November 2018 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for November 2018. 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.

Bone Indices on CT Scan Predict Fracture Risk in Older Adults

FRIDAY, Nov. 30, 2018 (HealthDay News) -- High-resolution peripheral quantitative computed tomography (HR-pQCT) indices improve prediction of fracture beyond bone mineral density and Fracture Risk Assessment Tool (FRAX) scores in older adults, according to a study published online Nov. 28 in The Lancet Diabetes & Endocrinology.

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Climate Change Ups Heat Deaths, Especially Among Elderly

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Risk for heat-related disease and death is rising worldwide due to climate change, according to a report published online Nov. 28 in The Lancet.

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Dementia Often Misclassified With Brief Cognitive Assessments

THURSDAY, Nov. 29, 2018 (HealthDay News) -- When using brief cognitive assessments, dementia is often misclassified, according to a study published online Nov. 28 in Neurology Clinical Practice.

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Persistent Back Pain Linked to Earlier Mortality in Older Women

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Frequent persistent back pain is associated with increased mortality in older women, according to a study recently published in the Journal of General Internal Medicine.

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Certain SGLT2 Inhibitors, GLP-1 RAs for T2DM Also Cut CV Risk

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Certain sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) demonstrate significant cardiovascular (CV) benefit and should be used for reducing CV risk in patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD), according to a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways published online Nov. 26 in the Journal of the American College of Cardiology.

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Protein Intake Tied to Disability Trajectory in Very Old

WEDNESDAY, Nov. 28, 2018 (HealthDay News) -- For very old adults, higher protein intake is associated with better disability trajectories, according to a study published online Nov. 1 in the Journal of the American Geriatrics Society.

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FDA to Update Medical Device Approvals Process

TUESDAY, Nov. 27, 2018 (HealthDay News) -- A major update of the United States' system for approving medical devices was announced yesterday by the Food and Drug Administration.

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Four Principles Underlie Patient and Family Partnership in Care

TUESDAY, Nov. 27, 2018 (HealthDay News) -- Patient and family partnership in care should include treatment of patients and families with dignity and respect, their active engagement in all aspects of care, and their contribution to the improvement of health care systems and education of health care professionals, according to a position paper published online Nov. 27 in the Annals of Internal Medicine.

Position Paper
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Food Assistance May Help Older Adults Adhere to Diabetes Meds

TUESDAY, Nov. 27, 2018 (HealthDay News) -- Participation in the Supplemental Nutrition Assistance Program (SNAP) may reduce the number of low-income older adults with diabetes forgoing medications because of cost, according to a study published online Nov. 19 in JAMA Internal Medicine.

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Risks of Trazodone Similar to Those of Atypical Antipsychotics

TUESDAY, Nov. 27, 2018 (HealthDay News) -- For older adults with dementia, trazodone is associated with a comparable risk for falls and fractures as that of atypical antipsychotics, according to a study published online Nov. 26 in CMAJ, the Journal of the Canadian Medical Association.

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FDA Approves New Treatment for Acute Myeloid Leukemia

MONDAY, Nov. 26, 2018 (HealthDay News) -- The U.S. Food and Drug Administration recently announced the approval of Daurismo (glasdegib) tablets for use in combination with a low dose of the chemotherapy cytarabine to treat newly diagnosed acute myeloid leukemia (AML). The treatment is indicated for patients aged 75 years or older who have comorbidities that may prevent the use of intensive chemotherapy.

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ACA Coverage Substantial, but Did Not Impact Labor Markets

MONDAY, Nov. 26, 2018 (HealthDay News) -- Millions of workers gained insurance coverage under the Affordable Care Act (ACA) without adverse effects on labor markets, according to a report published by the Robert Wood Johnson Foundation and the Urban Institute.

Report: How Have Workers Fared Under the ACA?

Bone Erosions More Frequent With Old Age at Onset of Early RA

WEDNESDAY, Nov. 21, 2018 (HealthDay News) -- Old age at onset of early rheumatoid arthritis (RA) is associated with more frequent bone erosions, according to a study published online Nov. 11 in the International Journal of Rheumatic Diseases.

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Arterial Stiffness May Predict Dementia Risk

WEDNESDAY, Nov. 21, 2018 (HealthDay News) -- Arterial stiffness may predict dementia risk, independent of subclinical brain damage, according to a study recently published in the Journal of Alzheimer's Disease.

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Pain Management Telementoring May Cut Opioid Prescribing

TUESDAY, Nov. 20, 2018 (HealthDay News) -- Military patients whose primary care clinicians participated in a telementoring program, including education on pain management best practices, have larger declines in opioid-related prescriptions than patients whose clinicians did not participate, according to a study published online Oct. 31 in the Journal of General Internal Medicine.

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Major Bleeding Up With Frailty in Acute MI Patients

TUESDAY, Nov. 20, 2018 (HealthDay News) -- Frail acute myocardial infarction (AMI) patients are less likely to undergo cardiac catheterization and have an increased risk for bleeding, according to a study published in the Nov. 26 issue of JACC: Cardiovascular Interventions.

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CDC: 8.8 Percent Uninsured in U.S. in First Half of 2018

FRIDAY, Nov. 16, 2018 (HealthDay News) -- In the first six months of 2018, 8.8 percent of U.S. individuals of all ages were uninsured, which was not significantly different from 2017, according to a report published Nov. 15 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Health Care Costs, Use Up for Untreated Hearing Loss

FRIDAY, Nov. 16, 2018 (HealthDay News) -- Older adults with untreated hearing loss have increased total health care costs and an increased risk for medical comorbidities, according to two studies published online Nov. 8 in JAMA Otolaryngology-Head & Neck Surgery.

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Patients Hospitalized for COPD Rarely Receive Pulmonary Rehab

FRIDAY, Nov. 16, 2018 (HealthDay News) -- Few patients hospitalized for chronic obstructive pulmonary disorder (COPD) receive pulmonary rehabilitation (PR), according to a study published online Nov. 12 in the Annals of the American Thoracic Society.

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Press Release - Survey

Name-Brand Medications Driving Spike in U.S. Drug Spending

THURSDAY, Nov. 15, 2018 (HealthDay News) -- Rising drug spending in the United States is being fueled by expensive name-brand prescription medicines, a new study shows.

NBC News Article
Blue Cross Blue Shield Report

CDC: Many Americans May Have Prediabetes and Not Know It

THURSDAY, Nov. 15, 2018 (HealthDay News) -- More than one-third of Americans have prediabetes, but 90 percent of them do not know they have it, medical experts say.

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Patient Experiences Shed Light on Diagnostic Errors

THURSDAY, Nov. 15, 2018 (HealthDay News) -- Data from patient- and family-reported error narratives indicate that problems related to patient-physician interactions are major contributors to diagnostic errors, according to a study published in the November issue of Health Affairs.

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AMA to Collect Data on Suicide Among Doctors-in-Training

WEDNESDAY, Nov. 14, 2018 (HealthDay News) -- By collecting data on suicides by medical students, residents, and fellows, the American Medical Association hopes to identify ways to reduce suicides among doctors-in-training. The data collection policy was approved at a meeting yesterday.

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Pharmacist-Led Effort Cuts Inappropriate Rx in Older Adults

WEDNESDAY, Nov. 14, 2018 (HealthDay News) -- A pharmacist-led intervention has the potential to reduce prescriptions for inappropriate medication in older adults, according to a study published in the Nov. 13 issue of the Journal of the American Medical Association.

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Access to In-Home Support Soon to Be Available for Seniors

TUESDAY, Nov. 13, 2018 (HealthDay News) -- In-home services such as help with household chores and caregiver respite will be available to seniors with private Medicare Advantage plans in more than 20 states next year.

AP News Article

Online Tool Helps Patients With Advance Care Planning

TUESDAY, Nov. 13, 2018 (HealthDay News) -- The patient-facing PREPARE advance care planning program plus an easy-to-read advance directive significantly increases documentation of advance care planning and patient-reported engagement, according to a study published online Oct. 29 in JAMA Internal Medicine.

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Coordinated Care Needed for Cancer Survivors, Caregivers

TUESDAY, Nov. 13, 2018 (HealthDay News) -- There is an urgent need for coordinated, comprehensive, personalized care for cancer survivors and caregivers, according to a report published online Oct. 30 in CA: A Cancer Journal for Clinicians.

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In-Hospital Infection May Up Readmission After Stroke

THURSDAY, Nov. 8, 2018 (HealthDay News) -- For patients with ischemic stroke, infection during stroke hospitalization is associated with increased odds of 30-day readmission, according to a study published online Nov. 1 in Stroke.

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Herpes Zoster Recombinant Vaccine Seems Most Effective

THURSDAY, Nov. 8, 2018 (HealthDay News) -- The herpes zoster adjuvant recombinant subunit vaccine may be more effective than the live attenuated vaccine, though it is associated with an increased risk for adverse events at the injection site, according to a review published online Oct. 25 in The BMJ.

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Medicaid Expansion Approved in Three Republican-Leaning States

WEDNESDAY, Nov. 7, 2018 (HealthDay News) -- Hundreds of thousands more low-income Americans could get health insurance after voters in three Republican-leaning states approved Medicaid expansion in the midterm elections.

CNBC Article

Nonadherence, Discontinuation of Statins High in 1st Year of Rx

WEDNESDAY, Nov. 7, 2018 (HealthDay News) -- First-year nonadherence and discontinuation are high among older adults prescribed statins, according to a study published online Nov. 7 in the British Journal of Clinical Pharmacology.

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Sign-Up Season Begins on HealthCare.gov

FRIDAY, Nov. 2, 2018 (HealthDay News) -- The federal government website where Americans can sign up for health insurance under the Affordable Care Act is up and running, officials said yesterday.

AP News Article
HealthCare.gov

Age, Racial Disparities Seen in Hospitalization for Heart Failure

FRIDAY, Nov. 2, 2018 (HealthDay News) -- For emergency department patients with heart failure, data reveal age and racial disparities in hospitalization rates, according to a study published in the November issue of the American Journal of Preventive Medicine.

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Second Hypertension Drug Recalled Due to Contamination

THURSDAY, Nov. 1, 2018 (HealthDay News) -- Another hypertension drug is being recalled due to contamination that could pose a cancer risk, the U.S. Food and Drug Administration says.

CNN Article
FDA Recall Alert

Financial Conflicts of Interest Prevalent Among CPG Authors

THURSDAY, Nov. 1, 2018 (HealthDay News) -- There is a high prevalence of financial conflicts of interest among authors of clinical practice guidelines (CPGs) related to high-revenue medications and in gastroenterology, according to two research letters published online Oct. 29 in JAMA Internal Medicine.

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Home BP of 130/80 mm Hg ID'd as Threshold for Stage 1 HTN

THURSDAY, Nov. 1, 2018 (HealthDay News) -- A home blood pressure (BP) reading of 130/80 mm Hg should be considered the threshold for stage 1 hypertension, according to a study published online Oct. 29 in Hypertension.

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