An untold number of older Americans are unable to get COVID-19 vaccines because they are too overwhelmed, too weak, or too impoverished to fend for themselves, reports the Associated Press . Nonprofits, churches, and advocacy groups are racing to find and inoculate isolated seniors. Compounding this situation is a wide gap between vaccine supply and demand in almost every part of the country. This imbalance tends to favor healthier seniors with resources "who are able to jump in their car at a moment's notice and drive two hours," said James Stowe with an association of city and county governments in the bistate Kansas City area. Some older adults who have missed vaccines are so disconnected they do not realize that they qualify, while others do but do not know how to make a vaccination appointment, and cannot get to one without Internet service or e-mail. Still others cannot venture outside their homes due to serious health issues, or because their fear of exposure to COVID-19 is insurmountable. In the hope of addressing access inequity, the Biden administration announced Wednesday that it will partner with health insurers to help vulnerable seniors get vaccinated.

A study published in Neurology found severe perivascular space (PVS) dilation pathology to be predictive of higher risk of cognitive decline among adults 72 to 92 years old, reports Neurology Advisor . The researchers looked at 414 community-dwelling older adults in that age range participating in the Sydney Memory and Aging study. Subjects received cognitive assessments and 3T magnetic resonance imaging, and were evaluated for consensus dementia diagnoses at baseline and once every two years for up to eight years. Investigators tallied up the number of PVS in two representative segments in the basal ganglia (BG) and centrum semiovale (CSO), and described severe PVS pathology as the top quartile. Roughly 38 percent of participants exhibited severe PVS pathology in either region, while 7 percent had severe pathology in both regions; 22 percent had severe BG PVS pathology and 24 percent had severe CSO PVS pathology. Those with severe BG PVS had much more white matter hyperintensities volume and were substantially more likely to have lacunes and multiple cerebral microbleeds, versus participants with absent/mild BG PVS. Subjects with severe PVS pathology in both regions suffered faster declines in global cognition compared to those with less severe pathology. The researchers determined that "further research is needed into the etiology and sequelae of PVS pathology since PVS may be an important potential biomarker to help with early dementia diagnosis, prognosis and subtyping."

An Alzheimer's Association report estimated that New York topped all other U.S. states in terms of care costs for Alzheimer's disease and dementia, according to the Rome Sentinel . New York is the only state to spend more than $5 billion on dementia care, with costs reaching $5.453 billion in 2020. This marked the fifth straight year New York has led the country in Medicaid spending on dementia care, and those costs are forecast to increase nearly 16 percent by 2025 to over $6.3 billion. The report also noted that the population of New Yorkers 65 and older living with Alzheimer's disease will grow 12.2 percent by 2025, with 460,000 projected to have the disorder. Over 500,000 New Yorkers are unpaid caregivers for someone living with Alzheimer's or other dementias. Last year 586,000 people in New York were dementia caregivers, whose cumulative 774 million hours of unpaid care was valued at $14.6 billion. Alzheimer's disease also was reported as a cause of death for 3,753 New Yorkers in 2019.

ABC 12 reports that MidMichigan Health has launched a program in the hope of alleviating seniors' loneliness during the pandemic. The five-week Bridge to Belonging virtual program will focus on subjects that many in isolation are struggling with. Seniors participating in the program will have opportunities to talk with others in the same situation, and offer strategies that could help decrease the feeling of loneliness. "It's our perspective that's often helpful and there's a number of things we can do to change that," said MidMichigan Health's Meghan Dahl. "So, for example, how we think about our situation. The thought part is very important. So we learn tools to shift our thinking." Dahl explained that seniors "really enjoy talking to one another about their own experiences and sharing tips. Just getting validation that it is hard, but it's not impossible. So finding that group that connection in the session has been really meaningful for people."

CBS News reports that the U.S. Centers for Disease Control and Prevention (CDC) is finalizing guidance to specify what activities are and are not allowable for Americans who have been vaccinated for COVID-19. Sources said the guidance should emphasize that fully vaccinated individuals can gather in small groups with other people who have also been immunized. The CDC currently does not advise in-person gatherings with the general public, saying "gathering virtually or with the people you live with is the safest choice." Even for fully vaccinated individuals, other mitigation measures, including wearing a mask in public and social distancing, will continue to be recommended. Chief White House medical adviser Anthony Fauci previewed the guidance at a Monday briefing, saying small gatherings among people who are "doubly vaccinated" are sufficiently low risk that masks would be unnecessary in social gatherings within the home.

A U.K. government study by Public Health England determined that AstraZeneca's COVID-19 vaccine was between 60 percent and 73 percent effective in adults aged 70 and older, reports Barron's . "This adds to growing evidence showing that the vaccines are working to reduce infections and save lives," said Public Health England's Mary Ramsay. "While there remains much more data to follow, this is encouraging and we are increasingly confident that vaccines are making a real difference." Public Health England's study used routine testing and vaccination data to calculate the vaccine's effects on COVID-19 cases in older adults. "This study provides the first real-world evidence of COVID-19 vaccine effectiveness against symptomatic COVID-19 in older people in the U.K.," the authors explained. "The effect of a single dose of the AstraZeneca vaccine against symptomatic disease was approximately 60-75 percent and there was again an additional protective effect against hospitalization, though it is too early to assess the effect and mortality."

CNBC reports that more than a dozen health insurers are launching a pilot program to get 2 million American seniors inoculated for COVID-19 as quickly as possible, said President Biden's senior pandemic adviser Andy Slavitt. Vaccine Community Connecters aims to educate seniors on the vaccines, help schedule vaccination appointments, and arrange transportation to appointments. Slavitt added that insurers also will discuss "vaccine efficacy, safety, and the value of vaccination," and may deploy mobile vans to communities in greatest need. The White House is collaborating with America's Health Insurance Plans and the Blue Cross Blue Shield Association on the pilot. The Biden administration is concurrently striving to boost the supply of vaccines and get them to most Americans as soon as possible. Insurers will work with federal, state, and local officials to ship vaccines to underserved communities and cooperate closely with pharmacies and other vaccination partners. "Vaccines save lives, and health insurance providers have been working hard to break down barriers that stand between Americans and COVID-19 vaccines," said America's Health Insurance Plans CEO Matt Eyles. "We will continue to work on that commitment with all levels of government and every organization that shares our goal until we defeat the COVID-19 crisis together."

Modern Healthcare reports that the U.S. National Institutes of Health (NIH) and private-sector partners have pledged nearly $74.9 million to Alzheimer's disease research over the next five years in the just-announced second phase of the Accelerating Medicine Partnership for Alzheimer's Disease (AMP AD) program, known as AMP AD 2.0. Among the technologies the effort will focus on is single-cell profiling and computational modeling to add precision medicine to Alzheimer's treatments. "AMP AD 2.0 aims to add greater precision to the molecular maps developed in the first iteration of this program," declared NIH Director Francis Collins. "This will identify biological targets and biomarkers to inform new therapeutic interventions for specific disease subtypes." The National Institute on Aging will supervise research activities, allocating $61.4 to the initiative over the next five years. Meanwhile, private-sector partners including Eisai, Gates Ventures, Takeda Pharmaceutical, the Alzheimer's Association, and GlaxoSmithKline have committed nearly $13.5 million altogether. The NIH funding will underwrite a data coordination center hosted by Sage Bionetworks, in addition to six cross-disciplinary academic research teams.

A report from the Alzheimer's Association found racial and ethnic disparities between people battling Alzheimer's, according to WFLX . The study determined that non-white populations expected and encountered more obstacles when accessing dementia care, and felt less confident that they can access health professionals who understand their ethnic and racial backgrounds and experiences. Forty-nine percent of Black Americans reported experiencing healthcare discrimination, as did 42 percent of Native Americans and 33 percent of Asian Americans and Hispanics. Black Americans also faced higher costs of care than white and Hispanic Americans due to additional co-morbidities and preventable hospitalizations. Moreover, less than half of Black Americans believed they had access to culturally competent providers. "It validates the statistic that has always been there, that African-Americans are two times as likely to have the disease," said Keith Gibson with the Alzheimer's Association in Southeast Florida. He agreed with the report that more diversity should be incorporated into clinical trials into cures or measures to slow the disease. Gibson added that the Alzheimer's Association is working harder to reach out to and nurture trust in communities of color.

The Texas Division of Emergency (TDEM), the Texas Department of State Health Services (DSHS), and the Texas Military Department (TMD) have announced 26 participating counties for the first week of Gov. Greg Abbott's Save Our Seniors program, reports KTRE Channel 9 . Texas has apportioned up to 8,000 COVID-19 vaccine doses for the first week of the initiative, which the state will use in collusion with local officials and service organizations to help Texans who are 75 years and older or homebound. TDEM and TMD will partner with local jurisdictions to deploy a central drive-through vaccine clinic in the community. Abbott said, "As more communities are identified and selected for the program, we will be able to get more shots in arms and further strengthen our response to this virus."