Home Geriatrics August 2015 Briefing – Geriatrics

August 2015 Briefing – Geriatrics

Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for August 2015. 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.

FDA Warns of Joint Pain Tied to DPP-4 Inhibitors

MONDAY, Aug. 31, 2015 (HealthDay News) — Use of dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes is tied to severe joint pain in some patients, the U.S. Food and Drug Administration warned on Friday.

Osteonecrosis of Jaw Risk Highest for IV Bisphosphonate Use

MONDAY, Aug. 31, 2015 (HealthDay News) — The risk of osteonecrosis of the jaw (ONJ) is highest in association with intravenous bisphosphonate use, according to a study published online Aug. 19 in the Journal of Bone and Mineral Research.

Periodontal Disease Predicts CAC Progression in Type 1 Diabetes

MONDAY, Aug. 31, 2015 (HealthDay News) — In patients with type 1 diabetes, but not those without diabetes, periodontal disease duration is an independent predictor of long-term progression of coronary artery calcium (CAC), according to a study published in the Sept. 15 issue of The American Journal of Cardiology.

Many Elderly Oncology Patients Taking Alternative Medicines

FRIDAY, Aug. 28, 2015 (HealthDay News) — Many elderly oncology patients use complementary and alternative medications (CAMs), including some that could interfere with their treatment, according to a study published online Aug. 12 in the Journal of Geriatric Oncology.

FDA Approves Repatha for Certain Patients With High Cholesterol

FRIDAY, Aug. 28, 2015 (HealthDay News) — Repatha (evolocumab) has been approved by the U.S. Food and Drug Administration, the second non-statin drug in its class approved to treat high cholesterol.

Growth Hormone May Benefit Bone Health in Older Women

FRIDAY, Aug. 28, 2015 (HealthDay News) — Older women with osteoporosis may benefit from a few years on growth hormone, a new, small trial suggests. The results were reported online Aug. 27 in the Journal of Clinical Endocrinology & Metabolism.

AMA: Ruling Makes It Easier for Insurers to Terminate Doctors

FRIDAY, Aug. 28, 2015 (HealthDay News) — The outcome of a recent case regarding the termination of physicians by an insurance company following a dispute over the necessity of medical services provided has serious implications for physicians and their patients, according to a report published by the American Medical Association (AMA).

Azithromycin Routine in Hospital Despite Risk for QTc Prolongation

FRIDAY, Aug. 28, 2015 (HealthDay News) — Azithromycin is routinely prescribed to hospitalized patients despite risk factors for corrected QT (QTc) prolongation and administration of interacting medications, according to a study published online Aug. 19 in the Journal of Hospital Medicine.

Periop Bridging Unnecessary for Most A-Fib Patients on Warfarin

THURSDAY, Aug. 27, 2015 (HealthDay News) — For most atrial fibrillation patients taking warfarin who require temporary interruption for a procedure, perioperative bridging with heparin is unnecessary, according to a study published in the Aug. 27 issue of the New England Journal of Medicine.

Exercise, Supplements Don’t Help Preserve Cognition in Elderly

TUESDAY, Aug. 25, 2015 (HealthDay News) — Neither exercise nor supplements such as omega-3 fatty acids seem to preserve cognitive function in the elderly, according to research published in the Aug. 25 issue of the Journal of the American Medical Association.

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Evidence Supports Flu Vaccine for Nursing Home Residents

TUESDAY, Aug. 25, 2015 (HealthDay News) — New evidence supports yearly influenza vaccination for protection among nursing home residents, a population for whom vaccine efficacy has been questioned, according to a study published online Aug. 17 in the Journal of the American Geriatrics Society.

High Uric Acid Levels Linked to Greater Mortality

TUESDAY, Aug. 25, 2015 (HealthDay News) — High serum uric acid levels are associated with greater risk of all-cause and cardiovascular mortality, but not cancer mortality, in elderly adults, according to a study published online Aug. 16 in the Journal of the American Geriatrics Society.

Too Few Blacks, Hispanics Pursuing Careers As Physicians

TUESDAY, Aug. 25, 2015 (HealthDay News) — Too few members of certain minority groups are pursuing careers in U.S. medicine, resulting in a serious lack of diversity among general practitioners and specialists, according to a research letter published online Aug. 24 in JAMA Internal Medicine.

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No Cognitive Benefits Seen for Elderly Who Stop HTN Rx

TUESDAY, Aug. 25, 2015 (HealthDay News) — Discontinuing antihypertensive treatment in seniors with mild cognitive deficits does not improve mental functioning, according to research published online Aug. 24 in JAMA Internal Medicine.

Exercise Can Help Control A-Fib in Overweight Patients

TUESDAY, Aug. 25, 2015 (HealthDay News) — Exercise appears to help control atrial fibrillation (AF) in overweight or obese patients, according to a study published in the Sept. 1 issue of the Journal of the American College of Cardiology.

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Corticosteroid Injections of Little Benefit for Low Back Pain

TUESDAY, Aug. 25, 2015 (HealthDay News) — Epidural corticosteroid injections for radicular low back pain or spinal stenosis may provide some relief for certain patients, but any benefits are temporary, according to a review published online Aug. 25 in the Annals of Internal Medicine.

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Increasing Use of Statins for Primary Prevention in Elderly

MONDAY, Aug. 24, 2015 (HealthDay News) — There has been a sharp rise in the use of statins among elderly patients who do not have vascular disease, but there is little research to guide the use of these medicines in this group of patients, according to a research letter published online Aug. 24 in JAMA Internal Medicine.

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Experts Warn Climate Change Will Bring More ER Visits, Mortality

MONDAY, Aug. 24, 2015 (HealthDay News) — High temperatures lead to increased emergency department visits and mortality, and the numbers will grow as climate change makes summers even hotter by the end of the century, according to research published online Aug. 7 in Environmental Health Perspectives.

Metformin Effects May Be Via Gut, Not Bloodstream

MONDAY, Aug. 24, 2015 (HealthDay News) — Metformin may act via a predominantly lower bowel-mediated mechanism, according to research published online Aug. 18 in Diabetes Care.

Nine Modifiable Factors May Be Key in Reducing Alzheimer’s Risk

FRIDAY, Aug. 21, 2015 (HealthDay News) — Up to two-thirds of Alzheimer’s cases worldwide may stem from any of nine conditions that often result from lifestyle choices, a broad research review suggests. The findings were published online Aug. 20 in the Journal of Neurology, Neurosurgery & Psychiatry.

Vitamin D Tied to Fewer Falls in Homebound Seniors

FRIDAY, Aug. 21, 2015 (HealthDay News) — Delivering vitamin D supplements to homebound seniors might help lower their risk of falls, according to a study published online Aug. 16 in the Journal of the American Geriatrics Society.

Spouses of Stroke Survivors Report Reduced Quality of Life

FRIDAY, Aug. 21, 2015 (HealthDay News) — Caring for a spouse who has had a stroke can harm both mental and physical health, according to research published online Aug. 20 in Stroke.

Patient, Family Advisors Can Play Key Role in Practices

FRIDAY, Aug. 21, 2015 (HealthDay News) — Practices can employ patient and family advisors in order to help them focus on patient-centered care needs, according to a report published by the American Medical Association (AMA).

Patient Navigators Tied to Shorter Hospital Stays

THURSDAY, Aug. 20, 2015 (HealthDay News) — Use of patient navigators (PNs) as inpatient care facilitators shortens hospital length of stay, according to a study published online Aug. 10 in the Journal of Hospital Medicine.

Two-Thirds of Acute AAA Occur in Those Aged 75 Years and Older

THURSDAY, Aug. 20, 2015 (HealthDay News) — Two-thirds of acute abdominal aortic aneurysm (AAA) events occur in those aged ≥75 years, with most events in men younger than 75 years occurring in smokers, according to a study published online Aug. 19 in the Journal of the American Heart Association.

Report Highlights Ways to Improve Physician Resilience

THURSDAY, Aug. 20, 2015 (HealthDay News) — Strategies can be adopted for improving physician resilience and the ability to handle the challenges presented by patient care, according to a report published by the American Medical Association (AMA).

Considerable Variation in Cost of Generic Topical Corticosteroids

THURSDAY, Aug. 20, 2015 (HealthDay News) — There is considerable variation in the unit cost of topical corticosteroids across potencies and by branded generic or generic product, according to a research letter published online Aug. 19 in JAMA Dermatology.

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Heart Safety of Testosterone Unclear for Older Men

WEDNESDAY, Aug. 19, 2015 (HealthDay News) — Trials should be conducted to better establish the cardiovascular safety of testosterone therapy, according to a perspective piece published in the Aug. 20 issue of the New England Journal of Medicine.

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Role of SNP Variant in FTO Explored in Obesity

WEDNESDAY, Aug. 19, 2015 (HealthDay News) — A single nucleotide variant in the FTO obesity locus disrupts a conserved motif, which has obesity effects, according to a study published online Aug. 19 in the New England Journal of Medicine.

AM, PM Cortisol Tied to Brain, Cognitive Variances in Later Life

WEDNESDAY, Aug. 19, 2015 (HealthDay News) — Evening and morning cortisol levels in older people may be differentially associated with tissue volume in gray and white matter structures and cognitive function, according to a study published online Aug. 19 in Neurology.

USPSTF Draft Recommendation Urges Against COPD Screening

TUESDAY, Aug. 18, 2015 (HealthDay News) — The U.S. Preventive Services Task Force (USPSTF) has found no net benefit for chronic obstructive pulmonary disease (COPD) screening in asymptomatic adults and consequently recommends against screening. These findings form the basis of a draft recommendation statement published online Aug. 17 by the USPSTF.

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Lumbar Spine BMD Ups Fx Risk in Women With Discordant T-Scores

TUESDAY, Aug. 18, 2015 (HealthDay News) — Lumbar spine (LS) bone mineral density (BMD) increases fracture risk among women with lower LS T-score than femoral neck (FN) T-score, according to a study published online Aug. 4 in the Journal of Bone and Mineral Research.

U-Shaped Link for Physical Activity, Heart Failure in Men

THURSDAY, Aug. 13, 2015 (HealthDay News) — There is a U-shaped correlation for physical activity with risk of heart failure among men, according to a study published online Aug. 12 in JACC: Heart Failure.

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CDC Determines Prevalence of Osteoporosis in Older Adults

THURSDAY, Aug. 13, 2015 (HealthDay News) — The prevalence of osteoporosis and low bone density has been examined among adults aged 65 years and older. The findings were published online Aug. 13 by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

Pattern of Cases, Surveillance Data Similar for Lyme Disease

THURSDAY, Aug. 13, 2015 (HealthDay News) — The estimated annual incidence of Lyme disease (LD) is 106.6 cases/100,000 persons in the United States, according to a report published online Aug. 12 in the U.S. Centers for Disease Control and Prevention’s Emerging Infectious Diseases.

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Studies Highlight Advances in Vaccines for Human RSV

THURSDAY, Aug. 13, 2015 (HealthDay News) — Chimpanzee adenovirus-vectored respiratory syncytial virus (PanAd3-RSV) vaccine candidate and a modified vaccinia Ankara (MBA-RSV) vaccine show potential for human RSV (HRSV), according to two studies published in the Aug. 12 issue of Science Translational Medicine.

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More Physicians Reporting Dissatisfaction With EHR Systems

THURSDAY, Aug. 13, 2015 (HealthDay News) — More physicians report being dissatisfied or very dissatisfied with their electronic health record (EHR) system, compared with five years ago, according to a report published by the AmericanEHR Partners and the American Medical Association.

Antibiotics Often Prescribed for Veterans With ARIs

THURSDAY, Aug. 13, 2015 (HealthDay News) — Though antibiotic prescribing for acute respiratory infections (ARIs) varies greatly among providers, veterans with ARIs commonly receive antibiotics, according to a study published in the July 21 issue of the Annals of Internal Medicine.

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Cholinesterase Inhibitors Pose Weight-Loss Risk

WEDNESDAY, Aug. 12, 2015 (HealthDay News) — Seniors with dementia newly prescribed cholinesterase inhibitors are at risk for significant weight loss, according to a study published online Aug. 3 in the Journal of the American Geriatrics Society.

Age Associated With Amyloid-β Kinetics

WEDNESDAY, Aug. 12, 2015 (HealthDay News) — Increasing age is associated with slowed amyloid-β (Aβ) turnover, according to a study published online July 20 in the Journal of Neurology.

Testosterone Doesn’t Spur Atherosclerosis in Older Men

TUESDAY, Aug. 11, 2015 (HealthDay News) — For older men with low or low-normal testosterone levels, testosterone administration for three years is not associated with atherosclerosis progression, according to a study published in the Aug. 11 issue of the Journal of the American Medical Association.

HAC Reduction Program Penalty Kicks in for FY2015

TUESDAY, Aug. 11, 2015 (HealthDay News) — The latest Centers for Medicare & Medicaid Services (CMS) effort to reduce hospital-acquired conditions (HACs) is the HAC Reduction Program, according to an Aug. 6 health policy brief published in Health Affairs.

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In-Person Staff Meetings Are Valuable for Health Care Teams

MONDAY, Aug. 10, 2015 (HealthDay News) — In-person staff meetings, which are not too short or too long and are held frequently, are valuable for health care team operation, according to an article published in Medical Economics.

Medicare Will Cover Expensive New Leukemia Medication

MONDAY, Aug. 10, 2015 (HealthDay News) — Medicare will pay for a new, expensive cancer medication that costs about $178,000 for a standard course of treatment, the Obama administration says.

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Calculated LDL-C Varies at Lower Values of Measured LDL-C

MONDAY, Aug. 10, 2015 (HealthDay News) — At lower values of measured low-density lipoprotein cholesterol (LDL-C), the variation and bias of calculated LDL-C increases, according to a study published in the Aug. 15 issue of The American Journal of Cardiology.

Stromal Catalase Deficiency Linked to Thymic Atrophy

MONDAY, Aug. 10, 2015 (HealthDay News) — Thymic atrophy seems to be accelerated by stromal catalase deficiency, and can be decreased by genetic complementation of catalase or chemical antioxidants, according to a study published online Aug. 6 in Cell Reports.

Limited Resection Generally Not Equivalent in Stage IA NSCLC

FRIDAY, Aug. 7, 2015 (HealthDay News) — For older patients with invasive, stage IA non-small-cell lung cancer, limited resection is generally not equivalent to lobectomy, according to a study published online Aug. 3 in the Journal of Clinical Oncology.

Coffee Habits Linked to Odds of Mild Cognitive Impairment

FRIDAY, Aug. 7, 2015 (HealthDay News) — A study of more than 1,400 Italian seniors has found a link between patterns of coffee consumption and risk for mild cognitive impairment (MCI). The findings are reported in the September issue of the Journal of Alzheimer’s Disease.

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How Do We Optimize Time With Patients in Primary Care?

FRIDAY, Aug. 7, 2015 (HealthDay News) — Primary care providers (PCPs) can improve the productivity of face-to-face visits with patients by identifying activities that can be delegated to another team member or performed using a different modality, according to research published in the August issue of the Journal of Evaluation in Clinical Practice.

Many Hospitals Being Penalized for 30-Day Readmissions

FRIDAY, Aug. 7, 2015 (HealthDay News) — About half of the nation’s hospitals are being penalized by Medicare for having patients return within a month of discharge, losing a combined $420 million, according to a report published by Kaiser Health.

Reduced Executive Function May Mean Higher CVD Risk

THURSDAY, Aug. 6, 2015 (HealthDay News) — Older adults with lower scores on executive function tests are significantly more likely to experience coronary heart disease or stroke, new research suggests. The study was published online Aug. 5 in Neurology.

Cardiac Rehab Participation Too Low Among Acute MI Survivors

THURSDAY, Aug. 6, 2015 (HealthDay News) — Cardiac rehabilitation programs are considered a key part of recovering from acute myocardial infarction (AMI) — but only a small minority of patients ever attend one, according to a research letter published online Aug. 3 in JAMA Internal Medicine.

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Phone-Delivered CBT Beneficial for Seniors With Anxiety

THURSDAY, Aug. 6, 2015 (HealthDay News) — A telephone-delivered cognitive behavioral therapy (CBT) intervention is superior to nondirective supportive therapy (NST) for older adults with generalized anxiety disorder (GAD), according to a study published online Aug. 5 in JAMA Psychiatry.

Sleeping on Side May Be More Efficient for ‘Clearing Brain’

THURSDAY, Aug. 6, 2015 (HealthDay News) — Removal of waste, including soluble amyloid β (Aβ), from the brain may be most efficient in the lateral versus the prone position, according to an experimental study published in the Aug. 5 issue of the Journal of Neuroscience.

Spicy Food Consumption Linked to Reduced Mortality Risk

WEDNESDAY, Aug. 5, 2015 (HealthDay News) — Adults who regularly eat spicy foods appear to have a reduced mortality risk, according to research published online Aug. 4 in The BMJ.

One in Four With MI and A-Fib Discharged on Triple Therapy

WEDNESDAY, Aug. 5, 2015 (HealthDay News) — About one-quarter of older patients with acute myocardial infarction (MI) and atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are discharged on triple therapy (warfarin, aspirin, and clopidogrel), according to a study published in the Aug. 11 issue of the Journal of the American College of Cardiology.

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Bone Health Benefits Lacking for Vitamin D Supplements

TUESDAY, Aug. 4, 2015 (HealthDay News) — High doses of vitamin D do not appear to protect postmenopausal women from osteoporosis, according to research published online Aug. 3 in JAMA Internal Medicine.

Review: mHealth Text Messages Promote Medication Adherence

MONDAY, Aug. 3, 2015 (HealthDay News) — Mobile health (mHealth) short message service text messages can improve medication adherence, according to a review published online July 27 in the Journal of Clinical Nursing.

Older Smokers With Migraines May Face Added Stroke Risk

MONDAY, Aug. 3, 2015 (HealthDay News) — Older smokers who experience migraines appear to be at increased risk of stroke, a new study suggests. The findings were published online July 22 in Neurology.

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