Skin Diseases are Common in Older Adults

Journal of the American Geriatrics Society Research Summary

As we age, our skin changes in ways that can make it more prone to disease. That’s because older skin is less oily, less elastic, and thinner. It bruises easily and can take a long time to heal when cut.

Although skin disorders are common in older adults, few studies have examined the connection between aging and skin disease. The studies we do have are mostly collected from specific groups of older adults, such as nursing home residents or those who have been treated in hospitals.

However, we do know that two studies of health records for large groups of older adults show that the most common skin diseases in older people are eczema, skin infections, and pruritus (severely dry and itchy skin). Recently, a research team designed a study to learn more about how common skin diseases are in adults aged 70 and older. They published their study in the Journal of the American Geriatrics Society.

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Cancer Prevention and Screening for Older Adults

Journal of the American Geriatrics Society Research Summary

Improved cancer screening and treatment, along with much lower rates of tobacco use, have led to a decrease in cancer diagnoses and deaths. However, because the risk for many cancers increases as people age, it is still the second most common cause of death in older adults after heart disease.

Cancer prevention is important for older adults in order to reduce deaths and prevent the poor quality of life that can be caused by advanced cancer and treatment side effects. Efforts focus on preventing cancer as well as identifying the disease in its early stages by using screening tests. When someone is diagnosed with an early-stage cancer, they are likely to require less extensive treatment and have a better chance for recovery.

Recently, a research team offered new information and guidance for healthcare providers about cancer screening and prevention for older adults. They published their guidance in the Journal of the American Geriatrics Society. According to the researchers, healthcare practitioners need to fully understand how a particular cancer will impact an older adult. They also need to consider the effectiveness, drawbacks, and expense of cancer prevention and screening. Finally, health care practitioners need to understand how well a person will fare—with and without cancer treatment—when they discuss cancer screening with older adults. Continue reading

Staying Safe as Your City Reopens: Friends and Neighbors May be Resuming Their Regular Activities—Should You?

Cities and counties across the country are beginning to ease or even end the regulations that closed stores, restaurants, businesses, services, and schools back in March 2020. But adults 65 years and older and those with chronic health conditions are still at high risk for contracting COVID-19 and facing its most serious complications, including death.

If you have underlying medical conditions, particularly if they are not well controlled, the CDC suggests that it’s wise to continue to maintain the highest level of vigilance about going out and resuming your regular activities. Some of the specific underlying health conditions noted by the CDC include:

  • Chronic lung disease
  • Moderate to severe asthma
  • Serious heart conditions
  • Being “immunocompromised”
    • People who are immunocompromised have a reduced ability to fight infections and other diseases.  Many things can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.
  • Severe obesity (body mass index [BMI] of 40 or higher)
  • Diabetes
  • Chronic kidney disease and undergoing dialysis
  • Liver disease

You can’t reduce your chances of contracting COVID-19 to zero. But if you understand the risks and use proven prevention measures, you may be able to help reduce the spread of the virus.

KEEP IN MIND: If you have COVID-19, have COVID-19 symptoms, or have been in close contact with someone who has COVID-19, you must stay home and away from other people. Talk to your healthcare provider about your specific precautions. When you can leave home and see others depends on different factors for different situations. Follow the CDC’s recommendations for your circumstances.

Here is the CDC’s science-based guidance for the best way to protect yourself as you begin to resume daily activities:

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Should Nursing Home Residents Nearing the End of Life Continue Taking Statins?

Journal of the American Geriatrics Society Research Summary

Cardiovascular disease (also called heart disease) is one of the most common medical conditions older adults face. In nursing homes, almost half of all older adult residents have been diagnosed with problems affecting the heart and/or blood vessels.

In spite of this, we know very little about how effective a class of popular heart disease medications may be for those 75 and older. Known as statins, these medications are prescribed to reduce the amount of cholesterol in your blood. High blood levels of cholesterol can damage your heart’s blood vessels and lead to the formation of blood clots, which can cause stroke and heart attacks.

The reason we have a knowledge gap as to how well statins work in older adults is because early medical studies that examined statin therapy for heart disease prevention included few adults age 75 and older. More recent trials that did include older adults often found that statin therapy did not help prevent these individuals from developing heart disease.

Why? It’s possible that, as we age, our sensitivity to medications may change. For instance, myopathy (muscle pain and weakness) is a commonly reported side effect of statins. This side effect may have a heightened effect on older adults who are already frail, which could speed up physical decline.

A team of researchers conducted a study to learn more about statin use among older adults, especially those nearing the end of their lives. Their study stemmed from concern about unclear statin prescribing guidelines for people over age 75, and a lack of information on the medications’ uses in nursing homes. The study, published in the Journal of the American Geriatrics Society, evaluated statin use by people with life-limiting conditions across nearly all U.S. nursing homes. The researchers hoped to identify statin use among nursing home residents who were unlikely to benefit from treatment. Continue reading

Should Diabetes Treatment Lessen for Older Adults Approaching the End of Life?

Journal of the American Geriatrics Society Research Summary

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One in four people aged 65 or older has diabetes. The disease is the seventh leading cause of death in the United States and a major contributor to heart disease. Experts have recommended that the best way to slow the progression of diabetes—and help prevent its many complications—is to maintain strict control of blood sugar levels. For healthy younger people, this means keeping the target blood sugar level (known as A1c or HbA1c) lower than 6.5 percent to 7.0 percent.

For older adults who have a limited life expectancy or who have advanced dementia, however, maintaining that target blood sugar level may cause more harm than good. For example, these older adults may not live long enough to experience potential benefits. What’s more, maintaining these strict blood sugar levels can raise the risk of potentially harmful events such as low blood sugar (also known as hypoglycemia). This can cause falls or loss of consciousness.

For these reasons, many guidelines now suggest targeting higher HbA1c targets—such as between 8.0 percent and 9.0 percent—for older adults who have multiple chronic conditions or limited life expectancy, or who live in nursing homes.

There is not much existing research to guide health care practitioners as to what the appropriate levels of diabetes medications are for this group of older adults. There is also little information about the effects for these individuals of taking fewer or lower dose of diabetes medications.

Experts suspect that lessening diabetes treatment in these older adults has the potential to prevent unnecessary hospitalizations due to lowering the risk for harmful drug events and increasing the patients’ comfort.

In order to investigate the issue, a team of researchers conducted a study—one of the first national studies to examine potential overtreatment and deintensification of diabetes management in nursing home residents with limited life expectancy or dementia. The researchers chose nursing home residents to study because admission to a nursing home could give healthcare practitioners a chance to learn more about patient goals and preferences and to review and adjust medications accordingly. The researchers published their results in the Journal of the American Geriatrics Society. Continue reading