High Blood Pressure Treatment and Nursing Home Residents

Journal of the American Geriatrics Society Research Summary

Although 27 percent of all older adults who live in nursing homes in this country have both high blood pressure and dementia, we don’t have enough research yet to inform healthcare providers about the best way to treat their high blood pressure.

Specifically, we don’t know when the benefits of taking medication to lower blood pressure outweigh the potential risks, especially in older adults who also have moderate to severe dementia and a poor prognosis (the medical term for the likely course of a disease). That’s because clinical trials for high blood pressure treatments typically do not include older adults who have severe chronic illnesses or disabilities.

 A team of researchers designed a study to learn more about the best high blood pressure treatments for older adults who live in nursing homes. Their study was published in the Journal of the American Geriatrics Society.

The research team used information from Medicare records. The team identified 255,670 long-term nursing home residents in the United States during 2013 who had high blood pressure. Of these, nearly half had moderate or severe dementia-related difficulties with thinking and decision-making. Slightly more than half of them had no or only mild cognitive impairment. Continue reading

Slower Walking Speed May Predict Future Mobility Problems

Journal of the American Geriatrics Society Research Summary

Being able to walk outside for several blocks at a leisurely pace plays an important role in living a vibrant, healthy life. Walking short distances allows you to get the physical activity you need, live independently, go shopping, access health care, and engage in a social life.

Being able to walk at even a slow speed is essential to all these benefits—but walking too slowly may foreshadow future problems that could prevent you from being fully mobile.

Until now, there has been no ideal way for healthcare providers to measure walking ability, since it involves more than just walking speed. It also is about how you deal with your environment (such as uneven pavement) and demands on your attention (such as traffic, other pedestrians, and street crossings).

In a new study, researchers assessed ways to measure complex walking tasks to learn more about early, subtle changes in walking. Their study was published in the Journal of the American Geriatrics Society.

In their study, the researchers examined whether performance on complex walking tasks involving both physical and mental challenges predicted a higher risk for an inability to walk one-quarter mile (roughly four blocks). The researchers suspected that these complex walking tasks would be more strongly tied to the risk for mobility problems than simple walking.

The researchers studied information from the Health Aging and Body Composition (Health ABC) study, which enrolled black and white adults in Pittsburgh and Memphis from 1997 to 1998. The participants were 70 to 79 years old when they entered the study, and they had no difficulty walking a quarter mile or climbing 10 steps without resting. Continue reading

How Do Older Adults Fare After Hip Fracture?

Journal of the American Geriatrics Society Research Summary

Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home.

As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called “activities of daily living,” or ADLs). They may not be able to get around for months to even years after their fracture. This physical decline can lessen their quality of life, and some 20 percent of older adults go on to long-term care facilities after having a hip fracture.

Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs.

What’s more, hip fractures affect not only the quality of life and health of the older adult, but also that of their caregivers—and can cause financial burdens when the individual requires more care.

Despite all this, the number of daily hours of care people need after a hip fracture has not been well studied. To learn more, researchers designed a study to better understand how older adults fare after suffering hip fractures. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Exercise Improves Anxiety and Mood in Older Adults Undergoing Chemotherapy

Journal of the American Geriatrics Society Research Summary

Although we know that exercise improves anxiety and mood problems in younger people with cancer, few studies have looked at the effects of exercise on older adults with cancer. Since most new cancer cases occur in adults aged 60 or older, a team of researchers from the University of Rochester Medical Center and other institutions designed a study to learn more.

Their study appeared in the June issue of the Journal of the American Geriatrics Society (JAGS).

Having cancer increases the chances of people experiencing anxiety and mood issues, which can affect emotional and social well-being. In turn, this may lead people to discontinue cancer treatments—which can mean shortening their survival.

Chemotherapy can benefit older adults with cancer, even though older people receiving this type of treatment often experience higher rates of dangerous side effects than younger people do. Older adults often experience anxiety and other mood disorders during their treatment for cancer, too—and treating those problems with medications can often cause potentially dangerous side effects.

What’s more, many anti-anxiety medications such as benzodiazepines and antidepressants are listed in the American Geriatrics Society (AGS) Beers Criteria® as being potentially inappropriate for older adults. That’s why it is desirable to seek alternative treatments that are safe and effective at improving anxiety, mood disturbances, and emotional and social well-being, including treatments that don’t rely on medications. For example, several studies have been conducted to examine the relationship between exercise and mood in cancer survivors and most have shown positive results. Continue reading

Older Adults with Blood Cancers: How They Fare

Journal of the American Geriatrics Society Research Summary

Although the majority of patients who have blood cancers are older adults, they make up only a small percentage of participants in the clinical trials that lead to new therapies. That’s because the standard research methods used in oncology (cancer medicine) are not ideal for identifying certain vulnerabilities linked to aging, such as having multiple chronic diseases and being frail.

To help remedy that situation, the American Society of Clinical Oncology (ASCO) issued a guideline recommending that older adults who have cancer receive a geriatric assessment to see if they are at increased risk for experiencing side effects from medication and other complications from cancer and its treatment. Recently, a team of researchers examined older adults who have cancer to see whether their ability to manage daily activities as measured by these assessments was linked to staying alive longer. The team published their study in the Journal of the American Geriatrics Society. Continue reading