Geriatric Update Oct 6, 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.
Electroacupuncture significantly increased the 6-week urinary continence rate (44% vs 22%) and reduced 24-hour urine leakage more effectively than sham treatment, with minimal adverse events.
More older adults are dying from falls. Several factors feed in: Today’s over-85 cohort may be frailer and sicker than the oldest-old were 30 years ago, Gill added, because contemporary medicine can keep people alive longer. The use of antidepressants and of gabapentin has increased, which are known to cause falls. We are less active, and many older adults move into one level homes, reducing their muscle strength and balance needed to maneuver stairs and curbs, or an uneven sidewalk.
The FDA approved 395 mg of pembrolizumab (Ketudra) and 4,800 units of berahyaluronidase alfa-pmph subcutaneous (SC) every three weeks or twice the dose of each, every six weeks for the treatment of solid tumors. Based on a study that showed no significant difference between this SC compared to intravenous pembrolizumab in adults with metastatic non-small cell lung cancer.
Bone-related biomarkers (osteocalcin, c-terminal cross-linking telopeptide of type 1 collagen, sclerostin, bicarbonate) were not associated with incident hip fracture among women, age 70, over more than 10 years of follow-up. Among men, higher sclerostin (OR 0.22 (95% CI 0.09, 0.54) for quintile 5 vs. quintile 1; p for trend < 0.001) were associated with lower risk of hip fracture; however, addition of sclerostin to clinical models predicting incident hip fracture provided limited additional predictive value.
Muscle relaxants are on the beers list. Compared with cyclobenzaprine, baclofen demonstrated a 69% greater risk (adjusted Hazard Ratio [aHR] 1.69, 95% Confidence Interval [CI] 1.51–1.88), and tizanidine carried a 34% greater risk (aHR 1.34, 95% CI 1.11–1.62) for composite injury outcomes.
Traumatic brain injury (TBI) is only associated with higher amyotrophic lateral sclerosis (ALS) risk in the 2 years immediately following injury but not thereafter, which may indicate reverse causality, with TBI in some individuals perhaps remembering a consequence of early, subclinical ALS.
In prognostically similar patients with acute subdural hematoma, receiving acute surgery in one center compared with another random center of conservative treatment, was not associated with a better outcome (OR, 1.05, 95% CI, 0.88-1.26).
Institutional markup ratios (MRs) ratio of charges to costs, across 1960 US hospitals performing 4 major elective operations (abdominal aortic aneurysm repair, colectomy, coronary artery bypass grafting, and hip replacement) The highest markup hospitals (HMH) were investor owned, for-profit hospitals located in metropolitan areas and cost MR was 8.5-fold the true costs of care, with the highest 50 showing a 13-fold MR. Following risk adjustment, care at HMH was associated with significantly greater odds of major morbidity (adjusted odds ratio [AOR], 1.45; 95% CI, 1.14-1.84), including higher adjusted risk of cardiac, respiratory, infectious, and kidney sequelae. Moreover, treatment at HMH was associated with 33%increased likelihood of nonelective readmission within 30 days, in a national cross-sectional study that evaluated 362,367 patients, avg age 65.
About 3 of 4 US children relied on publicly subsidized insurance (Medicaid, CHIP, or Marketplace) or experienced a period without any insurance by their 18th birthday in the post-Affordable Care Act, prepandemic policy environment. Substantial state heterogeneity in childhood uninsurance underscores the critical role of Medicaid, which will be worsened with the cuts in the OBBBA Medicaid cuts.
The CDC reports 1,523 , confirmed measles cases in 42 states, up from 1,454 in 42 states 1 week ago.
The OMDA call on Thu Oct 9th at 8 am is: Part 2 - State Budget, One Big Beautiful Bill, Trump Administration by Pete Van Runkle
Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.
Marie Curie
