February 2019 Briefing - Geriatrics

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

Risk Factors ID'd for Site Infection After Orthopedic Surgery in Seniors

THURSDAY, Feb. 28, 2019 (HealthDay News) -- Five risk factors are independently associated with surgical site infection among geriatric patients undergoing elective orthopedic surgery, according to a study published online Feb. 20 in the International Wound Journal.

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Lowering BP, Lipids in Healthy Elderly Has No Cognitive Effect

WEDNESDAY, Feb. 27, 2019 (HealthDay News) -- Candesartan plus hydrochlorothiazide, rosuvastatin, or their combination do not impact cognitive decline among older people, according to a study published online Feb. 27 in Neurology.

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Ultrasound of Calcaneus Efficient for Screening Bone Health

TUESDAY, Feb. 26, 2019 (HealthDay News) -- Ultrasonography (US) of the calcaneus is efficient for screening bone health, according to a study published in the March issue of the Journal of the American Osteopathic Association.

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Stereotactic Radiation Feasible for Oligometastatic Cancer

TUESDAY, Feb. 26, 2019 (HealthDay News) -- Stereotactic ablative radiation therapy (SABR) for recurrent oligometastatic cancer is a feasible and tolerable treatment option, according to a phase 2 study published in the January issue of the International Journal of Radiation Oncology, Biology, Physics.

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Prognostic Bleeding Risk Models Developed for Aspirin Use

MONDAY, Feb. 25, 2019 (HealthDay News) -- Prognostic bleeding risk models that can estimate the absolute bleeding harms of aspirin have been developed for individuals in whom aspirin is being considered for primary prevention of cardiovascular disease (CVD), according to a study published online Feb. 26 in the Annals of Internal Medicine.

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2014 to 2017 Saw Improvement in Burnout for U.S. Physicians

MONDAY, Feb. 25, 2019 (HealthDay News) -- From 2014 to 2017, there was an improvement in burnout and satisfaction with work-life integration among U.S. physicians, according to a study published online Feb. 22 in the Mayo Clinic Proceedings.

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Preoperative Phone Visits for Cataract Patients Safe, Efficient

MONDAY, Feb. 25, 2019 (HealthDay News) -- Phone visits can safely substitute for a standard, in-person history and physical (H&P) in patients undergoing cataract surgery, according to a study published online Feb. 7 in the Journal of General Internal Medicine.

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National Health Spending Set to Increase 5.5 Percent Annually

FRIDAY, Feb. 22, 2019 (HealthDay News) -- National health spending is projected to increase at an annual rate of 5.5. percent from 2018 to 2027, with fundamental economic and demographic factors the main drivers, according to a report published online Feb. 20 in Health Affairs.

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Higher Triglycerides May Be Protective in the Very Elderly

FRIDAY, Feb. 22, 2019 (HealthDay News) -- Higher triglycerides (TGs) is associated with a decreased risk of cognitive decline, activities of daily living (ADL) decline, frailty aggravation, and mortality in the oldest old, according to a study recently published in the Journal of the American Geriatrics Society.

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FDA: Gout Drug Uloric Increases Risk of Death

FRIDAY, Feb. 22, 2019 (HealthDay News) -- The gout medicine Uloric (febuxostat) carries a higher risk of death than allopurinol, according to the U.S. Food and Drug Administration.

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Most Patients Do Not Disclose Complementary Medicine Use

FRIDAY, Feb. 22, 2019 (HealthDay News) -- Just one-third of users of biologically based complementary medicine (CM) disclose their use to traditional health care providers, according to a review published online Feb. 7 in Scientific Reports.

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Odds of Receiving Tx for CAD Up With Medicare Advantage

FRIDAY, Feb. 22, 2019 (HealthDay News) -- For patients with coronary artery disease (CAD), those enrolled in Medicare Advantage (MA) are more likely to receive secondary prevention treatments than those enrolled in traditional fee-for-service (FFS) Medicare, according to a study published online Feb. 20 in JAMA Cardiology.

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8 More U.S. Communities to Be Assessed for PFAS Toxin Exposure

THURSDAY, Feb. 21, 2019 (HealthDay News) -- Eight additional communities near current or former U.S. military installations that will be included in assessments of human exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) were announced Thursday by federal officials.

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Vertical Integration Has Little Impact on Quality Measures

THURSDAY, Feb. 21, 2019 (HealthDay News) -- Vertical integration between hospitals and physicians has little impact on quality measures, while increased hospital market concentration is strongly associated with reduced quality in measures of patient satisfaction, according to a study published online Feb. 9 in Medical Care Research and Review.

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Experimental Test May Quickly Diagnose Sepsis

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- A blood test that can quickly diagnose dangerous sepsis infections has been developed, according to research published in the Feb. 1 issue of Biosensors and Bioelectronics.

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New Kaiser Permanente Medical School Plans to Waive Tuition

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- A new medical school to be opened by California-based health system Kaiser Permanente will waive tuition for all students in its first five graduating classes.

The New York Times Article
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Morning Exercise Linked to BP Reduction in Sedentary Seniors

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- In sedentary overweight/obese older adults, morning exercise reduces systolic blood pressure, with additional benefit seen by combining exercise with regular breaks in sitting, according to a study published online Feb. 20 in Hypertension.

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Deep Learning-Enhanced Device Detects Diabetic Retinopathy

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- A deep learning-enhanced device can accurately detect diabetic retinopathy (DR), according to a study published online Feb. 14 in Diabetes Care.

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Late-Onset Migraine With Aura Linked to Increased Stroke Risk

TUESDAY, Feb. 19, 2019 (HealthDay News) -- There is an increased stroke risk in late life among patients with late-onset migraine with aura (MA), according to a study published online Jan. 21 in Headache.

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Recombinant Zoster Vaccine Cost-Effective in Simulation

TUESDAY, Feb. 19, 2019 (HealthDay News) -- Vaccination with recombinant zoster vaccine (RZV) seems cost-effective under a wide range of conditions, according to a study published online Feb. 19 in the Annals of Internal Medicine.

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Hospital Prices Growing Faster Than Physician Prices

FRIDAY, Feb. 15, 2019 (HealthDay News) -- Growth in hospital prices and payments outpaced growth in physician prices and payments from 2007 through 2014, according to a report published in the February issue of Health Affairs.

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Fewer Older Men Assessed, Treated for Osteoporosis

FRIDAY, Feb. 15, 2019 (HealthDay News) -- Fewer older men than women undergo evaluation for or management of osteoporosis, according to a study published online Feb. 12 in the Journal of Investigative Medicine.

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Most A-Fib Patients Have at Least One Identifiable Trigger

FRIDAY, Feb. 15, 2019 (HealthDay News) -- Most patients with atrial fibrillation (AF) report at least one identifiable trigger, with the most common triggers being alcohol, caffeine, exercise, and lack of sleep, according to research published online Feb. 14 in HeartRhythm.

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Artificially Sweetened Drinks Linked to Stroke After Menopause

FRIDAY, Feb. 15, 2019 (HealthDay News) -- Among postmenopausal women, consumption of artificially sweetened beverages (ASB) is associated with an increased risk for stroke, coronary heart disease, and all-cause mortality, according to a study published online Feb. 14 in Stroke.

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Hip Preservation Appropriateness Guidelines May Be Limited

THURSDAY, Feb. 14, 2019 (HealthDay News) -- The American Academy of Orthopaedic Surgeons (AAOS) hip preservation surgery appropriateness classification system is driven almost entirely by age and radiographic hip osteoarthritis (OA) evaluation, according to a study published online Jan. 24 in Arthritis Care & Research.

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CDC: Severity of Influenza Season Low Through Feb. 2, 2019

THURSDAY, Feb. 14, 2019 (HealthDay News) -- The 2018 to 2019 influenza season has been low in severity so far, and overall vaccine effectiveness is about 47 percent, according to two reports published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Medicare Patients With MS Face Higher Out-of-Pocket Rx Costs

THURSDAY, Feb. 14, 2019 (HealthDay News) -- Medicare patients with multiple sclerosis (MS) face increasing out-of-pocket costs for disease-modifying therapies, according to a study published in the February issue of Health Affairs.

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CVD Does Not Modify Depression-Mortality Link in Elderly

THURSDAY, Feb. 14, 2019 (HealthDay News) -- In older adults, the association between depressive symptoms and mortality is not influenced by the presence of cardiovascular disease (CVD), according to a study recently published in the Journal of the American Geriatrics Society.

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Physical Activity Down Across Chronic Disease Subgroups

THURSDAY, Feb. 14, 2019 (HealthDay News) -- People with a wide variety of chronic diseases are less physically active than individuals without chronic diseases, according to a study published online Feb. 5 in the International Journal of Epidemiology.

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Rates of Osteonecrosis of the Jaw Low for Denosumab-Treated Women

THURSDAY, Feb. 14, 2019 (HealthDay News) -- For denosumab-treated women with postmenopausal osteoporosis, invasive oral procedures and events (OPEs), including dental implants, tooth extraction, natural tooth loss, scaling/root planning, and jaw surgery, are common and associated with osteonecrosis of the jaw (ONJ), although the overall rate of ONJ is low, according to a study published online Feb. 13 in the Journal of Clinical Endocrinology & Metabolism.

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Improved Outcomes Seen With Liver Grafts From Older Donors

WEDNESDAY, Feb. 13, 2019 (HealthDay News) -- From 2003 to 2016, liver graft loss and mortality improved among recipients of liver grafts from older donors, according to a study published online Feb. 13 in JAMA Surgery.

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Health Care Spending Per Person Increased to $5,641 in 2017

TUESDAY, Feb. 12, 2019 (HealthDay News) -- In 2017, health care spending per person reached $5,641, according to the Health Care Cost Institute (HCCI) annual Health Care Cost and Utilization Report.

Health Care Cost and Utilization Report

Many Systematic Reviews Do Not Fully Report Adverse Events

TUESDAY, Feb. 12, 2019 (HealthDay News) -- Many systematic review protocols in the International Prospective Register of Systematic Reviews (PROSPERO) do not include adverse event reporting, according to a study published in the April issue of the Journal of Clinical Epidemiology.

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Aspirin Underused for Advanced Colorectal Polyps

TUESDAY, Feb. 12, 2019 (HealthDay News) -- Aspirin is underused to reduce the risk for colorectal cancer among patients with advanced colorectal polyps, according to a study recently published in The American Journal of Medicine.

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Fractures Have Long-Term Impact on Quality of Life for Older Adults

TUESDAY, Feb. 12, 2019 (HealthDay News) -- Incident fragility fractures are associated with long-term impacts on health-related quality of life (HRQOL) in older people, according to a study published online Feb. 5 in the Journal of Bone and Mineral Research.

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Functional Decline Seen for Many Frail Patients After TAVR, SAVR

MONDAY, Feb. 11, 2019 (HealthDay News) -- Older patients with severe frailty undergoing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) frequently experience subsequent functional decline or lack of improvement, according to a study published online Feb. 4 in JAMA Internal Medicine.

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Women Less Likely to Get Periop Care Before Hip Fracture Surgery

MONDAY, Feb. 11, 2019 (HealthDay News) -- Although more women have hip fracture surgery, they are less likely to receive perioperative geriatric care and anesthesia consultations, according to a study published online Feb. 11 in CMAJ, the journal of the Canadian Medical Association.

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Johnson & Johnson to Provide Drug Prices in TV Ads

FRIDAY, Feb. 8, 2019 (HealthDay News) -- In a drug industry first, Johnson & Johnson will start giving the list prices of its prescription drugs in television ads.

AP News Article

Education Not Tied to Rate of Cognitive Change in Seniors

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Education is associated with global cognition but not with the rate of cognitive change in older adults, according to a study published online Feb. 6 in Neurology.

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CDC: Heart Attack Awareness Improved Since 2008

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Since 2008, there has been an increase in the number of U.S. adults with awareness of heart attack symptoms and knowledge of the appropriate response to a heart attack, according to research published in the Feb. 8 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Slower Gait Speed, Shorter Step Length Tied to Later Depression

FRIDAY, Feb. 8, 2019 (HealthDay News) -- Older people who develop depression have significantly slower gait speed and shorter step length several years before diagnosis, according to a study published online Feb. 5 in the Journal of the American Geriatrics Society.

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Trazodone Not Associated With Reduced Risk for Dementia

THURSDAY, Feb. 7, 2019 (HealthDay News) -- Trazodone is not associated with a reduced risk for dementia compared with other antidepressants at the prodromal stage of disease, according to a study published online Feb. 5 in PLOS Medicine.

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EEG-Guided Anesthesia Does Not Cut Postop Delirium in Seniors

WEDNESDAY, Feb. 6, 2019 (HealthDay News) -- For older adults undergoing surgery, electroencephalogram (EEG)-guided anesthetic administration is not associated with a reduction in postoperative delirium, according to a study published in the Feb. 5 issue of the Journal of the American Medical Association.

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Antidepressant Overprescribing Appears Common in Elderly

WEDNESDAY, Feb. 6, 2019 (HealthDay News) -- Potential antidepressant overprescribing appears to be common among elderly patients and involves mostly newer antidepressants used for nonspecific psychiatric symptoms and subthreshold diagnoses, according to a study published online Jan. 23 in Pharmacology Research & Perspectives.

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Ethnic Differences Seen at Time of Dementia Diagnosis in U.K.

TUESDAY, Feb. 5, 2019 (HealthDay News) -- In the United Kingdom, patients from minority ethnic groups have lower cognitive scores and are younger at first diagnosis of dementia than the white U.K.-born population, according to a study published online Jan. 24 in the International Journal of Geriatric Psychiatry.

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Long-Term Opioid Use With OA Varies Across States

TUESDAY, Feb. 5, 2019 (HealthDay News) -- There is substantial variation across states in rates of long-term opioid therapy among patients with advanced osteoarthritis, according to a study published online Jan. 28 in Arthritis & Rheumatology.

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Compounded Topical Pain Creams No Better Than Placebo

TUESDAY, Feb. 5, 2019 (HealthDay News) -- Compounded topical pain creams are no better than placebo creams for neuropathic pain, nociceptive pain, or mixed pain, according to a study published online Feb. 5 in the Annals of Internal Medicine.

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Expanded Recall of Warfarin Level Monitoring Test Strips

MONDAY, Feb. 4, 2019 (HealthDay News) -- Certain lots of Roche Diagnostics test strips should not be used with CoaguChek test meter devices to check levels of the blood thinner warfarin because patients may get inaccurate results and be at risk for serious injury or death, the U.S. Food and Drug Administration says in an updated recall notice.

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CDC Examines Safety of Recombinant Zoster Vaccine

MONDAY, Feb. 4, 2019 (HealthDay News) -- During the first eight months of recombinant zoster vaccine (RZV) use, there were reports of 4,381 adverse events, 3 percent of which were serious, according to research published in the Feb. 1 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Direct-to-Doctor Payments May Increase Opioid Prescribing

FRIDAY, Feb. 1, 2019 (HealthDay News) -- Physicians who receive direct pharmaceutical payments for opioid prescribing prescribe more opioids, especially hydrocodone and oxycodone, according to a study published online Jan. 22 in Addiction.

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Hearing Loss Linked to Subjective Cognitive Function Decline

FRIDAY, Feb. 1, 2019 (HealthDay News) -- For older men, hearing loss is associated with subjective cognitive function (SCF) decline, according to a study published online Jan. 29 in Alzheimer's & Dementia.

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Pharmacist-Led Phone Follow-Up May Cut Readmission Rates

FRIDAY, Feb. 1, 2019 (HealthDay News) -- A pharmacist-led, postdischarge structured telephone follow-up (TFU) intervention can reduce 30-day and 90-day readmission rates for polypharmacy patients, according to a study published online Jan. 23 in the British Journal of Clinical Pharmacology.

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