A recent study in JAMA of people with dementia found that almost one in seven participants are taking three or more brain and central nervous system (CNS) medications, despite experts' warnings that they should limit such drugs, reports Medical News Today . The issue is that age-related and dementia-related changes in brain chemistry may lead to undesirable interactions. The same percentage of dementia patients also do not live in a nursing community. Among those taking multiple CNS drugs, 92 percent took the most commonly prescribed class of drugs — antidepressants — while 62 percent were taking anti-seizure medications. Roughly 41 percent of the CNS-active polypharmacy cohort also had prescriptions for benzodiazepines. Moreover, 47 percent were taking antipsychotics, which are not among the approved medications for dementia. "It appears that we have a lot of people on a lot of medications without a very good reason," said Donovan Maust at the University of Michigan. He and his colleagues suggest that more drug reviews by medical professionals could help identify negative interactions when people use three or more brain and CNS drugs in combination.

Kaiser Health News reports that while the COVID-19 pandemic has fueled wide adoption of telehealth across the United States, there have been unforeseen consequences, including clashes between out-of-state and in-state health providers. For example, Montana's deployment of telehealth services from the Minnesota-based Hazelden Betty Ford Foundation caused leading Montana health provider Rimrock to worry that a flood of out-of-state providers could poach its privately insured patients. The foundation's Bob Poznanovich said, "We've heard grumblings, like 'Why are you coming into our state?'" but "more people have welcomed the entry into the marketplace because they think that we will help create a bigger marketplace." Florida radiologist Ashley Maru expects the telehealth rush will permanently change healthcare, potentially addressing a national shortage of doctors. However, Blue Cross and Blue Shield of Montana's John Doran is concerned that an influx of out-of-state telehealth providers could hurt local providers or force them out of business, especially in smaller states. Meanwhile, a New England Journal of Medicine article suggests the rapid uptake of telemedicine could exclude vulnerable people with limited Internet access or tech literacy, including seniors, the poor, and non-English speakers.

A study by University of Delaware researchers published in Arthritis Research & Therapy found older adults with concurrent hip osteoarthritis (OA) and chronic low back pain (CLBP) may be at elevated risk for accidental falls, reports Healio . The team prospectively tracked 210 adults 65 to 80 years old with CLBP for one year, and 97.1 percent exhibited signs and symptoms of hip OA. The authors recorded 219 falls from 42.4 percent of patients during the study period. Compared with patients who fell only once, the hip OA impairment burden was "significantly greater" among those who fell twice or more. Moreover, binary logistic regression uncovered a link between higher hip OA impairment burden and greater fall risk. The risk ratio for elevated fall risk among this subset was 1.23, while the odds ratio of multiple falls was 1.41. "Older adults with CLBP and concomitant hip impairments are an at-risk group for falling," the researchers concluded. "Healthcare professionals should employ falls screening and preventive measures to avoid negative sequelae in this vulnerable population."

Canada has departed from its original guidelines by recommending the AstraZeneca-Oxford COVID-19 vaccine for people older than 65, reports Al Jazeera . The government's National Advisory Committee on Immunization (NACI) had previously advised against the vaccine "due to limited information on its efficacy." But the NACI said this week that it changed its policy reviewing "real-world effectiveness studies." The recommendation still supports prioritizing Pfizer-BioNTech and Moderna vaccines for older populations. Canadian Prime Minister Justin Trudeau on Monday aimed to reassure residents that the AstraZeneca vaccine is safe after Germany, France, Italy, and Spain joined other nations in suspending its use. In response, AstraZeneca said it had reviewed the data on 17 million people who received doses across Europe and found 37 cases of that developed blood clots as of March 8. The company said there was "no evidence of an increased risk" of clots in any age group or gender, adding that "this is much lower than would be expected to occur naturally in a general population of this size and is similar across other licensed COVID-19 vaccines."

NorthJersey.com reports that New Jersey officials have begun getting seniors vaccinated for COVID-19 more than two months into the vaccine rollout. State Health Commissioner Judy Persichilli said her staff started reaching out to people 75 and older two weeks ago to schedule shots, with first doses in that demographic rising from 33 percent to 58 percent now. The state has prioritized that age group for vaccination because they account for nearly half of New Jersey's 23,000 COVID fatalities. Walmart and Sam's Club have begun reserving at least 10,000 doses a week for seniors at about three dozen stores, while the state has set up a special hotline for seniors to book shots.

Preliminary research to be presented at the American Stroke Association's International Stroke Conference 2021 found that ischemic stroke elevates dementia risk, which increases with the number and severity of strokes, reports News-Medical . The authors analyzed health data of nearly 15,800 adults 45 to 64 years old at baseline from the Atherosclerosis Risk in Communities (ARIC) study. They applied follow-up data from 30 years of the ARIC database to determine that the risk of dementia in individuals who had at least one ischemic stroke was twice as high than for those with no stroke. Moreover, adults who had one stroke were nearly 80 percent more likely to have dementia than those with no stroke. That risk rose 8.5 times for people who had three or more strokes during the study period, while the risk of dementia was almost five times higher among those with severe stroke than for those with minor stroke. "Our study uniquely characterizes the link between stroke and dementia and sets the stage for prevention strategies aimed at reducing the risk of dementia after a stroke," said Tel Aviv University's Silvia Koton.

Senior Care Partners CEO Laura Ferrara said participants in the company's Program of All-Inclusive Care for the Elderly (PACE) have seen success with the GrandPad, a tablet designed for seniors, during the pandemic, reports WWMT News Channel 3 . The GrandPad features simple apps and buttons, and users can reach technical expertise at the touch of a button. "It's especially for the older population that have more vision impairments, dexterity problems, and even cognitive challenges," said Ferrara. "The way they are enabled and designed . . . it's a simple on and off, the buttons are easier to see, they're larger." Ferrara said Senior Care Partners PACE provided 444 GrandPads to adults through grants, thanks to funding from donors like Calhoun County Senior Millage, the Battle Creek Community Foundation, and United Way. The program currently has about 600 participants at four West Michigan locations. "We're looking for any resource we can find right now because of the huge need for devices like this, for social connection," said Ferrara.

A new University at Buffalo (UB) study published in Pharmacoepidemiology and Drug Safety found that the percentage of adults 65 and older prescribed a drug that increased their risk of falling grew from 57 percent in 1999 to 94 percent in 2017, reports University at Buffalo News . Moreover, the rate of death caused by falls in older adults more than doubled. Fall-risk-elevating drugs include antidepressants, anticonvulsants, antipsychotics, antihypertensives, opioids, sedative hypnotics, benzodiazepines, and other nonprescription medications. Over the study period more than 7.8 billion fall-risk-increasing drug orders were filled by older adults in the United States, with most prescriptions for antihypertensives — although a sharp rise in the use of antidepressants was observed as well. Women, especially Black women, also were more likely than men to be prescribed fall-risk-increasing drugs. UB's Amy Shaver said the findings highlight the importance of interventions to de-prescribe potentially unsuitable drugs among older, frailer patients.

CNBC reports that White House senior adviser for COVID response Any Slavitt expects a growing number of Americans will continue to get immunized for COVID-19 due to messaging and evidence from trusted sources. "In Israel . . . 89 percent of seniors have chosen to take the vaccine," he said. "We think we can get up to those kinds of numbers, if we just continue to reliably answer people's questions, because these are very good, safe, effective vaccines." The U.S. Centers for Disease Control and Prevention said about 37 percent of Americans over the age of 65 have been fully vaccinated, and the Biden administration announced the planned launch of a nationwide vaccine availability website to serve as a link among the many vaccination registration websites from states, pharmacies, and other businesses. Slavitt said, "the idea would be if you put in your zip code, it would show you on a map, all of the places near you that claim to have vaccines." He also said streamlining the process would mitigate widespread frustration and hesitancy about vaccines.

WCBS Newsradio 880 reports that seniors in Nassau County, N.Y., can now set up COVID-19 vaccination appointments through a new county hotline. "We heard frustration loud and clear from seniors, and family members of seniors, who don't have access to technology, who don't have the time to sit and refresh their browser all the time, and were having a very hard time making an appointment for a vaccine," said Nassau County Executive Laura Curran. "So, as we say, our goal is to let everyone have a shot at getting a shot, especially our vulnerable communities, and we know that the seniors are the most vulnerable to this virus." Starting Thursday, seniors can get assistance scheduling a vaccine appointment by calling the 516-227-9590 hotline.