Geriatric Update Aug 25, 2025
The CDC reports 1375, confirmed measles cases in 42 states, up from 1353 in 41 states 2 weeks ago.
This CIDRAP podcast on vaccines points out that without mRNA vaccines we are not able to manage the next pandemic because other vaccines would take years to produce enough antigen and vaccine to treat millions.
Of 3,285 adult seen in 10 emergency department (ED) of 5 states, 85.9% of non–critically ill participants missed at least one CDC-recommended vaccine but 86.7% were willing to be vaccinated in the ED with all missing vaccines. nearly half (49.4%) had not heard of one or more CDC-recommended vaccines for their age group.
Gallup's latest Consumption Habits survey showed that 54% Americans reported drinking alcohol, compared with 58% in 2024 and 62% in 2023, and beating the record low of 55% in 1958 . A majority of Americans 53%, say moderate drinking is bad for health, up from 45% last year.
Life’s Essentials (LE) 8 includes 4 health behaviors (diet, physical activity, nicotine, sleep) and 4 health factors (body mass index, non‐high‐density lipoprotein blood cholesterol, blood glucose, and blood pressure); higher scores indicate better cardiovascular health. People with one or more heart-related health problems were less likely to adhere to the 8 lifestyle factors, score <60, mainly due to poor adherence to blood pressure control and exercise, while those without heart problems had an average score of 68.
Among males without prostate cancer (PC) at baseline, plant-based and healthy dietary patterns (eg, higher Healthy Eating Index, lower dietary inflammatory and hyperinsulinemic scores) were generally associated with lower total PC risk. Among patients with PC, Mediterranean, plant-based, and low-inflammatory diets were more consistently linked to lower risk of progression and PC-specific mortality. Randomized controlled trials (RCTs) testing various diet patterns showed mixed effects on prostate-specific antigen or tumor markers. The mixed results from RCTs maybe due to other lifestyle factors having an effect, such as weight loss and exercise, but does not negate the positive effect of Lifestyle Changes.
No long-term benefit of randomization to aspirin was observed for major acute coronary event (MACE) for the entire in-trial and post-trial period [hazard ratio (HR) 1.04, 95% confidence interval (CI) .94, 1.15]. And during the post-trial period (median 4.3 years), there was a higher rate of MACE (HR 1.17, 95% CI 1.01, 1.36) and major haemorrhage (HR 1.24, 95% CI 1.10, 1.39) in those randomized to aspirin compared with placebo, of the 19,114 participants of the ASPREE trial, randomized (9525 aspirin, 9589 placebo), age >70 years at enrollment.
After COVID-19, elevated fibrinogen relative to C-reactive protein was associated with both objective and subjective cognitive deficits at 6 and 12 months. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact, mediated by fatigue and shortness of breath, in 1,837 people who were hospitalized with COVID-19.
Participants with hearing loss with hearing aids showed a 61% lower risk (hazard ratio [HR] = 0.39; 95% confidence interval [CI], 0.17-0.89; P = .03) of new onset dementia among <70 years at hearing loss diagnosis, compared to those not wearing hearing aids, when followed up for up to 20 years. Participants without hearing loss had a 29% lower risk (HR = 0.71; 95% CI, 0.54-0.95; P = .02) for incident all-cause dementia, but no association between hearing loss or hearing aid use and incident dementia in people ≥70 years, based on 2,953 Framingham Heart Study participants, age 68.9 years.
Use of vaginal estradiol tablets was not associated with an increased rate of recurrent ischemic stroke (current use: adjusted hazard ratio [aHR] = 0.79, 95% confidence interval [CI], 0.52-1.20; P = .27; recent use: aHR = 1.09, 95% CI, 0.73-1.63, P = .67; and past use: aHR = 1.48, 95% CI, 0.95-2.30, P = .08), in a nationwide nested case-control study including all women aged ≥45 years, median age was 75, who developed a first ischemic stroke between 2008 - 2017, 3353 recurrent stroke cases were propensity matched by birth year with 3353 controls. This is encouraging for the women using vaginal estrogen for dryness or incontinence.
Estrogen replacement therapy (ERT) by skin patch did not improve knee pain and function in postmenopausal women, age 73.8 years, with knee osteoarthritis (KOA) over exercise alone, but may improve outcomes in early-stage KOA and mental health domains.
New policies will boost out-of-pocket health insurance premiums by 93% in the 32 states that allow the federal government to operate their Affordable Care Act insurance marketplaces. Most affected are rural county residents with an increase of 107%, while residents of urban counties will pay 89% more. This is because insurers participating in ACA marketplaces are increasing premiums by avg 18% for 2026 – the biggest jump since 2018 and 11 points more than the growth from 2024 to this year. That bump would come on top of the increase resulting from the expiration of the tax credits and the administration’s policy changes. About 2.8 million people who are enrolled in marketplace plans in the 32 states live in rural counties.
This TED talk outlined 5 net positive economic improvements that immigrants bring.
Increase the amount of economic investment in the community
Bring talents and skill
Bring innovation, technology, >1/3 of Patents are awarded to immigrants
They are consumers
They are taxpayers
Safety and health are improved with immigration.
This is an excellent short, 1:46 min, video explaining why how much and what we eat is more important than exercise in weight loss.
This is an excellent podcast on chronic pain mgmt, quite long, 2 hours 47 min.
Our article: Association between Dehydration and Stroke, a Retrospective Cohort Study of a Large Database was published open access. After controlling for common confounders in propensity score matching, individuals with dehydration were 1.98-3.99 times more likely to develop stroke: intracerebral hemorrhage (OR=3.99, 95% CI=3.41-4.67), ischemic stroke (OR=1.98, 95% CI=1.9-2.07), and TIA (OR=2.88, 95% CI=2.74-3.28). The diabetes group showed: intracerebral hemorrhage (OR=6.76, 95% CI=4-11.42), ischemic stroke (OR=1.97, 95% CI=1.81-2.16), and TIA (OR=2.81, 95% CI=2.33-3.39).
