Author Interviews, Exercise - Fitness, Geriatrics, JAMA / 15.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36426" align="alignleft" width="200"]Jennifer Brach, Ph.D., P.T. Associate professor, Department of physical therapy School of Health and Rehabilitation Sciences University of Pittsburgh Dr. Brach[/caption] Jennifer Brach, Ph.D., P.T. Associate professor, Department of physical therapy School of Health and Rehabilitation Sciences University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study compared two different group exercise programs to improve mobility in community-dwelling older adults. The first program, a seated program focused on strength, endurance and flexibility, was based on usual care. The second program, called On the Move, was conducted primarily in standing position and focused on the timing and coordination of movements important for walking. Both programs met two times per week for 12 weeks. It was found that the On the Move program was more effective at improving mobility than the usual seated program.
Author Interviews, Geriatrics, Psychological Science / 15.08.2017

MedicalResearch.com Interview with: Johanna MH Nijsten, Msc Clinical Neuropsychologist Archipel Landrijt, Knowledge Center for Specialized Care Eindhoven, the Netherlands Department of Primary and Community Care, Radboudumc Alzheimer Center Radboud University Medical Center Nijmegen, the Netherlands  MedicalResearch.com: What is the background for this study? Response: Apathy is common in nursing home (NH) patients with dementia and is repeatedly found to be the most prevalent neuropsychiatric symptom. Apathy is defined by diminished or lack of motivational, goal-directed behavior, and a lack of cognition and emotional affect. Apathy leads to reduced interest and participation in the main activities of daily living, diminished initiative, early withdrawal from initiated activities, indifference, and flattening of affect. Over the last two decades, more scientific knowledge has become available about specific fronto-subcortical systems in the brain that may be highly involved in apathy. Disruptions in these systems are found in patients with frontal lobe damage resulting from, for instance, (early-onset) dementia, traumatic brain injury, stroke, or multiple sclerosis. Fronto-subcortical circuits also play an important role in neurological disorders involving the basal ganglia such as Parkinson’s disease and Huntington’s disease. The neurodegenerative diseases and acquired brain injuries mentioned here are highly prevalent in patients receiving long-term NH care and the widespread clinical manifestation of apathy in NH-patients is thought to be related. Since apathy is very common in nursing home-patients and may lead to a poor prognosis, clear insight into its risk for mortality is needed and NH-staff need to understand this risk.
Author Interviews / 19.06.2017

MedicalResearch.com Interview with: Dr. Nathalie van der Velde Internist-Geriatrician Erasmus MC Rotterdam The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: In older persons, falls are the leading cause of injuries and often an adverse-drug reaction is involved. By lowering medication-related fall risk, loss of quality of life, institutionalization, and death can be prevented. Nevertheless, for optimal medication-withdrawal in clinical practice, better understanding of medication-related fall risk is essential, especially for the group of cardiovascular drugs, as previous studies showed contradictory results. Therefore, the objective of our study was to assess whether specific drug characteristics determine beta-blocker related fall risk, a frequently prescribed cardiovascular drug. Our study showed that fall risk was increased in users of non-selective beta-blockers. This was not the case for overall use of beta-blockers or other drug characteristics (lipid solubility, intrinsic sympathetic activity and CYP2D enzyme metabolism).
Author Interviews, Cancer Research, Geriatrics, JAMA, Johns Hopkins / 12.06.2017

MedicalResearch.com Interview with: Nancy Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Nancy Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine MedicalResearch.com: What are the main findings? Response: A lot of cancer screenings are not expected to save lives until up to 10 years later; however, the side effects of the test happen right away. Because of this, clinical guidelines have recommended against routine screening for those patients who will not live long enough to benefit but may experience the potential harm of the test in the short term. However, many patients with limited life expectancy still receive screening and clinicians are worried about how patients would react if they recommended that patients stop screening. This research is important because it is the first study that explores how patients think about the decision of stopping cancer screening and how patients want to talk to their doctors about this issue. Understanding patient perspectives would help improve screening practices and better align recommendations and patient preference.
Aging, Author Interviews, Geriatrics / 10.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35204" align="alignleft" width="100"]Raya Elfadel Kheirbek, MD, MPH Geriatrician and Palliative Care Physician  Washington DC VA Medical Center  Associate Professor of Medicine  George Washington University  School of Medicine and Health Sciences Dr. Raya Elfadel Kheirbek[/caption] Raya Elfadel Kheirbek, MD, MPH Geriatrician and Palliative Care Physician Washington DC VA Medical Center Associate Professor of Medicine George Washington University School of Medicine and Health Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the past decade, there has been a shift in the concept of successful aging from a focus on life span to health span. We all want to age gracefully “expecting” optimal health, quality of life and independence. Centenarians are living examples to the progress we have made in health care. They are the best example of successful aging since they have escaped, delayed or survived the major age-related diseases and have reached the extreme limit of human life. However, little is known about Veterans Centenarians’ incidence of chronic illness and its impact on survival. Utilizing the VA Corporate Data Warehouse (CDW), I worked with my colleagues’ researchers and identified 3,351 centenarians who were born between 1910 and 1915. The majority were white men who served in World War II and had no service related disability. The study found that 85 % of all the centenarians had no incidence of major chronic conditions between the ages of 80 and 99 years of age. The data demonstrate that Veteran centenarians tend to have a better health profile and their incidence of having one or more chronic illness is lower than in the general population.
Aging, Author Interviews, Depression / 02.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35003" align="alignleft" width="200"]Miranda T. Schram PhD Associate professor Department of Medicine Maastrich Dr. Schram[/caption] Miranda T. Schram PhD Associate professor Department of Medicine Maastrich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Late-life depression, also called vascular depression, is highly prevalent, recurrent and difficult to treat. Anti-depressants only relieve symptoms in about 50% of the patients. So we urgently need new treatment targets for this disease. In this study we found that microvascular dysfunction, irrespective if you measure this by biomarkers in the blood or in the brain, is associated with an increased risk for depression. Moreover, we found evidence from longitudinal studies that microvascular dysfunction, at least of the brain, may actually be a cause of depression. To investigate this, we undertook a meta-analyses of data from over 40,000 individuals of whom over 9,000 had a depression.
Author Interviews, Geriatrics, JAMA, Surgical Research / 24.05.2017

MedicalResearch.com Interview with: Cheryl Chia-Hui Chen, RN, DNSc Vice Dean for Student Affairs Professor of Nursing National Taiwan University Nurse Supervisor at National Taiwan University Hospital Taipei, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older patients undergoing abdominal surgery often experience preventable delirium, which greatly influences their postoperative recovery and hospital length of stay. The modified Hospital Elder Life Program (mHELP) utilizes nurses to reduce postoperative delirium and LOS among older patients undergoing abdominal surgery for resection of malignant tumor. The mHELP consisted of 3 protocols: oral and nutritional assistance, early mobilization, and orienting communication, researchers say. Researchers at the National Taiwan University Hospital randomly assigned 377 patients undergoing abdominal surgery for a malignant tumor to an intervention (n = 197) or usual care (n = 180). Postoperative delirium occurred in 6.6 percent of mHELP participants vs 15.1 percent of control individuals (odds of delirium reduced by 56 percent). Intervention group participants received the mHELP for a median of 7 days, and they had a median LOS that was two days shorter (12 vs 14 days).
Author Interviews, Geriatrics, JAMA, NYU, Primary Care / 22.05.2017

MedicalResearch.com Interview with: Benjamin Han, MD, MPH Assistant professor Departments of Medicine-Division of Geriatric Medicine and Palliative Care, and Population Health NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are an increasing number of older adults being prescribed statins for primary prevention, but the evidence for the benefit for older adults is unclear. Our study finds that in the ALLHAT-LLT clinical trial, there were no benefits in either all-cause mortality or cardiovascular outcomes for older adults who did not have any evidence of cardiovascular disease at baseline.
Author Interviews, Electronic Records, Geriatrics, Pharmacology / 29.11.2016

MedicalResearch.com Interview with: [caption id="attachment_30022" align="alignleft" width="130"]Jashvant Poeran MD PhD Assistant Professor Dept. of Population Health Science & Policy Icahn School of Medicine at Mount Sinai New York, NY Dr. Jashvant Poeran[/caption] Jashvant Poeran MD PhD Assistant Professor Dept. of Population Health Science & Policy Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: Falls are an important patient safety issue among elderly patients and may lead to extended hospitalization and patient harm. Particularly important in elderly patients are high risk drugs such as sleep medications which are known to increase fall risk and should be dosed lower in elderly patients. In this study we looked at patients aged 65 years or older who fell during hospitalization. We found that in 62%, patients had been given at least one high risk medication that was linked to fall risk, within 24 hours before their fall. Interestingly, we found that also a substantial proportion of these medications were given at doses higher than generally recommended for elderly patients.
Author Interviews, Breast Cancer, Geriatrics, Radiation Therapy / 23.11.2016

MedicalResearch.com Interview with: Emily C. Daugherty, MD Upstate Medical University Radiation Oncology Resident, PGY-4 MedicalResearch.com: What is the background for this study? Response: Adjuvant radiation following breast conserving surgery has been well established in the management of early-stage breast cancer as it has been shown to decrease the incidence of ipsilateral breast tumor recurrences and also reduce breast cancer mortality. Large prospective trials have shown for elderly patients with favorable, ER positive pathology, omission of radiation after lumpectomy can be considered. However, women with ER negative disease were typically not included in these trials and given their higher risk for relapse as well as lack of effective endocrine therapy, we hypothesized that adjuvant radiation would benefit women over 70 years with early-stage, ER negative tumors.
Author Interviews, Emergency Care, Geriatrics, Infections / 15.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29656" align="alignleft" width="150"]John P. Haran, MD Assistant Professor Department of Emergency Medicine University of Massachusetts Medical School UMass Memorial Medical Group Worcester, MA Dr. John P. Haran[/caption] John P. Haran, MD Assistant Professor Department of Emergency Medicine University of Massachusetts Medical School UMass Memorial Medical Group Worcester, MA MedicalResearch.com: What is the background for this study? Response: In 2014, the Infectious Disease Society of America (IDSA) updated their guidelines for the management of skin and soft tissue infection in response to high MRSA infection rates as well as high treatment failure rates for skin and soft tissue infections. Greater than 1 in 5 patients treated for a skin abscess will fail initial treatment. Historically antibiotics have been shown to be unnecessary in the treatment of uncomplicated purulent infections. This notion has been recently challenges when authors published a randomized control trial using trimethoprim-sulfamethoxazone in the NEJM that demonstrated a minimal increase in cure rates for outpatient treatment of uncomplicated skin purulent skin infections. In this study they did not follow IDSA-guidelines nor model or stratify their analysis. It is possible their findings may be due to at-risk patient groups that did not receive antibiotics. Many widely used clinical decision rules incorporate age into their decision algorithms, however the IDSA did not do this with their recent guidelines.
Author Interviews, Geriatrics, Medical Imaging, MRI, Weight Research / 08.11.2016

MedicalResearch.com Interview with: Fatemeh Mokhtari Medical Imaging PhD Student VT-WFU SBES MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study was to use baseline anatomical brain MRI scans to prospectively predict weight loss success following an intensive lifestyle intervention. In the study, 52 participants, age 60 to 79, were recruited from the Cooperative Lifestyle Interventions Programs II (CLIP-II) project. The participants were overweight or obese (BMI greater than 28 and less than 42) and had a history of either cardiovascular disease or metabolic syndrome. All participants had a baseline MRI scan, and then were randomized to one of three groups – diet only, diet plus aerobic exercise training or diet plus resistance exercise training. The goal of the 18-month diet and exercise program was a weight loss of 7 to 10 percent of body mass. Basic brain structure information garnered from the MRIs was classified using a support vector machine, a type of computerized predictive algorithm. Specifically, we trained a computational predictive model which mapped each subject’s brain scan to weight loss performance. Predictions were based on baseline brain gray and white matter volume from the participants’ MRIs and compared to the study participants’ actual weight loss after the 18 months. The accuracy of the model was then tested, and our prediction algorithms were 78% accurate in predicting successful weight loss. Brain gray matter volume provided higher prediction accuracy compared with white matter and the combination of the two outperformed either one alone.
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Geriatrics / 27.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28323" align="alignleft" width="124"]Xabier Garcia-De-Albeniz MD PhD Research Associate Department of Epidemiology Mongan Institute for Health Policy, Massachusetts General Hospital. Board Member, GEMCAD. Member, Group for Cancer Prevention, SEOM Dr. Xabier Garcia-De-Albeniz[/caption] Xabier Garcia-De-Albeniz MD PhD Research Associate Department of Epidemiology Harvard T.H. Chan School of Public Health Mongan Institute for Health Policy Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Randomized controlled trials are considered the gold standard to inform health care delivery. Unfortunately, no randomized controlled trials of screening colonoscopy have been completed. Ongoing trials exclude persons aged 75 or older, and will not have mature results before 2025. However, healthy persons older than 75 may live long enough to benefit from colorectal cancer (CRC) screening. The Medicare program reimburses screening colonoscopy without an upper age limit since the year 2001. We used the extensive experience of Medicare beneficiaries to evaluate the effectiveness and safety of screening colonoscopy.
Author Interviews, CDC, Cost of Health Care, Frailty / 23.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28318" align="alignleft" width="144"]Gwen Bergen, PhD Division of Unintentional Injury National Center for Injury Prevention and Control CDC Dr. Gwen Bergen[/caption] Gwen Bergen, PhD Division of Unintentional Injury National Center for Injury Prevention and Control CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older adult falls are the leading cause of injury death and disability for adults aged 65 years and older (older adults). In this study, we analyzed data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey. Our study found that, in 2014, older Americans reported 29 million falls. Almost a quarter of these or 7 million falls required medical treatment or restricted activity for at least one day. Women reported a higher percentage of falls (30%) compared with men (27%). Whites and American Indian/Alaskan Natives (AI/AN) were more likely to fall compared with Blacks and Asian/Pacific Islanders; and AI/AN were more likely to report a fall injury compared with all other racial/ethnic groups. The percentage of older adults who reported a fall varied by state, ranging from 21% in Hawaii to 34% in Arkansas.
Author Interviews, Dermatology, Geriatrics, Melanoma / 21.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28161" align="alignleft" width="93"]José Antonio Avilés-Izquierdo, PhD Department of Dermatology Hospital Gregorio Marañón Madrid, Spain Dr. José Antonio Avilés-Izquierdo[/caption] José Antonio Avilés-Izquierdo, PhD Department of Dermatology Hospital Gregorio Marañón Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Melanoma is responsible for most of skin cancer-related deaths and the cancer with the highest cost per death and the highest lost of productive-life years in Europe. Despite the importance on early diagnosis of cutaneous melanoma, there are few studies analyzing the reasons that lead patients with melanoma to consult. The impact on prognosis in patients with melanoma according to who first detects melanoma have not been established.
Accidents & Violence, Author Interviews, CDC, Cost of Health Care, Frailty, Geriatrics / 30.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27484" align="alignleft" width="150"]Elizabeth Burns, MPH Health Scientist, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control CDC Elizabeth Burns MPH[/caption] Elizabeth Burns, MPH Health Scientist, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control CDC MedicalResearch.com: What is the background for this study? Response: Falls are the leading cause of both fatal and non-fatal injuries among Americans aged 65 and older. In 2000, the direct cost of falls were estimated to be $179 million for fatal falls and $19 billion for non-fatal falls. Fall injuries and deaths are expected to rise as more than 10,000 Americans turn 65 each day. Within the next 15 years, the U. S. population of older Americans is anticipated to increase more than 50%, with the total number of older adults rising to 74 million by 2030.
Aging, Author Interviews, BMJ, Geriatrics, Mental Health Research / 10.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26773" align="alignleft" width="180"]Dr. Faiza Tabassum, PhD University of Southampton, Southampton Dr. Faiza Tabassum[/caption] Dr. Faiza Tabassum, PhD Southampton Statistical Sciences Research Institute  University of Southampton Southampton, UK MedicalResearch.com: What is the background for this study? Response: Previous research has shown that volunteering in older age is associated with better mental and physical health, but it’s unclear whether this extends to other age groups. We aimed to examine the association of volunteering with mental health or well-being among the British population across all ages. The British Household Panel Survey (BHPS) was used which has collected information from 1991 to 2008 from over 5000 households. The published study has analysed over 66,000 responses representing the whole of the UK. The BHPS included a wide range of questions on leisure time activities, which covered the frequency of formal volunteering—from at least once a week through to once a year or less, or never. The BHPS also included a validated proxy for mental health/emotional wellbeing known as the GHQ-12.
Author Interviews, Geriatrics, JAMA, Surgical Research / 15.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26055" align="alignleft" width="120"]Julia Berian, MD, MS ACS Clinical Research Scholar American College of Surgeons Chicago, IL 60611 Dr. Julia Berian,[/caption] Julia Berian, MD, MS ACS Clinical Research Scholar American College of Surgeons Chicago, IL 60611 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The US population is rapidly aging and older adults consume a disproportionate share of operations. Older adults experience a high rate of postoperative complications, which can affect quality of life. In this study, function, mobility and living situation are considered together as independent living. The study examined a large surgical database for the occurrence of loss of independence (defined as a decline in function or mobility, or increased care needs in one's living situation) and its relationship to traditional outcomes such as readmission and death after the time of discharge. Patients included in the study were age 65 or older and underwent an inpatient surgical operation. Loss of independence was assessed at the time of discharge. Readmission and death-after-discharge were assessed up to 30 days postoperatively.
Accidents & Violence, Author Interviews, Education, Geriatrics, Nursing / 10.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25985" align="alignleft" width="123"]Dr. Lisa Kirk Wiese PhD, RN, APHN-BC C.E. Lynn College of Nursing Florida Atlantic University Boca Raton, FL 3343 Dr. Lisa Wiese[/caption] MedicalResearch.com: What is the background for this study? What are the main findings? Response: The impetus for this article was our experience from working at FAU’s Christine E. Lynn College of Nursing’s Louis and Anne Green Memory and Wellness Center with families as we conducted assessments of older adults referred to our program by family members or law enforcement. We realized that there is a need to educate nurses that a) they can help to identify persons who may be at risk for unsafe driving before accidents occur, and b) there are resources to help families and nurses navigate this challenging topic. This awareness is especially important for persons and friend/family members who find themselves trying to cope with a known or potential diagnosis of dementia.
Author Interviews / 07.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25922" align="alignleft" width="125"]Sofiya Milman, MD, MS Assistant Professor of Medicine Divisions of Endocrinology and Geriatrics Albert Einstein College of Medicine Dr. Sofiya Milman[/caption] Sofiya Milman, MD, MS Assistant Professor of Medicine Divisions of Endocrinology and Geriatrics Albert Einstein College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aging is a major risk factor for most chronic diseases, including cancer, cardiovascular disease, diabetes, hypertension, stroke and osteoporosis. However, many very long-lived individuals delay the onset or never develop age-related diseases. This study compared groups of individuals with exceptional longevity (age ≥95 years) of different genetic and ethnic backgrounds to younger referent groups without familial longevity (age 49-93 years). Long-lived individuals from different groups similarly delayed the age of onset of cancer, cardiovascular disease, hypertension, osteoporosis, and stroke. For example, cancer onset was delayed by 30 years and cardiovascular disease by 24 years. The risk of developing any age-related disease was on average 80% lower in individuals with exceptional longevity compared to referents.
Author Interviews, Frailty, Geriatrics, Nursing / 27.06.2016

MedicalResearch.com Interview with [caption id="attachment_25579" align="alignleft" width="144"]Oleg Zaslavsky PhD Assistant Professor at the department of Biobehavioral Nursing and Health System School of Nursing University of Washington Dr. Oleg Zaslavsky[/caption] Oleg Zaslavsky PhD Assistant Professor at the department of Biobehavioral Nursing and Health System School of Nursing University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: Frailty is a common, but serious medical condition among older adults. It is characterized by weight and muscle loss, fatigue, slow walking and low levels of physical activity. It’s important to accurately diagnose and treat frailty, especially because demographic trends show the percentage of U.S. adults age 65 years and older will increase 19% by 2030. Frailty is commonly assessed by the Cardiovascular Health Study (CHS) frailty phenotype, which includes a set of physical measurements for slowness, weakness, fatigue, low physical activity and body-weight loss. According to the CHS phenotype, individuals with three or more of these characteristics are at increased risk for falls, hip fractures, disability and mortality. Although the CHS phenotype is good for predicting adverse conditions, it requires direct measurement of physical performance. Refining the phenotype so it doesn’t involve physical measurements of patients in a doctor’s office has practical advantages for research and clinical purposes. For this study, University of Washington School of Nursing researchers worked with Fred Hutchinson Cancer Research Center faculty to refine the Women’s Health Initiative (WHI) frailty phenotype, originally developed in 2005. This new phenotype uses self-reporting from patients instead of measurements of physical performance to determine frailty and associated health outcomes. In this report, we show that our newly-proposed WHI measuring scheme performs as well as the more complex CHS phenotype in predicting death, hip fractures and falls in older women.
Author Interviews, Geriatrics / 25.06.2016

MedicalResearch.com Interview with: Dr-Jinmyoung-ChoJinmyoung Cho, PhD Assistant Investigator Center for Applied Health Research Baylor Scott & White Health Temple, TX 76508 Texas A&M Health Science Center College Station, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Early life-course transition experiences to the adult years result in continuing consequences for health in later life. Many veterans have encountered life-threatening environments while they were on military service leading to a higher incidence of physical and mental diseases; greater comorbidity profiles in veterans contribute to higher mortality rate compared to non-veterans. With increased life expectancy and demographic shifts in our population, the proportion of oldest-old adults, aged over 80 years, continues to increase. The publicly funded Veterans Health Administration (VHA) must care efficiently and effectively for its increasing population of veterans, who are older, sicker, and socioeconomically disadvantaged relative to non-veterans. Given the large number of veterans over age 80 and the increasing emphasis on managing the aging process, it is important to identify associations between healthcare utilization and survival for VHA’s oldest patients. We identified protective and risk factors associated with mortality by age group. During a 5-year follow-up period, 44% of patients aged 85 years and over died with survival rates of 59% for 80’s, 32% for 90’s and 15% for 100’s. In the multivariable model, protective effects for veterans 80-99 were female sex, minority race or ethnicity, being married, having certain physical and mental diagnoses (e.g., hypertension, cataract, dyslipidemia, posttraumatic stress disorder, bipolar disorder), urgent care visits, invasive surgery, and few (one to three) prescriptions. Risk factors were lower VHA priority status, physical and mental conditions (e.g., diabetes, anemia, congestive heart failure, dementia, anxiety, depression, smoking, substance abuse disorder), hospital admission, and nursing home care. For those in their 100s, married status, smoking, hospital admission, nursing home care, invasive surgery, and prescription use were significant risk factors; only emergency department (ED) use was protective.
Alzheimer's - Dementia, Author Interviews, Geriatrics, Johns Hopkins / 03.06.2016

MedicalResearch.com Interview with: [caption id="attachment_24893" align="alignleft" width="151"]Halima Amjad, MD, MPH Post-doctoral Fellow Johns Hopkins University School of Medicine Division of Geriatric Medicine and Gerontology Dr. Halima Amjad[/caption] Halima Amjad, MD, MPH Post-doctoral Fellow Johns Hopkins University School of Medicine Division of Geriatric Medicine and Gerontology MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Amjad: Safety is an important aspect of dementia care. Dementia is underdiagnosed, however, and there is limited understanding of safety issues in people with undiagnosed dementia. We wanted to better understand potentially unsafe activities and living conditions in all older adults with dementia and specifically examine these activities in undiagnosed dementia. We found that in all study participants with probable dementia, the prevalence of driving, cooking, managing finances, managing medications, or going to physician visits alone was over 20%. The prevalence was higher in older adults with probable dementia without a diagnosis, and even after accounting for sociodemographic, medical, and physical impairment factors, the odds of engaging in these activities was over 2.0 in undiagnosed versus diagnosed probable dementia. Potentially unsafe living conditions including unmet needs and performance on cognitive tests were similar between these groups.
Aging, Author Interviews, Lifestyle & Health / 15.03.2016

MedicalResearch.com Interview with: [caption id="attachment_22664" align="alignleft" width="180"]Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney Dr. Melody Ding[/caption] Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ding: This study used data from the Sax Institute’s 45 and Up Study, a large Australia based cohort of adults aged 45 or older. We followed around 25,000 participants who were working at baseline (2006-2008) for an average of 3 years (follow-up in 2010). During the follow-up period, around 3,000 participants retired from the workforce. Participants were asked to report their health-related lifestyle behaviors, such as physical activity, smoking, and sleep time at both baseline and follow-up. We found that those who retired overall had significant improvement in their lifestyle as compared with those who did not, including more physical activity, less sitting time, and more sleep. Female smokers who retired were also more likely to have quit smoking.
Author Interviews, Mineral Metabolism, Nutrition / 30.01.2016

MedicalResearch.com Interview with: [caption id="attachment_21145" align="alignleft" width="133"]Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111 Dr. Simin Meydani[/caption] Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111 Medical Research: What is the background for this study? Dr. Meydani: A significant number of older people are zinc deficient which can result in a compromised immune system which weakens as the body ages, making older adults more susceptible to infections and higher incidence and morbidity from pneumonia. Older adults with impaired immune response, particularly T cell-mediated function, have a higher susceptibility to infections and cancer. Our research team from the Jean Mayer USDA Human Nutrition Research Center on Aging created a small double-blind, placebo-controlled trial involved adults age 65 or older from three Boston-area nursing homes to determine the feasibility of increasing serum zinc concentrations in older adults. The full findings are published in The American Journal of Clinical Nutrition. These results have a significant public health implication for the older adults because it shows directly that correction of a nutrient deficiency can improve immune response in older adult (a biological function which consistently has been shown to be impaired with aging).
Author Interviews, Geriatrics, Heart Disease, Lancet / 15.01.2016

Click Here for More on Heart Disease on MedicalResearch.com MedicalResearch.com Interview with: Bjørn Bendz MD PhD and Nicolai K. Tegn, MD Department of Cardiology, Oslo University Hospital, Rikshospitalet Oslo, Norway  Medical Research: What is the background for this study? What are the main findings? Response: According to life expectancy statistics, a person who reaches age 80 can expect to live an average of 8 years (in men) and 9 years (in women). People over 80 yrs are underrepresented in clinical trials, they are less likely to receive treatment according to guidelines. Our study, which directly targets the over-80 population, is the first to demonstrate that a more invasive strategy results in better outcomes in these patients. We believe our study provides a sufficient basis to recommend an invasive approach.”
AHA Journals, Author Interviews, Frailty, Geriatrics, Heart Disease, Johns Hopkins / 10.01.2016

[caption id="attachment_20532" align="alignleft" width="80"]Ariel R. Green, M.D., M.P.H Assistant Professor of Medicine Johns Hopkins University School of Medicine Dr. Green[/caption] MedicalResearch.com Interview with: Ariel R. Green, M.D., M.P.H Assistant Professor of Medicine Johns Hopkins University School of Medicine Medical Research: What is the background for this study? What are the main findings? Response: Implantable cardioverter-defibrillators (ICDs) are widely used to prevent sudden cardiac death in patients with systolic heart failure. Older adults with heart failure often have multiple coexisting conditions and are frail, increasing their risk of death from non-cardiac causes. Our understanding of outcomes in older patients with ICDs is limited. Medical Research: What should clinicians and patients take away from your report? Response: Our major finding was that more than 10% of patients currently receiving ICDs for primary prevention of sudden cardiac death (meaning that they have never had a potentially lethal arrhythmia but are at risk for one, usually due to systolic heart failure) are frail or have dementia.​ Patients with these geriatric conditions had substantially  higher mortality within the first year after ICD implantation than those without these conditions. Frailty and dementia were more strongly associated with mortality than were traditional comorbidities such as diabetes.
Author Interviews, Geriatrics, PLoS / 21.10.2015

[caption id="attachment_18621" align="alignleft" width="133"]Prof. Dr. med. Andreas Stuck Chefarzt Geriatrie Geriatrische Universitätsklinik Inselspital, Bern Prof. Andreas Stuck[/caption] MedicalResearch.com Interview with: Prof. Dr. med. Andreas Stuck Chefarzt Geriatrie Geriatrische Universitätsklinik Inselspital, Bern Medical Research: What is the background for this study? Prof. Stuck: The number of older persons increases worldwide. Unfortunately, many older persons cannot enjoy the benefits of increased life expectancy because they develop disability or die prematurely. In the search for an effective preventive method, we developed a novel intervention consisting of health risk assessment combined with individualized health counseling, and tested whether this novel intervention actually works. In a trial among more than 2000 older persons, we allocated persons randomly to a group receiving and a group not receiving this intervention, and compared long-term outcomes between these groups. Medical Research: What are the main findings? Prof. Stuck: We found that older participants who received the novel intervention, improved their risk factor profile, and subsequently, had a significantly improved survival as compared to the participants who had not received the intervention. From earlier studies it was known that health risk assessment can improve short term health risks in older people, but our study is the first to explore long-term health outcomes.