Geriatric Update March 18, 2024

Coronary artery calcium score was positively correlated with blood monocyte count and frequency of the classical monocyte subtype, in 757 patients with type 2 diabetes, and confirmed in another 259 patients with DM.

An electronic database review showed an inverse correlation between new prescriptions of GLP-1 agonists and depression or anxiety.  The lowest likelihood was with tirzepatide and depression 65%, and with anxiety 60%. I would have liked to have seen an analysis if reduction of depression paralleled weight loss. 

GLP-1 agonists were associated with increased residual gastric content, >1.5 mL/kg of clear liquid or any solid or other liquid, on preprocedural gastric ultrasonography in 56% of 124 patients, age 54, vs. 19% in patients not on GLP-1 meds.

Consumption of Coffee, Tea, and Caffeine at Midlife, was associated with lower risk of physical frailty in late life in a study of 12,583 Chinese adults age 73 after 20 years of follow up: OR, 0.82 (95% CI, 0.71-0.95), 0.54 (0.38-0.76), 0.77 (0.66-0.91), respectively.

Daily consumption of the three doses of 5-15 ml (1-3 teaspoons) of apple cider vinegar for 4-12 weeks led to significant reductions in anthropometric variables (weight, body mass index, waist/hip circumferences, and body fat ratio), blood glucose, and triglyceride and cholesterol levels.

A plant-based diet improve sexual and urinary health in 3500 patients treated for local prostate cancer, 8%-11% better in measures of sexual function, 14% better urinary health, with fewer instances of incontinence, obstruction, and irritation, and up to 13% better scores in hormonal health, marked by symptoms like low energy, depression, and hot flashes. While research including randomized controlled trials showed benefit in cardiovascular and dementia outcomes, for some patients the benefit on sexual function and continence may be the convincing argument.

Interpersonal behavior change strategies (BCSs) (peer-to-peer sharing or learning) in 304 older adults, age 77 was effective at increasing physical activity, while Intrapersonal BCS (goal setting) did not.

Quitting smoking before age 40 years brings overall mortality back to the level of nonsmokers as early as the third year after quitting. This decreases with increasing age and in our patients, aged 60-79 years, the mortality is lowered by −40% in men and −33% in women.

Even mild traumatic brain injury (TBI) at avg age 34 in 51 veterans confers an increased risk of Alzheimer’s compared to 85 veterans without TBI history, later at avg age 50, based on: lower CSF Aβ42 and Aβ40, poorer verbal memory and fluency, slower trail making test B time by 34 seconds and the mean California verbal learning test 2nd ed. short-delay recall was lower by 4.2 points.

This study provides experimental evidence that hearing loss can promote Alzheimer’s by downregulating the growth differentiation factor 1 (GDF1). I could not find much about GDF1 but we will likely hear more about it as it is found in tumor dissemination and metastasis. 

Care by a SNFist was associated with a reduced risk of: hospital transfer in the last 3 days of life (−1.6%), lack of continuity in NHs after hospitalization (−4.8%), and decedents experiencing multiple hospitalizations for any reason or any hospitalization for pneumonia, urinary tract infection, dehydration, or sepsis (−5.8%).

Congress is investigating private equity acquisition of hospitals, which is good but they did not do when it happened to nursing homes 5 years earlier, even though there are 60% more NH than hospital beds.

Thank you, Joe for sharing that in car accidents, women had greater overall shock index than men, even in less severe crash injuries; women had more pelvis and liver injuries.

Last week the link to Becker’s Hospital Review 16 healthcare takeaways in the administration’s budget did not stick.