Geriatric Update Oct 13, 2025

Walking increased equally in customized, computer-driven short message service (SMS) system, 116.4 minutes per week vs. standard human telephone counseling, 113.6 minutes per week over 12 months among 280 inactive randomized sedentary Hispanic or Latino/a adults, age 51, body mass index 33, in Northern California.

Those who engaged in one or two-minute bursts of exercise roughly three times a day, like speed-walking while commuting to work or rapidly climbing stairs, showed a nearly 50% reduction in cardiovascular mortality risk and a roughly 40% reduction in the risk of dying from cancer as well as all causes of mortality, compared with those who did no vigorous spurts of fitness. A 2020 study linked four-minute bursts of exercise with longer life spans; another in 2019 found that climbing stairs for 20 seconds, multiple times a day, improved aerobic fitness, and repeating just four-second intervals of intense activity could increase strength or counteract the metabolic toll of sitting for long stretches of time.

Five years of supervised exercise training in older Norwegians aged 70-77 years had little effect on cardiovascular risk profile and did not reduce cardiovascular events. The control group was healthy and engaged in exercise, but the intervention group that participated in high intensity training was more fit with higher peakVO2, but the same continuous cardiovascular risk score and the study had substantial cross contamination. This supports that any exercise is beneficial.

Cardiovascular diseases (CVDs) were the leading cause of disability-adjusted life-years (DALYs) and deaths in 2023, with an increase in the number of CVD deaths globally, from 13.1 million in 1990 to 19.2 million in 2023. There were 437 million CVD DALYs globally as of 2023, representing a 1.4-fold increase from 320 million in 1990.

Before a heart attack, stroke or other cardiovascular disease hit, there are almost always, >99% of cases, warning signs, including blood pressure levels, blood sugar, cholesterol or smoking, in more than 600,000 cases of cardiovascular disease in South Korea and another 1,000 cases in the U.S.

Deaths did decreased by 15% from 2010, but fatalities linked to conditions like high blood pressure, heart failure, and atrial fibrillation were not falling more, and more young adults are diagnosed with heart failure,  stroke, and hypertension. Fewer than 1 in 10 Americans qualify as having ideal cardiovascular health, The AHA’s forecast for the next three decades is that cardiovascular disease will mostly increase by 2050, worsened by obesity, a crisis in primary care, deep racial and ethnic disparities and an aging population. 

Intentional weight loss of 5% or more, coupled with reduced waist circumference was associated with lower risk for death from cancer, CVD or any cause among postmenopausal women followed for >18 years. Intentional weight loss without a reduction in waist circumference was associated only with a reduction in cardiovascular (CV) risk, whereas unintentional weight loss or weight gain were each associated with increased mortality risk.

Soft drinks may contribute to major depressive disorder (MDD) through alterations in gut microbiota, with stronger effects seen in women. Consumption was linked to increased Eggerthella but not Hungatella abundance in women. The results have been found in other studies as well, that women tend to be more vulnerable than men to the effects of unhealthy diet and pro-inflammatory diets.  

In a randomized clinical trial of 800 older adults, age 73, with chronic low back pain (CLBP), acupuncture needling (both a standard course and additional maintenance sessions) improved pain-related disability with CLBP at 6 months and 12 months, with no statistically discernible benefit of additional maintenance sessions.

The FDA approved cryoablation for breast cancer after a 5 year follow up showed ipsilateral breast tumor recurrence rate was 4.3% and breast cancer survival was 96.7%. Of the 124 patients who received endocrine therapy only, the IBTR was 3.7%. The women ≥70 years of age, avg 75, with unifocal, ultrasound visible, invasive ductal carcinoma ≤ 1.5 cm in size, histologic grade 1–2, hormone receptor (HR)-positive, and human epidermal growth factor receptor 2 (HER2)-negative. The study did not compare with lumpectomy, which is a simple procedure, and was funded by the manufacturer of the cryoablation device that was approved.

IV hydration spas have grown rapidly in the US and one study looked at 3 components: state laws, provider websites and a secret shopper that ordered spa IV hydration in 2 locations of every state. Laws varied widely with only 4 state policies addressed governance, prescriber credentials, dispensing practices, and compounding practices. Only 2 of the 255 facility websites (0.8%) cited sources for their beneficial health claims, e.g. glutathione, magnesium and vitamins.  Only a quarter (24.4%) described potential risks and (27.6%) required consultation with a licensed medical professional before treatment.

Over 25 rural hospitals facing financial headwinds and frustrated with prior authorization demands are withdrawing from contracts with Medicare Advantage plans because of lower reimbursement, more aggressive prior authorization, and increased administrative demands when compared with traditional Medicare.

Patients in rural areas are already at higher risk for poor health outcomes. Squeezing the physician practices that care for them by further cutting Medicare and Medicaid beyond the 33% cuts over the last 20 years is not the answer. 

Incorporating visceral adipose tissue (VAT) measurements alongside waist circumference (WC) data improved the ability to identify individuals at high risk for coronary heart disease (CHD) compared to using WC alone. Both VAT and WC proved to be more accurate indicators of CHD risk than abdominal subcutaneous adipose tissue (ASAT). However, VAT alone did not fully account for the CHD risk associated with elevated WC levels. Neither VAT nor ASAT showed an association with the risk of stroke, HF and AF.

Discordant VAT above the median with WC below presented a HR of 1.43 (95% CI: 1.15-1.78) for CHD, compared with concordant VAT and WC below the median. Similar results were found for discordant WC above the median with VAT below, with a HR of 1.46 (95% CI: 1.18-1.81).

A short course of antibiotics, 5 days, was adequate in community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), in patients who have clinically improved, based on 30 systematic reviews of treatment durations. Hospital-acquired pneumonia (HAP), acute sinusitis, and streptococcal pharyngitis, tonsillitis, or pharyngotonsillitis need studies to assess short treatment courses. 

Statin use was associated with increased glaucoma prevalence when compared with statin nonuse (adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 1.01–1.26). Of 79,742 individuals with hyperlipidemia in AoU, there were 6365 (8.0%) statin users. Higher serum levels of LDL-C were associated with increased odds of glaucoma (aOR: 1.003, 95% CI: 1.003, 1.004). While the result is statistically significant, and confounders were accounted for, additional underlying factors may be contributing, and in observational studies, an odds ratio of >2 is considered significant.

Gastrointestinal procedures in 70 patients taking GLP-1 meds showed almost 4 times inadequate bowel preparation in the GLP-1RA than 139 patients in the control group (10 of 47 individuals [21.3%] vs 6 of 93 individuals [6.5%]; OR, 3.9; 95% CI, 1.3-11.6). No aspiration events, respiratory distress, or aspiration pneumonia occurred. Age was 62.7, BMI 34.4.

The D-dimer (DD) median for >75 year olds to rule out pulmonary embolus was more accurate after changing the cutoff point to above 4.33 mg/L, the specificity increased from 42.5% to 93.9%, reducing false positive.

The CDC reports 1,542 , confirmed measles cases in 42 states, up from 1,523 in 42 states 1 week ago.

The OMDA call on Thu Oct 16th at 8 am is: The Academy of Senior Health Sciences, Inc, Chris Murray

Rome’s empire was fueled by the love of power. God’s empire was fueled by the power of love.

—Brian McLaren