Geriatric Update June 3, 2024

In 2021 and 2022, 5 or 6 doses of Tokyo-strain BCG vaccines administered over about 4 months to 93 patients with type 1 diabetes, provided significant protection against COVID-19 disease (p = 0.023) and strong platform protection against all infectious diseases (p < 0.0001), compared to 43 DM1 patients on placebo, while COVID-19 mRNA vaccine alone provided no protection from COVID-19 disease (p = 0.43) in this population.

Sep 25 I wrote: About 8 years before the diagnosis of dementia, Finances: net worth (all assets minus all debts), financial wealth (liquid assets), and home ownership start to decline compared to propensity matched controls.  A new Federal Reserve Bank article combined credit report data with Medicare data of 11.4 million households, tracked it from 2000-2017 and found the financial consequences of undiagnosed dementia to be profound for patients and families, especially weakening credit scores and increasing payment delinquency, for mortgage and credit card accounts specifically.

This matched cohort study of 8916 patients with Alzheimer’s disease and dysphagia found no evidence that the use of thickened liquids reduced mortality, aspiration, or choking, compared with thin-liquid diets. Patients receiving thick liquids were less likely to be intubated (odds ratio [OR], 0.66; 95% CI, 0.54-0.80), but they were actually more likely to have respiratory complications, such as pneumonia (OR, 1.73; 95% CI, 1.56-1.91).

In 20 Randomized controlled trials involving 1477 older adults with cognitive impairment or dementia, simultaneous dual-task training showed significantly enhanced global cognition (0.477, 0.282 to 0.671), executive function (-0.310, -0.586 to -0.035), working memory (0.714, 0.072 to 1.355), gait (0.418, 0.252 to 0.583), physical activity (0.586, 0.012 to 1.16), and depression (-0.703, -1.253 to -0.153).

Higher intake of vegetables, particularly green leafy vegetables, was associated with improved glucose control. Potatoes prepared in a healthy way had no effect, while consuming potato fries/chips, worsened glucose tolerance and insulin sensitivity.  The 8009 participants, avg age 52 years, had an avg vegetable intake of 132 g/day, by questionnaire of 10 point frequency rating. Participants with moderate cruciferous vegetables intake had a 25% lower risk of T2D at the end of 12 years of follow-up.

Based on food questionnaires, 7447 high-risk participants who were recruited from primary healthcare centers in Spain, the highest daily intake of tomatoes (>110 g) showed a 36% reduction in the risk of having hypertension (HR, 0.64; 95% CI, 0.51–0.89), compared to the lowest (<44 g), over a 3-year period. The authors postulate that the antioxidant lycopene is the reason, as tomatoes make up 85% of our lycopene intake, and it can “mop up free radicals.”

Among 3614 individuals, age 51.4; 269 individuals (7.4%) developed stroke, of whom 120 individuals (44.6%) were dead or ADL dependent at 3 months. Intermediate (adjusted hazard ratio [aHR], 0.54; 95% CI, 0.38-0.77) and high (aHR, 0.47; 95% CI, 0.31-0.73) levels of leisure time physical activity were associated with a reduced incidence of stroke compared with low levels, as was intermediate level activity in transportation (aHR, 0.69; 95% CI, 0.52-0.93). High levels of leisure time physical activity were also associated with a reduced risk of poststroke death or ADL dependency (adjusted odds ratio, 0.34; 95% CI, 0.16-0.71) compared with low levels. Work time and household physical activity were not associated with stroke incidence or stroke outcomes.

98,000 people taking part in a US-based cancer study, and found a 24% lower risk of lung cancer in people who had the lowest amount of fat in their diets. This was even more pronounced in smokers at 29% reduced risk. Diets high in saturated fats were associated with a 35% increased risk of all lung cancer, and double the risk of small-cell lung cancer.

In obese patients with atrial fibrillation, age 67, BMI 41.2, dual cardioversion was more successful than single cardioversion (97 of 99 patients [98%] vs 87 of 101 patients [86%]; P = .002), (odds ratio, 6.7; 95% CI, 3.3-13.6; P = .01). Patients in the single cardioversion cohort whose first attempt failed underwent dual cardioversion with all subsequent attempts (up to 3 total), all of which were successful: 12 of 14 after second cardioversion and 2 of 14 after third cardioversion.

Becker’s published the healthiest and unhealthiest states for seniors in 2024, Ohio ranked 36.

Today is world bicycle day. Let’s celebrate the benefits of sustainable, active transport that provides moderate physical activity.