A recent Cochrane review cited by Medscape investigated whether withdrawal of antihypertensive medications has adverse consequences in more than 1,000 individuals aged 50 years and older across six randomized controlled trials. Compared with the groups that continued antihypertensive medication, the discontinuation groups had higher odds of all-cause mortality, myocardial infarction, and stroke. But the certainty of evidence was low and none of the differences were statistically significant. Systolic blood pressure and diastolic blood pressure were both significantly higher in the discontinuation groups. Also, more participants in the discontinuation groups experienced increased blood pressure or other clinical criteria that would require restarting of therapy or removal from the study. However, many of the studies in the review had limitations including selective reporting, incomplete outcome data, and lack of blinding of participants and personnel. These limitations "mean that we cannot make any firm conclusions about the effect of deprescribing antihypertensives on these outcomes," the authors conclude. "Older adults should not stop any of their medications without talking to a health care professional."

Presentations at the Alzheimer's Association International Conference 2020 indicate that the COVID-19 pandemic has affected research, outcomes, long-term care, and disparities associated with Alzheimer's disease and other dementias, reports Healio . "Our aging population is at unique risk for COVID-19, both for infectivity as well as for serious complications," said Gregory Jicha with the Alzheimer's Association Clinical Trials Advancement and Methods professional interest area. "Although COVID-19 risks are high . . . Alzheimer's disease and related dementias carry a 100 percent risk for death." Approaches for safely conducting research among this populace include screening for symptoms, maintaining social distancing, minimizing exposure, limiting time in the clinic, and mask use. Jicha stressed that many promising Alzheimer's treatments require testing, and it is critical to carefully negotiate the pandemic and its shifting protocols, less recruitment, and elevated attrition to avoid overlooking pharmacologic research opportunities. A presentation from Rush University's Neelum T. Agarwal showed cardiovascular and cerebrovascular risk factors play prominent roles in Alzheimer's development, bringing health disparities into sharp relief. "These disparities have been unmasked and amplified by COVID-19, and it just adds another layer to our discussion regarding cognitive functioning and risk for Alzheimer's disease," he said. The Alzheimer's Association's Beth A. Kallmyer added that populations at long-term care communities may be especially vulnerable to COVID-19, since so many live with dementia.

Two University of Texas at Austin (UT) freshmen and a high school junior have founded Big & Mini, a nonprofit that pairs college-aged students with older adults to help relieve seniors' loneliness during the current pandemic, reports KXAN . The collaborators borrowed money to set up the Big & Mini website, which currently has about 500 Bigs (older adults) and 500 Minis (students) enrolled. Membership is free, although the site is funded by donations. All ages are welcomed, and participants are quickly trained on platform operations and Internet safety. They also must answer a questionnaire about their common interests, after which Bigs and Minis are placed a matching pool. The service assigns matches, schedules their first meet-up, and provides some icebreakers. Participants use a portal on the site to access video chat, so they can communicate directly with the nonprofit about their experience, with calls handled through the open-source Jitsi platform. Following the initial meeting, Bigs and Minis can schedule future meetings through the website, without disclosing personal information.

CNBC reports that 85-year-old venture capitalist Alan Patricof has announced a $32 million investment fund to focus on technology startups that cater to aging Americans. In partnership with former Thrive Global President Abby Miller Levy, the Primetime Partners fund is designed to leverage what Levy calls "a silver tsunami" that Silicon Valley investors typically ignore. "There's been this myth that older adults aren't online, they don't buy things, they don't change their behaviors, and I think that's fundamentally changing," Levy said. "You have older adults now, thanks to COVID, shopping online and using e-commerce in different ways." Primetime will draft checks of $250,000 to $1 million for anything from services and experiences for people older than 60 to financial security for retirees, and Patricof also noted an opportunity to invest in more "mature" entrepreneurs. Primetime investors include the University of Pittsburgh Medical School and Thirty Five Ventures co-founder and National Basketball Association star Kevin Durant.

Eli Lilly announced the start of a Phase III trial within nursing and assisted-living communities of a neutralizing antibody to prevent the virus that causes COVID-19, reports TheStreet.com . The drugmaker has partnered with the U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases for this trial, which involves the participation of several long-term care communities throughout the United States. The trials will enroll residents and staff who live or work in communities that have a recently diagnosed case of COVID-19 and who are at a high risk of exposure. Lilly said the study will determine whether a single dose of LY-CoV555 "reduces the rate of SARS-CoV-2 infection through four weeks as well as complications of COVID-19 through eight weeks." The company expects to enroll up to 2,400 participants, and it said earlier trials indicted LY-CoV555 "has been well tolerated at all doses tested and no drug-related severe adverse events have been observed to date." The antibody is designed to block the virus from binding to and penetrating human cells. Lilly is employing customized mobile research units to support the on-site study.

President Trump this week signed an executive order to grant telehealth services a larger role in Medicare, reports the Associated Press . The measure instructs the U.S. Departments of Agriculture and Health and Human Services, and the Federal Communications Commission, to collaborate on developing the infrastructure to support rural telehealth services. While the order specifically applies to rural beneficiaries, it serves as a call to Congress to move toward in making virtual doctor visits a permanent Medicare fixture for all enrollees. The directive also will advance an experiment in which hospitals in rural communities could receive a more predictable flow of Medicare payments in return for delivering improved performance on certain measures of quality. "In an earlier age, doctors commonly made house calls, said Centers for Medicare & Medicaid Services Administrator Seema Verma. "Given how effectively and efficiently the health care system has adapted to the advent of telehealth, it's become increasingly clear that it is poised to resurrect that tradition in modern form."

A new study in Neurology suggests that higher levels of education might decelerate early-onset Alzheimer's disease by slowing development of beta-amyloid plaques in the brain, according to U.S. News & World Report . The researchers examined a group of 106 people, average age 67, and a parent diagnosed with Alzheimer's. Among this cohort, 39 percent carried the APOE4 gene mutation associated with Alzheimer's. In a second cohort of 117 people, average age 35, 31 percent had the mutation. Both groups had 15 years of education on average, and higher levels of education were connected to fewer amyloid plaques in the brain among people with familial early-onset Alzheimer's. In both cohorts, people with less than a decade of education had about twice as many amyloid plaques, versus those with more than 16 years of education. "While it has been believed that people with familial Alzheimer's disease, with its strong genetic causes, may have few ways to slow development of the disease, our study shows that education may be somewhat protective, perhaps promoting brain resistance against these plaques, just as it has been shown to be in people with unknown causes of the disease," concluded McGill University's Sylvia Villeneuve.

The New York Alliance Against Insurance Fraud says quarantined residents should look out for telemedicine-related scams which often target seniors, reports the Rome Sentinel . The group warns that fraudsters have started cold-calling people, especially older adults, claiming to offer free telemedicine conferences and medical aid. Their claims include offers of free braces and medicine to deceive targets into handing over their medical and insurance information, which the scammers can exploit to steal their identity and falsely bill their insurance. The alliance recommends a number of avoidance strategies, including refusing to accept medical help from strangers and doctors one does not know; checking medical statements for suspicious charges or overcharging; using an official telemedicine phone application or phone number; having one's prescriptions on hand when consulting with a real doctor; having a flashlight to help the doctor see wounds and injuries more clearly; and conducting telemedicine calls at a quiet place in one's home. The advisory says people suspected of being victimized by scams can call 1-844-FRAUDNY.

Health psychologist Roger McIntosh writes in Next Avenue that self-quarantine or isolation during the COVID-19 pandemic can have serious repercussions on the physical and mental health of older adults. "Behavioral research widely supports the observation that socially isolated older adults have lower T-cells counts and higher levels of inflammation than their socially integrated counterparts," he explains. "More frequent engagement in meaningful social interactions enhances immune function by lowering the suppressive effect of stress on immune resilience." The burden on isolated seniors is compounded by their generally greater reliance on instructive/support services, large group formats, and committed space for exercise, recreation, and physical therapy. Furthermore, McIntosh cites the well-documented benefits of fresh air and sunlight on immune system function. Meanwhile, he refers to a review in The Lancet analyzing self-quarantined populations worldwide, which "suggests social isolation during an epidemic has negative psychosocial consequences, including post-traumatic stress symptoms, confusion, and anger." As for solutions, McIntosh suggests interactions between families and residents of long-term care communities through telecommunication technology for virtual visits when in-person visits are not permitted. "These same applications can be used to provide fitness and life coaching for the isolated, as well as facilitating telemedicine to ensure older patients maintain some standard of care," he writes.

A nationwide study published in the Journals of Gerontology: Social Sciences: Series B found that U.S. baby boomers scored lower on a test of cognitive function than did members of previous generations, reports ScienceDaily . Average cognition scores of adults 50 and older increased from generation to generation, beginning with the greatest generation and peaking among war babies. Scores started declining in the early boomers and fell further in the mid boomers, suggesting a reversal in the trend of declining dementia in the United States in coming decades. "What was most surprising . . . is that this decline is seen in all groups: men and women, across all races and ethnicities and across all education, income, and wealth levels," said Ohio State University Professor Hui Zheng. Results indicated lower cognitive functioning in baby boomers was associated with less wealth, along with more loneliness, depression, inactivity, and obesity, and reduced likelihood of matrimony. "If it weren't for their better childhood health, more favorable family background, more years of education, and higher likelihood of having a white-collar occupation, baby boomers would have even worse cognitive functioning," Zheng noted. Among the contributing factors highlighted as unique to the United States was the lack of universal access and high cost of healthcare.