Geriatric Update Dec 29, 2025
Physical therapy and/or occupational therapy evaluations for fall prevention in the emergency room (ED) were associated with reduced subsequent ED revisits at 1, 2, and 6 months for older adults, based on 5 datasets. Evaluations in the ED were not associated with increased hospital admission rates or ED length of stay.
Pesticides applied to golf courses may play a role in the incidence of Parkinson’s disease (PD) for nearby residents. A case-control study found the greatest risk of PD within 1 to 3 miles of a golf course, and that this risk generally decreased with distance. Effect sizes were largest in water service areas with a golf course in vulnerable groundwater regions. Living within 1 mile of a golf course was associated with 126% increased odds of developing PD compared with individuals living more than 6 miles away from a golf course (adjusted odds ratio [aOR], 2.26; 95% CI, 1.09-4.70). Individuals living within water service areas with a golf course had nearly double the odds of PD compared with individuals in water service areas without golf courses (aOR, 1.96; 95% CI, 1.20-3.23).
A study made the news this week that showed that people who ate more high-fat cheese were at 13% lower risk for all-cause dementia and a 29% lower risk for vascular dementia than those who didn’t eat much high-fat cheese over 25 years. There was no significant relationship between cheese intake and Alzheimer's disease. This video by Dr. Perry Wilson describes that it may be the lifestyle factor of higher income people that can afford the higher fat cheeses identified in the Swedish food recall.
This website: “Understanding dementia: symptoms, causes, types, and treatment” is excellent and easy to read and understand.
In 120 participants with early symptomatic Alzheimer’s disease and fever blisters, herpes simplex seropositivity, treatment with valacyclovir was not effective in reducing the progression of dementia. Change in the 11-item Alzheimer’s Disease Assessment Scale Cognitive Subscale score (range, 0-70; higher scores indicate greater impairment) at 78 weeks was 10.86 in the valacyclovir group vs 6.92 in the placebo group, which was a significant difference favoring placebo.
This New York Times article summarizes the Lancet Commission report from 2024 into 10 Small Things Neurologists Wish You’d Do for Your Brain
Wear a helmet
Put in earplugs when you’re mowing the lawn or are exposed to loud noises
Get your eyes checked
Take a walk, and swap your chair for a stool
Manage your cholesterol
Floss every day
Join a book club
Wear a mask on smoggy or smoky days
Protect your neck
Sleep well
Several studies showed reduced new onset dementia with GLP-1 receptor agonists. The EVOKE trials of patients with early Alzheimer’s disease did not slow progression, even though inflammation was reduced based on CRP. The final results are expected in October 2026. The difference seems to be that GLP-1 meds may work for prevention but not treatment, but previous studies are observational and the EVOKE is a randomized controlled trial.
Type 2 diabetes (T2D) is a risk factor for vertebral fractures. Glucagon-like peptide 1 receptor agonists (GLP-1s) are associated with lower incidence of vertebral fractures, 1.5% vs 1.8%; odds ratio (OR) 0.83 (95% CI, 0.79-0.87) in a propensity matched study of 193,563 TriNetX database participants, age 58. The mechanisms underlying this association are:
GLP-1s may directly promote bone formation and inhibit resorption by modulating osteoblast and osteoclast activity through the RANKL/OPG signaling pathway.
They may also enhance bone microarchitecture by affecting calcium and phosphate metabolism and regulation of bone-related hormones through the hypothalamic pituitary-parathyroid axis.
GLP-1s mitigate chronic inflammation and insulin resistance, which may preserve osteoblast function and bone matrix quality, thereby reducing skeletal fragility.
Tirzepatide showed over 10 years the atherosclerotic cardiovascular disease (ASCVD) risk score of 2.0% with either 5 or 10 mg tirzepatide and -6.4% with 15 mg tirzepatide, vs. 36.7% with placebo.
This economic evaluation found that although tirzepatide and semaglutide offered substantial long-term health benefits, they were not cost-effective at current net prices and a quality adjusted life year (QALY) of $100,000.
Patients taking semaglutide had a lower rate of first hospital admission for any indication, total hospitalizations, and number of days hospitalized. The SELECT trial included 17,604 patients >45 years (avg age 61) with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes.
Supine hypertension with or without seated hypertension was associated with increased risk of adverse cardiovascular disease events compared with seated hypertension alone.
A single treatment with nitrous oxide, laughing gas, provided at a 50% or 25% concentration produced rapid and significant reductions in depression symptoms in patients with treatment-resistant depression and bipolar depression. At 2 hours (pooled MD −2.74, 95% Confidence Interval (CI): −4.72 to −0.76; p = 0.007) and 24 h (MD −3.32, 95% CI: −5.09 to −1.55; p < 0.0001), but not at 1 week post-inhalation (MD −1.52; 95% CI: −4.07 to 1.03; p = 0.24). Adverse effects were mild and transient and less with 25%.
The CDC reports 1,988 confirmed measles cases in 44 states, up from 1,934 in 43 states 1 week ago. For flu activity, the CDC reports 11 hospitalizations per 100,000 population with the most frequently reported influenza viruses A(H3N2).
The Ohio data for: flu 722 hospitalizations this week vs last week 329, COVID-19 446 vs last week 356, and RSV 158 vs last week 111.
