An updated forecast from the U.S. Bureau of Labor Statistics (BLS) lists the 10 fastest-growing jobs in the country over the next decade, driven by an aging populace and technological and energy innovations, reports Fox 5 New York . Among those occupations are nurse practitioners, who are expected to command an annual salary of $109,820. Other expected top 10 professions include occupational therapy assistants, home health and personal care aides, physical therapist assistants, and medical and health services managers. "Factors that are expected to contribute to the large increase in the healthcare sector include increased demand to care for the aging baby-boom population, longer life expectancies, and continued growth in the number of patients with chronic conditions," said BLS. All boomers are expected to reach age 65 by 2029, and Arena CEO Michael Rosenbaum explained that Americans are "also living longer and need more advanced care," increasing demand for more healthcare jobs unrelated to COVID-19 over the next 10 years.

COVID-19 infections tend to be more severe among older adults and males, and a study in PLOS Biology suggests that varying immune responses to SARS-CoV-2 due to age and sex may be reliant on viral load and the time-course of infection, reports ScienceDaily . Researchers extracted and sequenced viral RNA from swabs collected from 430 COVID-19 positive cases and 54 negative controls, then analyzed the hosts' antiviral and immune responses across infection status, viral load, age, and sex. Immune cell responses were inactive until after three days following onset of infection, while immune cell composition and function fluctuated with viral loads to suggest a dysfunctional antiviral response in males and seniors. "Collectively, our data demonstrate that host responses to SARS-CoV-2 are dependent on viral load and infection time with observed differences due to age and sex that may contribute to disease severity," the authors concluded.

Harvard Medical School physician Haider J. Warraich writes in the Washington Post that the term "palliative care" scares many people with critical illnesses and their families, as specialists in this field are almost always involved with patients approaching the end of life. The current pandemic compounds this fear, and it and other trends are driving a movement to rename palliative care so that patients and doctors will be less reluctant to use it. A study in the Journal of Palliative Medicine rating public perception among more than 5,000 older Americans indicated that over 70 percent of participants did not even know what palliative care was. Of those who were aware of palliative care, nearly two-thirds thought it was the same as hospice, which is provided for persons with an expected survival of no more than six months. Despite its association with imminent mortality, palliative care has been shown to repeatedly improve quality of life in people with conditions such as cancer and heart failure, and even extend life in certain cases. Palliative care practices throughout the United States are substituting the phrase "palliative care" with "supportive care" in an attempt to boost the acceptability of palliative care for both patients and doctors. A study in The Oncologist from the MD Anderson Cancer Center in Houston showed that this name change increased referrals 41 percent, while people seen by "supportive care" lived on average for 6.2 months, versus 4.7 months among those seen by "palliative care." "Because of the pandemic, palliative care doctors believe that they might have an opportunity to redefine what they do and demonstrate its value to patients in need," Warraich notes.

A decline in telemedicine visits across the United States is forcing providers to recalibrate their services, reports STAT . Electronic health record company Epic estimates that telehealth visits fell from 69 percent of total encounters at the early height of the COVID-19 crisis in April to 21 percent by the middle of July. In the wake of this slippage, hospitals that scrambled to retrain staff to deliver virtual care in March are now struggling to rebalance according to shifting patient preferences and requirements. "We're trying to right-size, but it's really hard because during the pandemic we switched to nearly 100 percent virtual in some clinical areas, and we know that's not realistic or sustainable," said Michigan Medicine's Jessie DeVito. Several large health systems said the transition involves careful consideration of which clinical conditions should prioritize in-person attention and which cases can be handled just as effectively with virtual appointments. Also vital is determining when hybrid in-person/virtual visits will be most cost-efficient for providers as they attempt to optimally manage both patients and bottom lines after months of plummeting revenue. Not all specialities are seeing declines, as traditional providers are still conducting most mental health visits over phone or video, while specialists that usually provide more hands-on care — like orthopedists — are seeing more clients return to their offices.

COVID-19 highlights the critical need to include older adults in vaccine trials since they are more vulnerable to the virus, yet they have been historically underrepresented in clinical trials for certain treatments, reports KJZZ News . University of Arizona College of Medicine Professor Shad Marvasti says medical research has been constrained to "middle aged white men," while more diverse inclusion efforts have been insufficient. "We're still falling way too short, in terms of our inclusion of not only black and brown Americans, but also older Americans," he says. Older adults can have more complex medical ailments, meaning their response to a vaccine could differ from that of a healthy 25-year-old. Marvasti warns that if certain populations are overlooked, researchers will lack a complete picture of the impact of a particular treatment. "The outcome is that you have unanticipated side effects that occur with those individuals," he says. "They tend to also have more complex, other medical conditions. Because older adults also tend to be on multiple medications, Marvasti adds that "we don't know the interactions that may occur with common medications and seniors or common chronic conditions among them."

Seattle-based Athira Pharma is pursuing the advancement of an Alzheimer's drug to several trials, funding them through an initial public offering (IPO), reports Xconomy . The ATH-1017 drug is designed to promote the ability of a protein called hepatocyte growth factor to trigger a signaling pathway that promotes neuron regeneration. The company says its small molecules can cross the blood-brain barrier, and potential applications include treatment for various nervous system disorders like Alzheimer's and Parkinson's, and peripheral conditions such as neuropathies. A Phase 1 study indicated that the drug was well tolerated with no adverse events, while improvement in brain network activity suggested "potentially positive effects on brain function," said Athira in its IPO filing. Among the company's plans for the drug is a Phase 2/3 clinical trial on patients with mild-to-moderate Alzheimer's to evaluate the safety, tolerability, and efficacy of two different doses. A separate Phase 2 study will assess the same two doses in the same type of patients, with the effect on memory processing speed and other cognitive measures to be targeted.

Research demonstrates that areas of the brain can continue to grow and change as people age, and engaging in learning activities, or brain games, can help maintain brain health, reports the Northwest Herald . Brain games like learning activities and puzzles can benefit older adults by helping to slow cognitive decline, as they require participants to apply strategic thinking and creativity. Brain games also can help augment short-term memory and performance on attention and reasoning tests. Games and puzzles can help enhance visual-spatial reasoning while evoking feelings of accomplishment and well-being. For older adults, such activities also can help mitigate feelings of depression and loneliness, and offer opportunities for social inclusion. A third brain game benefit is a lifelong source of entertainment.

The Oaks at Braselton assisted living community in Georgia started offering socially distanced outdoor visits last month, using a unique setup to allow residents to hug loved ones safely, reports the Gainesville Times . The Oaks at Braselton built a "hugging booth" outside its memory care unit, which wellness director Erika Fenley said was inspired by a similar booth showcased on Facebook. Her husband Jason erected the booth from a shower curtain, plastic tarp, and wood. Users wear disposable plastic gloves used in veterinarian clinics. Lifestyle director Summer Wilkie said those who use the booth hold each other. "Being able to connect our elders to their loved ones in such a creative way has been such a gift to everyone," she noted. "Touch is such an integral part of a person's well-being."

Research from the American Red Cross Scientific Advisory Council and the American Academy of Nursing found older adults are more vulnerable and suffer more casualties after a natural disaster than any other age group, reports the Post and Courier . Older adults may have more chronic conditions and medication issues, and may be more reliant on assistive devices and support from caregivers; social isolation also can add to their vulnerability. This month as hurricane season continues, the Red Cross of South Carolina is encouraging everyone — especially older adults — to prepare for emergencies. Officials said older adults should consider what they would do during a disaster in advance — and realize how their medical, physical, and cognitive needs may affect their ability to respond if staying inside for weeks or an evacuation were necessary. Building a support network and identifying helpers like family, friends, neighbors, caregivers, and care providers is critical. Red Cross officials recommend that older adults build two emergency supply kits — a stay-at-home kit and one for evacuation — and a one-month supply of prescription medication. They also advise older adults to ask friends or relatives outside their area if they can stay with them; they should additionally check to see if they have any COVID-19 symptoms or people at home at higher risk for serious illness, and make alternate arrangements if so.

A study published in JAMA Network Open that compared dementia risk among prostate cancer patients receiving different types of androgen deprivation therapy noted a correlation between antiandrogen monotherapy and dementia and Alzheimer's disease, reports Docwire News . The researchers examined 23,651 men with prostate cancer, and slightly less than a third did not receive androgen deprivation therapy. Half were administered gonadotropin-releasing hormone (GnRH) agonists, 3.7 percent received orchiectomy, and 17.1 percent got antiandrogen monotherapy. Over a median follow-up of 3.46 years, 1,525 subjects were diagnosed with dementia. Those receiving antiandrogen monotherapy, versus those who did not, had a greater risk of dementia and Alzheimer's. In comparison with patients not receiving androgen deprivation therapy, dementia risk did not largely deviate for those getting GnRH agonists or orchiectomy. "GnRH agonist usage reduces testosterone and luteinizing hormone (LH) levels," the researchers explained. "Future studies should assess whether the suppressed LH counteracts the biological effect of low testosterone on cognitive decline."