Five Things to Know Right Now About Coronavirus Disease (COVID-19)

You may have heard a lot recently about “coronavirus” or COVID-19, the virus responsible for a current global outbreak. Scientists and health experts are still learning more, but here are five things to know to keep yourself and those you care for safe and informed.

1. What is COVID-19?

COVID-19 is a type of coronavirus, which is a family of viruses common in humans and many different animals. Viruses in this family can cause respiratory illnesses ranging from the common cold to more severe diseases. Cases of COVID-19 in particular can be mild, but others can be more severe and occasionally deadly—especially for those living with other chronic health conditions.

2. Where is it?

Click here for a list of countries impacted by COVID-19.

3. What are the symptoms and what should I do if I experience them?

In general, COVID-19 causes a respiratory illness that ranges from mild to severe, though for some it can be deadly. Symptoms, which usually appear 2 to 14 days after someone gets infected, can include:

  • fever
  • chills or repeated shaking with chills
  • muscle pain
  • headache
  • sore throat
  • new loss of taste or smell

If you have these symptoms, call your healthcare professional first, before visiting an office. Your healthcare professional will determine if your symptoms match COVID-19 and whether you should be tested. Also contact your healthcare professional if you have been in close contact with a person known to have COVID-19 and/or have recently traveled to an area where COVID-19 cases have occurred.

If you develop emergency warning signs such as difficulty breathing, call 911 immediately. Let the 911 operator know that you may have COVID-19 symptoms.

4. How does it spread?

Scientists are still learning more, but coronavirus appears to spread person-to-person during close contact with someone infected, specifically from respiratory droplets when that person coughs.

It appears COVID-19 may also be able to spread on household surfaces and in the air, so it’s always best to exercise as much caution as possible while scientists learn more.

5. How can I protect myself and others?

For now, the CDC recommends that older adults or those with chronic medical conditions consider postponing travel, especially to areas impacted by COVID-19.

Additionally, the CDC recommends everyone follow these everyday practices:

  • Stay at home as much as possible and avoid crowds or poorly ventilated areas.
  • Make sure you have access to several weeks of medications and supplies in case you need to stay home for prolonged periods of time.
  • Stay home when you are sick.
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wash your hands often with soap and water (or an alcohol-based hand sanitizer with at least 60% alcohol) for at least 20 seconds. Soap up and then sing the “Happy Birthday” song twice before you rinse off the soap. You should especially wash your hands after going to the bathroom; before eating; after blowing your nose, coughing, or sneezing; and after encountering anyone who is or may be sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue isn’t readily available, sneeze or cough into your elbow to reduce the risk of spreading infection with your hands.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning product.

Stay Empowered, Stay Informed

Many Older Adults Face New Disabilities After Hospital Stays for Serious Illnesses

Journal of the American Geriatrics Society Research Summary

Older adults often face new disabilities after a hospital stay for a serious illness. Among the problems they may need to adjust to are difficulties with bathing and dressing, shopping and preparing meals, and getting around inside and outside the home. These new disabilities can lead to being hospitalized again, being placed in a nursing home, and more permanent declines in well-being. The longer a serious disability lasts, the worse it can be for an older adult.

To learn more about this issue, a research team studied information about a particular group of people. They looked at individuals who were hospitalized for a medical issue but did not require critical care. The study was based on data from the Precipitating Events Project (PEP), an ongoing study of 754 people, aged 70 or older, who lived at home at the beginning of the study. At that time, the participants were not disabled and did not need assistance in four basic activities: bathing, dressing, walking inside the house, and getting out of a chair. The researchers published their study in the Journal of the American Geriatrics Society. Continue reading

Frailty Can Affect How Well Older Adults Fare Following Emergency Surgery

Journal of the American Geriatrics Society Research Summary

Frailty is the medical term for becoming weaker or experiencing lower levels of activity/energy.  Becoming frail as we age increases our risk for poor health, falls, disability, and other serious concerns. This can be especially true for older people facing surgery, up to half of whom are classified as frail.

Studies show that frail people may have a higher risk of complications, longer hospital stays, and a higher risk for death within 30 days of their surgery. This is a special concern when frail older adults face emergency surgery for abdominal conditions such as bleeding ulcers and bowel perforations (the medical term for developing a hole in the wall of your intestines). This is because there is no time to help someone facing emergency surgery get stronger before their procedure.

Right now, experts have information on how well frail people do within 30 days of surgery. However, they don’t yet know how well frail older adults do 30 days later and beyond. This information is important so that healthcare providers can inform patients about risks and help them set expectations for recovery after surgery.

A new study in the Journal of the American Geriatrics Society sought to gain more information about how frailty affects older adults in the months after surgery. The research team wanted to test their theory that these people would have a higher risk for death a year after surgery, have higher rates of being sent to long-term care facilities rather than to their homes, and have poorer health one year after surgery. Continue reading

Can Home-Based Physical Therapy Benefit Older Adults with Dementia?

Journal of the American Geriatrics Society Research Summary

Dementia is the leading cause of disability for more than 5 million people aged 65 and older in this country. By 2050, that number is predicted to quadruple. Dementia can cause memory, language and decision-making problems, mood changes, increased irritability, depression, and anxiety.

Dementia also can cause poor coordination as well as balance problems and falls. These difficulties can affect quality of life, reduce caregiver well-being, and increase healthcare costs.

Researchers designed a study to learn more about whether physical therapy (PT) rehabilitation services could improve dementia-associated declines. They published their findings in the Journal of the American Geriatrics Society.

The researchers noted that we understand that physical activity and exercise programs provided by physical therapists can improve balance and reduce fall risk. However, we don’t know whether providing PT in the home could benefit people with dementia. The researchers wanted to learn whether home health PT could help older adults with dementia improve their ability to perform daily functions. These functions include activities like grooming, dressing, bathing, being able to get to and from the toilet (and being able to clean yourself properly after using the bathroom), getting from bed to a chair, walking, eating, being able to plan and prepare light meals, and being able to use the telephone. The researchers also wanted to learn what amount of home-based PT services resulted in the most improvement with these essential tasks. Continue reading

Blood Pressure Control for People Aged 80 and Older: What’s the Right Target?

Journal of the American Geriatrics Society Research Summary

The number of people who are 80-years-old and older is on the rise, and will account for nearly 10 percent of the whole U.S. population by 2050. Since the lifetime chance for developing high blood pressure is at least 70 percent by age 80, more and more people will be at risk for the health problems that high blood pressure can cause.

High blood pressure, or hypertension, is sometimes called the “silent killer” because it produces few, if any, symptoms. In fact, you might not even realize you have high blood pressure. But if it’s not treated, this condition can lead to heart attacks, strokes, kidney disease, and other serious problems, including a risk for dementia.

The 2017 American College of Cardiology and American Heart Association blood pressure guidelines recommend that most people aged 65 or older maintain their systolic blood pressure (the first number in a blood pressure reading) at less than 130 mmHg. But, people 80 years or older often also have multiple chronic health conditions, can be frail, take several medicines, and could have cognitive problems. Because of this, it’s still unclear whether the risks and benefits of lowering systolic blood pressure to less than 130 mm Hg are the same for people aged 80 years and older as they are for people aged 65 to 80.

Given this knowledge gap, a team of researchers focused on this group of older adults within a large randomized trial called the Systolic Blood Pressure Intervention Trial (SPRINT). They published their findings in the Journal of the American Geriatrics Society. In their analysis of SPRINT data, the researchers focused on people aged 80 and older, who had reported heart disease events (such as heart attacks or strokes), changes in kidney function, cognitive impairment, quality of life, or death. The researchers also explored whether impairments in cognitive or physical function had any effect on intensive blood pressure control.

The analysis included 1,167 participants. Most were around 84 years old, and about 3 percent were 90 or older. Their baseline systolic blood pressure was around 142 mmHg. Most of the participants had at least three chronic health conditions. More than half were taking at least five medications and about 27 percent had a history of heart disease.

The participants were randomly assigned to one of two groups. One group received “intensive” treatment targeting to lower their blood pressure to less than 120 mmHg. The other group received treatment to target lowering their blood pressure to less than 140 mmHg.

The people who received treatment to lower their blood pressure to less than 120 mmHg experienced a lower risk for heart disease events, as well as less risk for mild cognitive impairment and death from all causes. However, people in this group also experienced an increased risk of small, but meaningful, declines in kidney function as well as hospitalizations for short term kidney damage (from which most people recovered). Attempting to lower systolic blood pressure to less than 120 mmHg did not increase the risk for injury-causing falls. This is important, since falls raise the risk for death in older adults and low blood pressure can result in falls.

While the rate of developing dementia was similar in the two groups, participants in the intensive 120 mmHg group were 28 percent less likely to develop mild cognitive impairment.

The researchers also reported that people with better cognitive function (remembering, thinking, and making decisions) at the beginning of the study benefited the most from intensive blood pressure control. They also experienced less heart disease and fewer deaths. This same benefit was not seen in participants who had poorer cognitive function at the beginning of the study. However, there was not strong evidence of intensive blood pressure control having a harmful impact on death rates or developing heart disease for those with poorer cognitive function.

The researchers concluded that, for adults aged 80 years or older, intensively controlling systolic blood pressure to less than 120 mmHg lowers the risk of heart attacks, stroke, death, and mild cognitive impairment, but increases the risk of declines in kidney function. Benefits related to the risk for heart disease and death were highest in people with higher cognitive performance at the beginning of the trial.

This summary is from “Intensive versus Standard Blood Pressure Control in Adults 80 years or Older: A Secondary Analysis of the Systolic Blood Pressure Intervention Trial.” It appears online ahead of print in the December 2019 issue of the Journal of the American Geriatrics Society. The study authors are  Nicholas M. Pajewski, PhD; Dan R. Berlowitz, MD, MPH; Adam P. Bress, PharmD; Kathryn E. Callahan, MD; Alfred K. Cheung, MD; Larry J. Fine, MD; Sarah A. Gaussoin, MS; Karen C. Johnson, MD, MPH; Jordan King, PharmD; Dalane W. Kitzman, MD; John B. Kostis, MD; Alan J. Lerner, MD; Cora E. Lewis, MD, MSPH; Suzanne Oparil, MD; Mahboob Rahman, MD; David M. Reboussin, PhD; Michael V. Rocco, MD; Joni K. Snyder, RN; Carolyn Still, PhD; Mark A. Supiano, MD; Virginia G. Wadley, PhD; Paul K. Whelton, MD; Jackson T. Wright Jr., MD, PhD; and Jeff D. Williamson, MD, MHS.