality in Hematologic Cancers

WEDNESDAY, April 17, 2019 (HealthDay News) -- For older adults with hematologic malignancies, instrumental activities of daily living (iADL) dependency is associated with increased mortality and acute care utilization, according to a study published online April 4 in the Journal of the American Geriatrics Society.

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About One-Quarter of Seniors Store Firearms Unlocked, Loaded

WEDNESDAY, April 17, 2019 (HealthDay News) -- The prevalence of mental health or memory loss indicators does not vary by household firearm ownership or storage practices among older adults, according to a research letter published online April 16 in the Annals of Internal Medicine.

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Sleep Myths Are Commonly Circulated

WEDNESDAY, April 17, 2019 (HealthDay News) -- Commonly held sleep myths have a questionable evidence base, according to a study published online April 16 in Sleep Health.

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Intensive BP Lowering May Up Cognitive Decline in Elderly

TUESDAY, April 16, 2019 (HealthDay News) -- Older adults (aged ≥75 years) undergoing antihypertensive treatment with systolic blood pressure (SBP) >150 mm Hg have less cognitive decline than those with SBP <130 mm Hg, according to a study published in the March/April issue of the Annals of Family Medicine.

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Low Scam Awareness May Indicate Alzheimer Risk in Seniors

TUESDAY, April 16, 2019 (HealthDay News) -- Low scam awareness is associated with an increased risk for Alzheimer disease and mild cognitive impairment among older adults, according to a study published online April 16 in the Annals of Internal Medicine.

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More Than 80 Percent of STEMI Patients Treated in ICU

TUESDAY, April 16, 2019 (HealthDay News) -- Most patients with ST-segment elevation myocardial infarction (STEMI) are treated in the intensive care unit (ICU), according to a study published in the April 22 issue of JACC: Cardiovascular Interventions.

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Replacing 30 Minutes of Sitting With Activity May Cut Mortality

TUESDAY, April 16, 2019 (HealthDay News) -- Replacing half an hour of daily sitting time with even light physical activity is associated with a reduction in mortality risk among less active adults, according to a study published online March 21 in the American Journal of Preventive Medicine.

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Over Half of Patients Have Suboptimal Response to Statins

TUESDAY, April 16, 2019 (HealthDay News) -- More than half of patients initiating statin therapy have a suboptimal low-density lipoprotein cholesterol (LDL-C) response within 24 months, according to a study published online April 15 in Heart.

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Terminally Ill People in New Jersey Given Right to End Lives

MONDAY, April 15, 2019 (HealthDay News) -- Terminally ill adults in New Jersey will soon be allowed to seek medical help to end their lives.

CNN Article

Standardizing Demographics Ups Accuracy of Patient Matching

MONDAY, April 15, 2019 (HealthDay News) -- Standardizing demographic data can improve the accuracy of patient matching, according to a study published in the May issue of the Journal of the American Medical Informatics Association.

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Telehealth Video Visits Risk Fragmenting Care

MONDAY, April 15, 2019 (HealthDay News) -- Although telehealth video visits offer users greater convenience, they risk fragmenting care without greater coordination with usual care providers, according to a study recently published in the Journal of the American Medical Informatics Association.

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AEDs Tied to Higher Pneumonia Risk in Alzheimer Patients

MONDAY, April 15, 2019 (HealthDay News) -- Antiepileptic drug (AED) use may increase the risk for pneumonia in patients with Alzheimer disease (AD), according to a study recently published in the Journal of Alzheimer's Disease.

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Normalizing BP in Elderly With Hypertension May Up Mortality

MONDAY, April 15, 2019 (HealthDay News) -- Normalized blood pressure (BP) is associated with an increased risk for all-cause mortality for older adults during hypertension treatment, with increased risk seen in octogenarians and those with previous cardiovascular events, according to a study recently published in the European Heart Journal.

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ACR Issues Position Statements on Drug Pricing, Step Therapy

FRIDAY, April 12, 2019 (HealthDay News) -- Two position statements developed in relation to drug pricing and step therapy have been issued by the American College of Rheumatology (ACR).

Position Statement - Drug Pricing
Position Statement - Step Therapy

Older Adults With Hearing Loss Have Lower Patient Activation

THURSDAY, April 11, 2019 (HealthDay News) -- Nearly half of older adults report difficulty hearing, and those reporting difficulty are at risk for low patient activation, according to a study published online April 2 in the Journal of the American Geriatrics Society.

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Mindfulness Yoga Aids Patients With Parkinson Disease

THURSDAY, April 11, 2019 (HealthDay News) -- Mindfulness yoga is a safe and effective treatment option for patients with mild-to-moderate Parkinson disease to help them manage stress and symptoms, according to a study published online April 8 in JAMA Neurology.

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Domestic Responsibilities Tied to Physician Mothers' Satisfaction

THURSDAY, April 11, 2019 (HealthDay News) -- For physician mothers in procedural specialties, being responsible for five or more domestic tasks is associated with an increased likelihood of career dissatisfaction, according to a study published online April 10 in JAMA Surgery.

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FDA: Patients Should Not Abruptly Stop Taking a Prescribed Opioid

WEDNESDAY, April 10, 2019 (HealthDay News) -- Because of the danger of "serious harm" to patients, the U.S. Food and Drug Administration is advising doctors not to suddenly stop patients from taking opioid painkillers, or drastically lower the dose.

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Caregiving for Older Cancer Patients Takes Emotional Toll

WEDNESDAY, April 10, 2019 (HealthDay News) -- Poor emotional health is common among caregivers of older cancer patients, particularly when patients have higher numbers of geriatric assessment (GA) impairments, according to a study published online March 29 in the Journal of the American Geriatrics Society.

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New, Revised Topics Released in ACR Appropriateness Criteria

TUESDAY, April 9, 2019 (HealthDay News) -- The latest edition of the American College of Radiology (ACR) Appropriateness Criteria has been released and includes 188 diagnostic imaging and interventional radiology topics, with 908 clinical variants covering more than 1,670 clinical scenarios.

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More Secondary Prevention Meds May Reduce Deaths After AMI

TUESDAY, April 9, 2019 (HealthDay News) -- For older nursing home residents, use of three or four secondary preventive medications following acute myocardial infarction (AMI) is associated with reduced mortality, according to a study published in the April issue of Circulation: Cardiovascular Quality and Outcomes.

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Older Patients With Crohn Disease May Benefit From Early Combo Tx

MONDAY, April 8, 2019 (HealthDay News) -- A post hoc analysis of data from a randomized trial shows no difference between older and younger patients for the safety and efficacy of early combined immunosuppression therapy compared with conventional management for Crohn disease, according to a study published online March 19 in Alimentary Pharmacology and Therapeutics.

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October May Be Best Time for Older Adults to Receive Flu Shot

FRIDAY, April 5, 2019 (HealthDay News) -- It may be best for older adults to wait until October to receive their flu vaccine, unless that delay would cause them to skip getting their flu shot altogether, according to a study published in the April issue of the American Journal of Preventive Medicine.

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Pregnancy History Not Likely Tied to Later Cognitive Function

FRIDAY, April 5, 2019 (HealthDay News) -- There is no clinically meaningful long-term association between pregnancy history and age-related change in cognitive function, according to a study published online March 18 in Menopause.

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CDC: Violence Against Seniors on Rise, Especially Among Men

THURSDAY, April 4, 2019 (HealthDay News) -- There has been an increase in the rates of violence among older adults, especially among older men, according to research published in the April 5 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Older Patients With Vision Loss Have Higher Hospital Use, Costs

THURSDAY, April 4, 2019 (HealthDay News) -- Hospitalized Medicare beneficiaries with vision loss experience longer mean length of stay, higher readmission rates, and higher costs during hospitalization and postdischarge, according to a study published online April 4 in JAMA Ophthalmology.

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Readmission Risk Up With Shorter Stay at Nursing Facility

THURSDAY, April 4, 2019 (HealthDay News) -- For patients with heart failure discharged to a skilled nursing facility (SNF) and then home, the risk for readmission is highest during the first two days at home and is attenuated with a longer SNF length of stay, according to a study published in the April issue of the Journal of Post-Acute and Long-Term Care Medicine.

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Most Osteoporosis Guidelines Do Not Discuss Patient Choices

THURSDAY, April 4, 2019 (HealthDay News) -- Less than 40 percent of osteoporosis clinical practice guidelines include any mention of patients' beliefs, values, or preferences (BVPs), according to a study published online March 11 in Osteoporosis International.

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Patient-Report Instrument Helps Identify ADEs in Older Adults

THURSDAY, April 4, 2019 (HealthDay News) -- A patient-report instrument has good predictive value for identifying adverse drug events (ADEs) in older adults in the community setting, according to a study published in the March/April issue of the Annals of Family Medicine.

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Population Mortality Affects Long-Term Follow-Up of AlloHCT

WEDNESDAY, April 3, 2019 (HealthDay News) -- For older patients undergoing allogeneic hematopoietic cell transplantation (alloHCT), a considerable part of total nonrelapse mortality (NRM) is attributable to population mortality, according to a study recently published in Leukemia.

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New Plan Limits Out-of-Pocket Costs for Insulin

WEDNESDAY, April 3, 2019 (HealthDay News) -- Out-of-pocket costs for insulin could be restricted to $25 a month for people under a drug benefit plan announced Wednesday by Express Scripts.

The New York Times Article

Amyloid PET Linked to Changes in Management for MCI, Dementia

TUESDAY, April 2, 2019 (HealthDay News) -- For Medicare beneficiaries with mild cognitive impairment (MCI) or dementia of uncertain etiology, amyloid positron emission tomography (PET) is associated with changes in clinical management, according to a study published in the April 2 issue of the Journal of the American Medical Association.

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Americans Borrowed $88 Billion in Past Year to Pay for Health Care

TUESDAY, April 2, 2019 (HealthDay News) -- About one in eight Americans borrowed a total of $88 billion in the past year to pay for health care, a new West Health-Gallup survey shows.

CNN Article
West Health-Gallup Survey

Guidelines for Asymptomatic Bacteriuria Updated

TUESDAY, April 2, 2019 (HealthDay News) -- Recommendations have been updated for the management of asymptomatic bacteriuria (ASB); the Infectious Diseases Society of America clinical practice guideline was published online March 21 in Clinical Infectious Diseases.

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Over-the-Counter Meds Save Health Care System Money

TUESDAY, April 2, 2019 (HealthDay News) -- On average, each dollar spent on over-the-counter (OTC) medicines saves the U.S. health care system $7.20, totaling nearly $146 billion in annual savings, according to a report released March 18 by the Consumer Healthcare Products Association (CHPA).

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Doctors Unclear on Legal Obligations in Caring for Patients With Disability

MONDAY, April 1, 2019 (HealthDay News) -- Practicing physicians might not understand their legal responsibilities when caring for people with disability, which may contribute to inequalities in their care, according to a study published online April 1 in Health Affairs.

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Vitamins, Carotenoids Associated With Lower Risk for Cataract

MONDAY, April 1, 2019 (HealthDay News) -- Higher consumption of certain vitamins and carotenoids is associated with a significantly decreased risk for age-related cataract (ARC) in cohort studies, according to a meta-analysis published in the January issue of The American Journal of Clinical Nutrition.

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