Author Archives: HIA Guest Blog

Keep Moving to Prevent Major Mobility Disability

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Journal of the American Geriatrics Society Research Summary

Having trouble getting around on your own—such as difficulty walking, climbing steps, or being able to get in and out of a chair—can lead to physical disability and losing your independence.

According to research, being physically inactive is the strongest risk factor for disability as we age.

We know that physical activity has proven health benefits, especially moderate-to-vigorous physical activity such as walking to the store or many types of gardening. But perhaps surprisingly, we don’t know much about the benefits of lighter forms of physical activity or the effects of spreading our physical activity throughout the day. Understanding the benefits of moving more often and engaging in even lighter forms of physical activity is important for older adults’ health. These types of physical activity may be easier for older adults to practice regularly, especially those who are frail.

That’s why a team of researchers created a study to examine the effects of performing light physical activity and moderate-to-vigorous physical activity on older adults. The researchers were interested in studying how participating in these different intensities of activity, and whether a person spreads their physical activity throughout the day, affects the chances for developing a major mobility disability. The participants in the study were older adults who had challenges with physical function and who participated in the Lifestyle Interventions and Independence for Elders (LIFE) study. The researchers published their study in the Journal of the American Geriatrics Society. Continue reading →

COVID-19: Addressing Elder Abuse, Social Isolation, and Other Key Concerns

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By now, we’re all aware that COVID-19 poses heightened risks to older adults. The CDC reports that eight out of 10 deaths in the United States have been in people aged 65 and older.

But becoming infected with this potentially deadly virus isn’t the only risk that warrants our careful attention. Older adults face other COVID-19 related challenges, including issues that can impact emotional, physical, and even financial wellness. Reports of elder abuse (the mistreatment of someone because of their age) in its several terrible forms are sadly on the rise. But there are steps we can all take to help support those who need us.

“This is a test and I hope we pass it,” says Laura Mosqueda, MD. Dr. Mosqueda is Dean of the Keck School of Medicine, USC, and codirector of the National Center on Elder Abuse. Dr. Mosqueda shared her worries with us about the health and safety of older adults during this global pandemic. She is particularly concerned about four key issues that target older adults.

Social Isolation

“To me, what’s really interesting right now is that we know that the dangers of social isolation are really significant for older adults. In fact, we’ve been making all kinds of public health statements about just how dangerous social isolation is,” Dr. Mosqueda notes. “And now we’re telling everyone to socially isolate and to practice social distancing.”

Vulnerability to Financial Abuse

Because of this social isolation, older adults are now potentially more vulnerable to things like financial scams. This is because they may no longer have friends or family members dropping in regularly. According to Dr. Mosqueda, “these days, when an older adult just needs to get a home repair or something done, they don’t have as many people around who might be advocating for their best interests.” Continue reading →

Are Older Adults Getting the Most Effective Cancer Treatments?

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Journal of the American Geriatrics Society Research Summary

As people age, cancer becomes an increasing health concern. Solid cancer tumors are cancers that don’t affect the blood and instead form tumors, or growths of abnormal cells in certain parts of the body. These solid cancer tumors mainly impact people who are 65 and older.

If you or an older loved one is diagnosed with cancer, many different factors come into play to guide treatment choices. However, leading geriatric oncologists (specialists who treat cancer in older adults) say that, perhaps surprisingly, age is not necessarily one of them. Recently, leaders in the field emphasized that being older, on its own, does not necessarily mean that surgical treatment is not an option for you.

Older patients with cancer may not receive the same treatment as younger adults. The reasons for this are unclear and may include the fact that surgical oncologists fear a higher risk of poor outcomes for older cancer patients following surgery. They may be uncertain about how surgery will affect an older patient’s survival and quality of life. But since long-term outcomes after surgery for older adults with cancer have not been well-studied, we don’t know whether such concerns are justified.

Fortunately, a screening tool exists that may help surgical oncologists and other physicians decide which patients might face complications after surgery. The “Preoperative Risk Estimation for Onco-Geriatric Patients” (or PREOP) risk score uses several easy-to-administer tests and can be given to people before surgery. The risk score includes a nutritional risk score to make sure you aren’t malnourished and a test called Timed Get Up and Go (TUG). In this simple test, you are timed getting out of a chair, walking 10 feet, and sitting back down again.

In addition to these two tests, the PREOP risk score also takes into consideration your gender, how significant your surgery will be, and an anesthesiologist’s assessment of your physical condition. In a previous study, a high PREOP risk score was found to be associated with an increased risk of major postoperative complications within 30 days after surgery.

A team of researchers recently examined how the PREOP score might predict how older adults fared following surgery for cancer. The researchers said they hoped their study would help both physicians and patients make decisions regarding cancer surgery. They published their study in the Journal of the American Geriatrics Society. Continue reading →

After a Hospitalization, Older Adults Prescribed Potentially Inappropriate Medications May Face Health Risks

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Journal of the American Geriatrics Society Research Summary

“Potentially inappropriate medications (PIMs)” are treatments that sometimes pose risks that outweigh their benefits, particularly for people who are 65 or older. About 20 to 60 percent of older adults take medicines that may be potentially inappropriate. That can increase the risk for being hospitalized, needing to visit the emergency department, having poor quality of life, and/or experiencing a harmful reaction.

When older adults are hospitalized for medical reasons or for surgery, they often go home with prescriptions for treatments that may be different from those they were taking beforehand. These treatments may include PIMs. Until now, however, few studies have examined how PIMs affect older adults when prescribed at the time of their hospital discharge.

A team of researchers recently designed a study to learn more about this important issue. They examined information from medical and surgical patients to evaluate the association of PIMs (both the ones the patients had been taking earlier as well as those newly prescribed at their hospital discharge) with the risk of four outcomes. The outcomes were harmful drug problems, emergency department visits, readmission to the hospital, and death after hospital discharge. The study was published in the Journal of the American Geriatrics Society. Continue reading →

During the Coronavirus Crisis: Things to Consider if Someone You Care for is in Long-Term Care

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If you are caring for someone who lives in a long-term care facility, you may have questions about their care and well-being during the coronavirus crisis. You’ve probably wondered whether it would be safer to take them out of the nursing home and move them into your home.

We put some of the questions you may be asking to Sharon K. Inouye, MD, MPH, Director, Aging Brain Center, Milton and Shirley F. Levy Family Chair Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center.

“These are very difficult and individual decisions for each family. There is no right or wrong situation, just a balance of the specific considerations,” says Dr. Inouye. “I had to consider this for my own mother. Ultimately, we were unable to move her out of her facility because our home was not set up for her safety (too many stairs, lack of adapted bathrooms, narrow hallways that would not permit her walker).”

Dr. Inouye noted other hazards at her sister’s home (who lives closest to her mother). Her children who are home from school might pose an exposure risk. Her family also has pets who could create fall risks.

“The facility where my mother lives has outstanding infection control processes and procedures in place, with a highly trained staff. So, with difficulty, we made the decision to keep her in the facility. Five weeks later, after one documented case of COVID-19, my mother remains safe without any additional cases. This turned out to be the right decision for our family, but it was a very difficult one—and obviously, had more cases emerged, it might have shifted the equation for us,” Dr. Inouye said.

Questions to Consider Continue reading →