Geriatric Update Mar 31, 2025

Measles is continuing to gain momentum with 483 confirmed cases reported by 20 states: Alaska, California, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York City, New York State, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, and Washington. The Ohio data has not been updated since Mar 20.

Influenza is winding down with a total of 151 influenza-associated pediatric deaths occurring during the 2024-2025 season.

Heat (sauna) exposure can prolong life due to release of heat shock protein, but prolonged heat can accelerate aging as much as smoking. Life was shortened by aging clock: 2.48 years for PCPhenoAge, 1.09 year for PCGrimAge, and 0.05 years for DunedinPACE over 7 years.

AROMHA Brain Health Test (ABHT), an at-home odor identification memory test, revealed age-related olfactory decline, and discriminated cognitively normal older adults and those with subjective cognitive complaints from those with cognitive impairment, >55 (n=123), independent of age, sex, education, language, self-administration and test duration time.

Waist circumference (WC) was shown to be a stronger marker than body mass index (BMI) for the risk of developing obesity-related cancers in Swedish men, a 1-standard deviation (SD) increase in WC was associated with a 25% higher risk of obesity-related cancers (HR1-SD=1.25, 95% CI = 1.21-1.30), compared to a 19% increase for BMI (HR1-SD=1.19, 95% CI = 1.15-1.23. In women both measurements increased risk the same, 13%. 

Higher weight-adjusted waist index (WWI) (waist circumference in cm: √ weight in kg) was associated with age-related macular degeneration (AMD) in 5,132 US adults >40 years (OR = 1.76 (1.52, 2.04); p < 0.0001) the highest 1/3 exhibited a stronger association compared to the lowest tertile (OR = 2.90 (2.18, 3.86); p < 0.0001). The mechanism is thought to be through oxidative stress reactions in the eyes, through excess calories, damaging the retina; and chronic inflammation. Exercise 3 times per week of vigorous activity vs none reduced AMD progression by 25%.

Compared with patients receiving alternative weight loss medications, those receiving GLP-1 RAs showed a 50.4% and 58.5% reduced risk for primary open-angle glaucoma at 3 years (risk ratio [RR], 0.496; 95% CI, 0.371-0.664) and 5 years (RR, 0.415; 95% CI, 0.316-0.545), respectively. The risk for ocular hypertension was reduced by 55.9% at 3 years (RR, 0.441; 95% CI, 0.318-0.611) and 65.8% at 5 years (RR, 0.342; 95% CI, 0.250-0.466). Reductions in BMI were greater in patients receiving GLP-1 RAs than in those receiving alternative weight loss medications at both follow-up periods (P < .0001), with women receiving GLP-1 RAs showing a greater reduction than men receiving GLP-1 RAs (P < .0001). 

But patient adherence to GLP-1 regimens is low, with more than 50% of patients stopping treatment within the first 3 months and only 33% still adhering to their prescription at 1 year. This article describes coaching tools and strategies to increase adherence and maintain weight loss after stopping. 

Knee osteoarthritis pain, stiffness and physical function improved more and faster in patients with supplementation of 200 mg glucosamine sulphate, 160 mg chondroitin sulphate, 270 mg calcium carbonate, 80 mg rhizoma drynariae, 80 mg casein phosphopeptides and 230 mg excipients. Both randomized groups, age 56, received the same exercise of strength and balance training for 50 min at a center on 2 days per week for 6 months.

A meta-analysis of 2851 patients with breast, gastrointestinal, and gynecological cancers, found that cryotherapy significantly reduced the incidence of chemotherapy-induced peripheral neuropathy overall (relative risk [RR], 0.23), especially among patients undergoing taxane-based chemotherapy. In another meta-analysis of 2250 patients, cryotherapy reduced neuropathy (RR, 0.65 for sensory; RR, 0.18 for motor). While observational data is strong, no randomized controlled trials have been done, and the most recent, 2020 American Society of Clinical Oncology guidelines say "no recommendations can be made.

Vitamin D supplementation has multiple beneficial immunomodulatory effects. A new study has shown immune modulation to be the mechanism in the prevention of multiple sclerosis. Past association studies have already predicted a favorable vitamin D effect reducing relapses by 50–70%, but results are less clear for the progressive degenerative component. It is now reasonable to supplement MS patients with vitamin D, using a moderate physiological dose and correcting their vitamin insufficiency.

Healthy aging is improved with higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes and low-fat dairy products. The odds ratios for the highest quintile versus the lowest ranged from 1.45 (95% confidence interval (CI) = 1.35–1.57; healthful plant-based diet) to 1.86 (95% CI = 1.71–2.01; Alternative Healthy Eating Index). This was even stronger when the age threshold for healthy aging was shifted to 75 years, the Alternative Healthy Eating Index diet showed the strongest association with healthy aging, with an odds ratio of 2.24 (95% CI = 2.01–2.50), after 30 years of follow-up, of 105,015 participants (mean age = 53 years at start). In contrast, higher intakes of trans fats, sodium, sugary beverages and red or processed meats (or both) were inversely associated.

Better diet quality in midlife was significantly associated with enhanced hippocampal functional connectivity to the occipital lobe and cerebellum, with the left hippocampus showing a volume of 9176 mm3 (P < .05) and better white matter connectivity. Higher waist hip ratio (WHR) in midlife was associated with significantly lower cognitive performance scores on a number of tests, including verbal episodic memory (false discovery rate-corrected P = .003), digit span (P = .002), and semantic fluency (P = .007). interventions to improve diet and manage central obesity might be most effective between ages 48 and 70 years.

Coffee contains dipertenes: cafestol and kahweol, which raise LDL cholesterol. Coffee filters reduce intake of LDL cholesterol-generating diterpenes in coffee and subsequently may lower risk for atherosclerotic heart disease. Workplace brewing machines produced coffee with dipertene concentrations several times higher compared with coffee made using paper or fiber filters. The average cup volume obtained from the machines was 137.5 ml, about 5 oz. Replacing three cups of brewing machine coffee with paper-filtered coffee five days per week was estimated to reduce LDL cholesterol by 0.58 mmol/L or 22.4 mg/dL. For comparison, this estimated diterpene effect equals to adding 60 mL full fat (40 %) cream per cup of paper-filtered coffee. Conversely, adding 250 ml of oat milk containing 1 g of cholesterol-lowering beta-glucans to each cup would not fully neutralize the effect of the diterpenes. The corresponding reduction in ASCVD relative risk for a 0.58 mmol/L reduction in LDL cholesterol was 13 % over five years; or 36 % over 40 years.

A congressional house bill will require insurers’ prior authorization denials align with medical need, as determined by board-certified physician of the relevant specialty, and establish and publish online written clinical criterial on their preauthorization standards that is in line with current standards of care, and is evaluated or updated at least once a year.

This 36-minute documentary is about the musical ‘Makin’ Movin’ that follows residents of a North Carolina retirement community as they write and perform an original musical about "freshman year" in a senior community.

My mentor Dr. Phil Sloane was part of the production team and also wrote this song: “The Older You Get the Slower You Go,” with the line: “because we are in no hurry to die…”