Home Geriatrics September 2017 Briefing – Geriatrics

September 2017 Briefing – Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for September 2017. 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.

Nursing Home Use Up With Cognitive Impairment Category

FRIDAY, Sept. 29, 2017 (HealthDay News) — Nursing home (NH) use increases with increasing cognitive impairment category, according to a study published online Sept. 11 in the Journal of the American Geriatrics Society.

Embezzlement Widespread in Medical Practices

FRIDAY, Sept. 29, 2017 (HealthDay News) — Embezzlement is widespread among medical practices, and knowing the warning signs is helpful for preventing it, according to an article published in Medical Economics.

Upper Abdominal Cancer Resections Up in Octogenarians

FRIDAY, Sept. 29, 2017 (HealthDay News) — Rates of major upper abdominal cancer resections in octogenarians are increasing, according to a study published online Sept. 7 in Cancer.

End-Stage Renal Disease Patients’ Readmission Rate High

FRIDAY, Sept. 29, 2017 (HealthDay News) — Nearly a quarter of hospital admissions among patients with end-stage renal disease (ESRD) on hemodialysis (HD) have a subsequent 30-day unplanned readmission, according to a study published online Sept. 28 in the Clinical Journal of the American Society of Nephrology.

Meditation May Help With Cardiovascular Risk Reduction

FRIDAY, Sept. 29, 2017 (HealthDay News) — Meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction, although the benefits need to be more fully established, according to a scientific statement published online Sept. 28 in the Journal of the American Heart Association.

More Than 78 Percent of Health Care Personnel Receive Flu Shot

THURSDAY, Sept. 28, 2017 (HealthDay News) — More than 78 percent of health care personnel (HCP) and 53.6 percent of pregnant women received influenza vaccination during the 2016-2017 influenza season, according to two studies published in the Sept. 29 issue of Morbidity and Mortality Weekly Report.

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Optimal Length of Post-Op Opioid Pain Medication Rx Identified

THURSDAY, Sept. 28, 2017 (HealthDay News) — The optimal length of opioid pain medication prescription after common surgical procedures lies between the observed median prescription length and the early nadir, according to a study published online Sept. 27 in JAMA Surgery.

Psychosocial Intervention Ups Adherence to Antidepressants

THURSDAY, Sept. 28, 2017 (HealthDay News) — A psychosocial intervention can improve early adherence to antidepressants among middle-aged and older adults, according to a study published online Sept. 27 in JAMA Psychiatry.

FDA: New Glucose Monitoring System Eliminates Finger Pricks

THURSDAY, Sept. 28, 2017 (HealthDay News) — The FreeStyle Libre Flash Glucose Monitoring System has been approved by the U.S. Food and Drug Administration, making it the first sanctioned device to monitor blood glucose in adult patients with diabetes without the need for a finger prick.

Notification Rates of New HIV Diagnoses Up in Older Adults

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — Notification rates of new HIV diagnoses in older adults increased in 16 European countries from 2004 to 2015, according to a study published online Sept. 26 in The Lancet HIV.

Working With a Scribe Improves Physician Satisfaction

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — Working with a scribe significantly improves physicians’ overall satisfaction, satisfaction with chart quality and accuracy, and charting efficiency, according to a study published online Sept. 11 in the Annals of Family Medicine.

VA Models Provide Guidance for Care of Hepatitis C Infection

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — The U.S. Department of Veterans Affairs (VA) has developed models of care that can be used to reduce the overall burden of hepatitis C virus (HCV) infection, according to a study published online Sept. 25 in the Annals of Internal Medicine.

Cancer Risk Up for RA Patients With Venous Thromboembolism

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — Patients with rheumatoid arthritis (RA) and venous thromboembolism (VTE) have increased risk of cancer in the first year after VTE and during a longer follow-up period, according to a study published online Sept. 15 in the Journal of Thrombosis and Haemostasis.

Fragmented QRS Predicts Cardiac Death During Exercise

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — Fragmented QRS complex may predict risk of exercise-related sudden cardiac death, according to a study published online Sept. 20 in the Journal of Cardiovascular Electrophysiology.

USPSTF Recommends Exercise for Preventing Falls in Seniors

TUESDAY, Sept. 26, 2017 (HealthDay News) — The U.S. Preventive Services Task Force (USPSTF) recommends exercise to prevent falls in at-risk community-dwelling adults aged 65 years and older. These findings form the basis of a draft recommendation statement published online Sept. 26 by the USPSTF.

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Bayesian Method Useful for Noncompleters of 400-m Walk

TUESDAY, Sept. 26, 2017 (HealthDay News) — A Bayesian multiple imputation (MI) method is useful for calculating the speeds of those who are unable to complete the 400-m walk test within the time constraint (noncompleters), according to a study published online Sept. 8 in the Journal of the American Geriatrics Society.

Low-Dose Oxygen No Benefit in Adults With Acute Stroke

TUESDAY, Sept. 26, 2017 (HealthDay News) — The prophylactic use of low-dose oxygen does not reduce death or disability at three months among patients with acute stroke, according to a study published in the Sept. 26 issue of the Journal of the American Medical Association.

Chronic Respiratory Disease Mortality Up From 1980 to 2014

TUESDAY, Sept. 26, 2017 (HealthDay News) — From 1980 to 2014 there was a considerable increase in mortality from chronic respiratory diseases in the United States, according to a study published in the Sept. 26 issue of the Journal of the American Medical Association.

Blame Common in Patient Safety Incident Reports

TUESDAY, Sept. 26, 2017 (HealthDay News) — Blame is a common element in family practice patient safety incident reports, according to a study published in the September/October issue of the Annals of Family Medicine.

Back Pain in Older Men Tied to Incident Vertebral Fractures

TUESDAY, Sept. 26, 2017 (HealthDay News) — Incident, clinically undiagnosed radiographic vertebral fractures (VFs) are associated with increased likelihood of back pain symptoms, according to a study published online Sept. 7 in the Journal of Bone and Mineral Research.

CDC Launches Campaign to Fight Prescription Opioid Epidemic

TUESDAY, Sept. 26, 2017 (HealthDay News) — The U.S. Centers for Disease Control and Prevention is launching a communication campaign featuring accounts of people recovering from opioid use disorder, and those who have lost someone to opioid overdose, in an effort to fight the prescription overdose epidemic.

Nut Consumption Linked to Nutritionally Rich Food Intake

TUESDAY, Sept. 26, 2017 (HealthDay News) — Among overweight and obese women, nut consumption is associated with increased consumption of nutritionally rich foods and with reduced body mass index (BMI), according to a study published online Sept. 21 in the U.S. Centers for Disease Control and Prevention’s Preventing Chronic Disease.

Discontinuing Low-Dose Aspirin Ups Cardiovascular Risk

MONDAY, Sept. 25, 2017 (HealthDay News) — There is more than a 30 percent increased risk of cardiovascular events following discontinuation of low-dose aspirin in long-term users, according to a study published in the Sept 26 issue of Circulation.

Worker Contribution to Health Benefits Up in 2017

MONDAY, Sept. 25, 2017 (HealthDay News) — In 2017, health benefits coverage remained stable, while workers faced considerable variation in costs, according to a report published online Sept. 19 in Health Affairs.

Self-Reported Function IDs Post-Op Course in Elderly

MONDAY, Sept. 25, 2017 (HealthDay News) — Self-reported function is more informative than frailty phenotype in predicting a negative postoperative course in older adults, according to a study published online Sept. 19 in the Journal of the American Geriatrics Society.

Tibetan Yoga Improves Sleep Quality During Chemo

MONDAY, Sept. 25, 2017 (HealthDay News) — Participation in a Tibetan yoga program (TYP) during chemotherapy results in modest, short-term benefits in sleep quality, with long-term benefits seen over time for those who practice at least two times a week, according to a study published online Sept. 20 in Cancer.

Low Health Beliefs for Salt Intake in Hemodialysis Patients

MONDAY, Sept. 25, 2017 (HealthDay News) — Health beliefs regarding salt intake are low among patients undergoing hemodialysis, according to a study published online Sept. 5 in the Journal of Renal Care.

APOE Allele Type Tied to Mortality Risk

FRIDAY, Sept. 22, 2017 (HealthDay News) — The apolipoprotein E (APOE) ε4 allele increases the risk of overall and cardiovascular mortality, while the APOE ε2 allele decreases the risk, according to a study published online Sept. 12 in the Journal of the American Geriatrics Society.

Diabetes Treatment Failure May Actually Be Nonadherence

FRIDAY, Sept. 22, 2017 (HealthDay News) — Apparent diabetes treatment failures may in fact be attributable to nonadherence, according to a study published online Sept. 15 in Diabetes Care.

Few Older Patients Aware of Deprescribing

FRIDAY, Sept. 22, 2017 (HealthDay News) — The majority of older patients are aware of medication harms, but far fewer understand deprescribing, according to a brief report published online Sept. 15 in the Journal of the American Geriatrics Society.

Fasting Blood Glucose Trajectory May Predict Future MI

FRIDAY, Sept. 22, 2017 (HealthDay News) — For individuals without diabetes, certain fasting blood glucose (FBG) trajectories are associated with the risk of future myocardial infarction (MI), according to a study published online Sept. 8 in Diabetes Care.

Diabetes Insipidus Can Occur After Stopping Vasopressin

FRIDAY, Sept. 22, 2017 (HealthDay News) — Although rare, diabetes insipidus (DI) can occur following discontinuation of vasopressin infusion for septic shock, according to a case study published online Sept. 11 in the Journal of Clinical Pharmacy & Therapeutics.

Artificial Intelligence Can Detect Diabetic Retinopathy

THURSDAY, Sept. 21, 2017 (HealthDay News) — Deep neural network or artificial intelligence is able to detect referable diabetic retinopathy from photographs, according to research published online Sept. 4 in Clinical & Experimental Ophthalmology.

More Than 1 in 10 Patients May Be Overtreated for Diabetes

THURSDAY, Sept. 21, 2017 (HealthDay News) — Medicare recipients are more frequently overtreated than undertreated for diabetes, and those who are overtreated rarely have their regimens deintensified, according to a study published online Sept. 13 in the Journal of General Internal Medicine.

Magnesium Levels Tied to Dementia Risk

WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Magnesium levels, either too high or too low, are associated with an increased risk of dementia, according to a study published online Sept. 20 in Neurology.

Ultrasound Echo Intensity Is Potential Frailty Biomarker

WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Higher levels of echo intensity (EI) on ultrasound are associated with lower levels of muscle strength (MS) and greater frailty in the elderly, according to a study published online Sept. 7 in the Journal of the American Geriatrics Society.

Insurer Market Power Lowers Providers’ Prices

WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Insurers have the bargaining power to reduce provider prices in highly concentrated provider markets, according to a report published in the September issue of Health Affairs.

Proton Pump Inhibitors Overused Worldwide

WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Proton pump inhibitors (PPIs) are overused worldwide, with wide variation seen in the extent of inappropriate use, according to research published online Sept. 11 in the Journal of Clinical Pharmacy and Therapeutics.

Naloxegol Has No Effect on Opioid Dose in Opioid-Tied Constipation

WEDNESDAY, Sept. 20, 2017 (HealthDay News) — For patients with noncancer pain and opioid-induced constipation (OIC), naloxegol has no clinically relevant effect on patient-reported pain levels or mean daily opioid dose, according to research published online Sept. 12 in PAIN Practice.

Total of 0.21 Years Lost Due to Opioid-Related Poisoning Deaths

TUESDAY, Sept. 19, 2017 (HealthDay News) — From 2000 to 2015, drug-poisoning deaths contributed a loss of 0.28 years in life expectancy, according to a research letter published in the Sept. 19 issue of the Journal of the American Medical Association.

Deaths, Cardiac Arrest Not Rare in Triathlon Participants

TUESDAY, Sept. 19, 2017 (HealthDay News) — The incidence of deaths or cardiac arrest is 1.74 per 100,000 USA Triathlon participants, according to a study published online Sept. 19 in the Annals of Internal Medicine.

ACP Does Not Support Legalization of Assisted Suicide

TUESDAY, Sept. 19, 2017 (HealthDay News) — The American College of Physicians (ACP) does not support the legalization of physician-assisted suicide, a practice that raises ethical, clinical, and other concerns, according to a position paper published online Sept. 19 in the Annals of Internal Medicine.

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Editorial 2 (subscription or payment may be required)

CPAP Telemonitoring Improves 90-Day Adherence

TUESDAY, Sept. 19, 2017 (HealthDay News) — The use of continuous positive airway pressure therapy (CPAP) telemonitoring with automated feedback messaging improves 90-day adherence in patients with obstructive sleep apnea (OSA), according to a study published online Aug. 31 in the American Journal of Respiratory and Critical Care Medicine.

Narrow Networks in ACA Marketplace for Mental Health

MONDAY, Sept. 18, 2017 (HealthDay News) — Networks in mental health are generally narrower than in primary care, with plan networks including 11.3 percent of mental health providers practicing in a given state-level market, according to a study published online in the September issue of Health Affairs.

Physicians Tweeting About Drugs May Have Conflict of Interest

FRIDAY, Sept. 15, 2017 (HealthDay News) — Most physicians on Twitter with a financial conflict of interest (FCOI) and frequent tweets mention specific drugs for which they have a conflict, according to a study published in the September issue of The Lancet Haematology.

Lower Mortality Risk Seen With Statin Use in Older Men

FRIDAY, Sept. 15, 2017 (HealthDay News) — Statin use is associated with a significantly lower risk of mortality in older male physicians, and a non-significant lower risk of cardiovascular disease (CVD) events, according to a study published online Sept. 11 in the Journal of the American Geriatrics Society.

Mental Health, Dental Issues Top Avoidable ER Visits

FRIDAY, Sept. 15, 2017 (HealthDay News) — Mental health and dental conditions account for a significant number of “avoidable” emergency department visits, according to a study published online Aug. 31 in the International Journal for Quality in Health Care.

Doctors Spend Almost Six Hours Per Day on EHR Tasks

FRIDAY, Sept. 15, 2017 (HealthDay News) — Physicians spend almost six hours per day in the electronic health record (EHR), with 4.5 hours spent during clinic hours and 1.4 hours spent after clinic hours, according to a study published in the September/October issue of the Annals of Family Medicine.

Hospital Quality Independently Impacts Readmission Rates

FRIDAY, Sept. 15, 2017 (HealthDay News) — Hospital quality contributes to readmission rates independent of factors involving patients, according to a study published in the Sept. 14 issue of the New England Journal of Medicine.

Sleep Quality, Duration Linked to CKD Progression

FRIDAY, Sept. 15, 2017 (HealthDay News) — Shorter sleep duration and poor sleep quality are associated with progression of chronic kidney disease (CKD), according to a study published online Sept. 14 in the Journal of the American Society of Nephrology.

‘Science Spin’ Found Prevalent in Biomedical Literature

FRIDAY, Sept. 15, 2017 (HealthDay News) — Spin in biomedical literature (also referred to as “science hype”) is prevalent, with trials having the highest and greatest variability in the prevalence of spin, according to a review published online Sept. 11 in PLOS Biology.

Greater Awareness Needed for Potential of T2DM Remission

THURSDAY, Sept. 14, 2017 (HealthDay News) — For many patients with type 2 diabetes, remission can be achieved with sustained weight loss of ~15 kg, yet this often flies under the radar for patients and clinicians alike, according to an analysis published online Sept. 13 in The BMJ.

New Test Developed to Assess Geriatrics Fellowship Programs

THURSDAY, Sept. 14, 2017 (HealthDay News) — A geriatrics knowledge test demonstrates sound reliability for use in evaluating geriatrics fellowship programs, according to a study published online Aug. 28 in the Journal of the American Geriatrics Society.

Some Aspects of Empathy Improve During Medical Training

WEDNESDAY, Sept. 13, 2017 (HealthDay News) — Certain aspects of empathy improve during medical student training, according to a study published online Sept. 7 in Medical Education.

Short Duration of Hospice Seen for Seniors at End of Life

WEDNESDAY, Sept. 13, 2017 (HealthDay News) — The presence and number of restricting symptoms and the number of disabilities are associated with increased likelihood of hospice admission for older adults during their last year of life, according to a study published online Sept. 12 in the Journal of the American Geriatrics Society.

Vitamin D Deficiency Tied to Neuropathic Pain

WEDNESDAY, Sept. 13, 2017 (HealthDay News) — Vitamin D deficiency may be associated with increased neuropathic pain (NP) in patients with rheumatoid arthritis (RA), according to a study published online Aug. 31 in the International Journal of Rheumatic Diseases.

Are Physicians Obligated to Help on Planes?

TUESDAY, Sept. 12, 2017 (HealthDay News) — Does being a physician carry a moral obligation to respond to calls for medical assistance on airplanes? That is the topic of an article published in the Sept. 12 issue of the Journal of the American Medical Association.

Hormone Therapy in Menopause Not Tied to Increased Mortality

TUESDAY, Sept. 12, 2017 (HealthDay News) — Menopausal hormone therapy is not tied to any increase in long-term all-cause or cause-specific mortality, according to a study published in the Sept. 12 issue of the Journal of the American Medical Association.

Sedentary Time Volume, Accrual Linked to All-Cause Mortality

TUESDAY, Sept. 12, 2017 (HealthDay News) — Sedentary time volume and its accrual in prolonged, uninterrupted bouts are associated with increased risk of all-cause mortality, according to a study published online Sept. 12 in the Annals of Internal Medicine.

Most Opioid Use Concentrated in Top 10 Percent of Users

TUESDAY, Sept. 12, 2017 (HealthDay News) — The top 10 percent of privately insured U.S. adults without cancer using opioids account for most opioid use, according to a research letter published online Sept. 12 in the Annals of Internal Medicine.

2017 Standards of Medical Care in Diabetes Released

TUESDAY, Sept. 12, 2017 (HealthDay News) — Recommendations for the management and pharmacologic treatment of patients with diabetes have been updated; the new clinical guidelines were published online Sept. 12 in the Annals of Internal Medicine.

Airway Mucin Concentrations May Help Predict Chronic Bronchitis

FRIDAY, Sept. 8, 2017 (HealthDay News) — Airway mucin concentrations may be a marker for chronic bronchitis, according to a study published online Sept. 6 in the New England Journal of Medicine.

Statins Tied to Reduced Mortality Risk in COPD

FRIDAY, Sept. 8, 2017 (HealthDay News) — Statin use is associated with a reduced risk of all-cause and pulmonary-related mortality in patients with chronic obstructive pulmonary disease (COPD), according to a study published online Sept. 7 in Chest.

Intensive BP Control Associated With Increased CKD Risk

THURSDAY, Sept. 7, 2017 (HealthDay News) — Intensive systolic blood pressure (SBP) lowering is associated with an increased risk of chronic kidney disease (CKD) events but a reduced risk of cardiovascular events and mortality, according to a study published online Sept. 4 in the Annals of Internal Medicine.

Budget Cuts Threaten Research on Antimicrobial Resistance

THURSDAY, Sept. 7, 2017 (HealthDay News) — Proposed budget cuts could seriously hamper efforts to address antimicrobial resistance (AMR), according to an article published online Sept. 4 in the Annals of Internal Medicine.

Strong Evidence for Healthy Lifestyle Reducing CRC Risk

THURSDAY, Sept. 7, 2017 (HealthDay News) — There is strong evidence that physical activity and a healthy diet reduce the risk of colorectal cancer, according to a report published online Sept. 7 by the American Institute for Cancer Research and the World Cancer Research Fund.

Alendronate Effective, Safe in ‘Oldest Old’ With Prior Fracture

THURSDAY, Sept. 7, 2017 (HealthDay News) — Alendronate treatment reduces the risk of hip fracture in elderly patients with a prior fracture, with sustained safety, according to a study published online Aug. 30 in the Journal of Internal Medicine.

Knowledge on Primary Prevention ICD Use Found Lacking

WEDNESDAY, Sept. 6, 2017 (HealthDay News) — Referring physicians have limited knowledge regarding indications for primary prevention implantable defibrillator (ICD) use, according to a study published online Aug. 25 in the Journal of Cardiovascular Electrophysiology.

Acute Diverticulitis Recurrence More Likely With Barium Enema

WEDNESDAY, Sept. 6, 2017 (HealthDay News) — For patients with acute diverticulitis, recurrence is more likely among those undergoing barium enema, according to a study published online Aug. 30 in the Journal of Digestive Diseases.

CYP2C9 Variants Linked to Clinical Events in VTE

TUESDAY, Sept. 5, 2017 (HealthDay News) — For elderly patients treated with vitamin K antagonists for venous thromboembolism (VTE), CYP2C9 variants are associated with any clinical event, according to a study published online Aug. 22 in the Journal of Thrombosis and Haemostasis.

More Research Needed for Vitamin D’s Cardiac Effect in PCI

TUESDAY, Sept. 5, 2017 (HealthDay News) — More research is needed to assess the role of vitamin D in the prevention of periprocedural myocardial injury, according to a study published online Aug. 25 in the Journal of Clinical Pharmacology.

Perception of Nursing Home Safety Varies by Employee Type

TUESDAY, Sept. 5, 2017 (HealthDay News) — Perceptions of safety culture vary widely among nursing home staff members, according to a study published online Aug. 28 in the Journal of the American Geriatrics Society.

Cognitive Test Predicts Elderly Insulin Injection Success

TUESDAY, Sept. 5, 2017 (HealthDay News) — A cognitive test involving animal name recall can predict which elderly patients succeed in mastering an insulin self-injection technique within one week, according to a study published online Aug. 28 in the Journal of Diabetes Investigation.

Benefit of Aspirin After A-Fib Ablation Questioned

FRIDAY, Sept. 1, 2017 (HealthDay News) — For atrial fibrillation (AF) ablation patients undergoing their index ablation, long-term aspirin therapy is associated with increased rates of bleeding and may not lower risk of stroke, according to a study published online Aug. 28 in the Journal of Cardiovascular Electrophysiology.

β-2 Adrenergic Agonists May Help Fight Parkinson’s Disease

FRIDAY, Sept. 1, 2017 (HealthDay News) — β-2 adrenergic agonists might be able to combat Parkinson’s disease, according to a study published in the Sept. 1 issue of Science.

Low Incidence of Adverse Events for A-Fib Catheter Ablation

FRIDAY, Sept. 1, 2017 (HealthDay News) — The incidence of adverse events (AEs) is low for patients undergoing catheter ablation (CA) for atrial fibrillation (AF), according to a study published online Aug. 30 in JACC: Clinical Electrophysiology.

Electronic Alert Doesn’t Up Appropriate Thromboprophylaxis

FRIDAY, Sept. 1, 2017 (HealthDay News) — A computer-based alert system with a Geneva Risk Score calculation tool in the electronic patient chart does not improve appropriate thromboprophylaxis in patients admitted to general medical wards, according to a study published online Aug. 24 in the Journal of Thrombosis and Haemostasis.

Self-Tonometry Feasible, Acceptable for Glaucoma Patients

FRIDAY, Sept. 1, 2017 (HealthDay News) — For patients with glaucoma, self-tonometry is feasible and acceptable to patients, according to a study published online Aug. 31 in JAMA Ophthalmology.

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