Reuters has learned Pfizer is piloting a delivery system for its experimental COVID-19 vaccine in four states, as the drugmaker focuses on distribution hurdles related to the vaccine's ultra-cold storage requirements. The vaccine must be transported and stored at -94 degrees F, significantly below the standard for vaccines of 36-46 degrees F. Pfizer said, "We are hopeful that results from this vaccine delivery pilot will serve as the model for other U.S. states and international governments, as they prepare to implement effective COVID-19 vaccine programs." The company selected Rhode Island, Texas, New Mexico, and Tennessee for the pilot after examining such factors as size, diversity of populations, immunization infrastructure, and individuals residing in varied urban and rural settings.

Arizona Public Media reports that with COVID-19 cases in Arizona spiking, Gov. Doug Ducey's task force on long-term care is discouraging residents of assisted living communities from going to see family for the holidays. This concerns experts like University of Arizona Professor Melvin Hector, who said the severity of isolation's mental health effects on older people is shaped by a person's pre-existing health. He noted that isolation can worsen blood pressure, anxiety, and depression, and along with loneliness can accelerate cognitive decline like dementia — which many assisted living community residents are living with. "It is as much a factor leading to patients' premature death as things that we would classically consider, like smoking or obesity or a sedentary lifestyle," Hector warned. The chair of Gov. Ducey's task force, Christina Corieri, said a top priority for the group is finding ways to help residents' mental health. She acknowledged that in-person visits mean a lot to people, even if virtual visits are offered. "That's why we were able to come up with a program to safely allow designated essential visitors to come in, and we know those will be especially important during the holiday season," Corieri explained. With most Arizona counties now exhibiting moderate COVID-19 spread, she said the task force recommends that residents remain in their communities at all times, except to see the doctor.

ScienceDaily reports that a study in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring identified certain regions in the retina that are more affected by Alzheimer's disease than others. "Detecting these signs can help diagnose the disease more accurately, allowing for earlier and more effective treatment intervention," said Professor Maya Koronyo-Hamaoui at the Cedars-Sinai Medical Center. The clinical trial involved individuals older than 40 showing signs of cognitive decline, whose retinal images were recorded via sectoral retinal amyloid imaging. Subsequent analysis highlighted certain peripheral regions in the retina that corresponded more closely to brain damage and cognitive status. This enabled the scientists to detect subjects with a greater accumulation of retinal amyloid protein, indicating a higher probability of developing Alzheimer's disease or cognitive impairments. Another study published in Aging Cell tested mice to further validate the retina's role in exhibiting hallmark Alzheimer's disease indicators, and identified a potential treatment. Koronyo-Hamaoui said the treatment would involve "reducing toxic proteins and harmful inflammation in the brain and, in return, enhancing a protective type of immune response that preserved the connections between neurons, which are tightly connected to cognition."

WDIO-TV reports that University of Minnesota Duluth (UMD) Professor Arshia Khan and her team are investigating the use of social robots to help frontline workers and residents at assisted living communities. They are programming the robots to engage with and monitor residents. "The robots have emotion detection capabilities so they can detect where the patient's feelings are going and then relay that information," said UMD's Anna Martin. The robots are designed to comfort and help residents feel less alone through social interaction. "Having to go into people's spaces and not have to worry about infection during the pandemic particularly for vulnerable populations can be very valuable," explained Martin. According to Khan, the robots also can administer medication, track emotions, and monitor physiological changes like blood pressure and heart rate through a sensor that residents will wear. The robots also can dance and gossip. Khan added that they "will know residents' activities because the robot will start assisting them as soon as they're diagnosed with dementia and learn and remind people of their behavior."

Medical Xpress reports that a study in Nature Neuroscience explored the implications of star-shaped "reactive astrocytes" in the mechanism of Alzheimer's disease. The researchers found the severity of these cells is a key indicator for Alzheimer's onset. They learned that mild reactive astrocytes can naturally reverse astrocytic reactivity, while severe reactive astrocytes can induce irreversible neurodegeneration. "This finding suggests experiences such as traumatic brain injury, viral infection, and post-traumatic stress disorder might be necessary to transform a healthy brain to be vulnerable to Alzheimer's disease via excessive oxidative stress," explained C. Justin Lee at the Institute for Basic Science. "The excessive oxidative stress disables the body's ability to counteract the harmful effects of overproduced oxygen-containing molecules, subsequently transforming mild reactive astrocytes into neurotoxic severe reactive astrocytes." The researchers determined that toxin-responsive astrocytes trigger a cellular restoration mechanism and boost hydrogen peroxide by activating monoamine oxidase B — which plays a critical function in reducing dopamine that impedes the signal transmission to generate smooth, purposeful movement. "This study suggests that an important step to establishing a new treatment strategy for Alzheimer's disease should be by targeting reactive astrocytes that appear to be overly activated in the early stages," said Ryu Hoon at the Korea Institute of Science and Technology.

NBC4 says a University of Southern California (USC) study published in Neurology found older women who live in areas with high concentrations of air pollution may have more Alzheimer's-like brain shrinkage than those living in areas with cleaner air. "Our study found that women in their 70s and 80s who were exposed to higher levels of PM2.5 (fine particulate pollution) outdoors were more likely to have the pattern of brain atrophy that would increase their risk for Alzheimer's disease over five years," said USC's Diana Younan. The investigators considered 712 women who underwent magnetic resonance imaging brain scans at the start of the study, and again five years later. There was a 0.03-point increase in brain shrinkage scores for each three-microgram boost in air pollution exposure levels that may elevate the risk of Alzheimer's disease by 24 percent over five years. Younan said the results have "important public health implications" because brain shrinkage was detected not only in women exposed to the highest levels of fine particulate pollution, but also in those exposed to levels lower than those the U.S. Environmental Protection Agency deems safe. "While more research is needed, federal efforts to tighten the air pollution exposure standards in the future may help reduce the risk of Alzheimer's in our older populations," she explained.

CNBC reports that a study in The Lancet found a coronavirus vaccine being developed by the University of Oxford and AstraZeneca is safe in older adults. The phase two trial involved 560 healthy adults, including 240 older than 70, and the ChAdOx1 nCoV-19 vaccine triggered a similar immune response among people older than 56 and those between 18 and 55 years old. AstraZeneca previously said interim data indicated that the experimental vaccine had produced an immune response in older and younger adults. The Oxford vaccine candidate caused few side effects, and activated immune responses in both parts of the immune system in all age groups and at low and standard dose. The study's authors said these results could be promising if the immune responses are found to be linked to protection against COVID-19 infection, with this to be determined by a phase three trial. "We hope that this means our vaccine will help to protect some of the most vulnerable people in society, but further research will be needed before we can be sure," said Oxford's Maheshi Ramasamy.

NBC 12 reports that researchers at James Madison University (JMU) in Virginia are developing an autonomous vehicle to benefit retirement communities by helping transport seniors. Two years ago, the JMU Autonomous Cart (JACart) research group began a project with faculty and students to retrofit golf cart that can sense objects and drive a path on its own within 15 weeks. Last year the team received a $120,000 grant through the Jeffress Trust Awards Program in Interdisciplinary Research to continue the work, and this week it tested out its second autonomous golf cart on JMU's campus. The cart combines computers, cameras, and sensors to drive a passenger to multiple locations via voice command. "The earliest deployments of completely autonomous systems are likely to be in these retirement communities because they're these closed campuses with low speeds," said JMU's Nathan Sprague. "So that actually solves a lot of the autonomy problems and makes them simpler and it's a community that could really benefit from this technology."

WBAL TV reports that nursing and assisted-living communities in Maryland are imposing tighter coronavirus restrictions as cases mount. Gov. Larry Hogan on Tuesday announced new restrictions for nursing and assisted-living communities, with indoor family visits limited mainly to compassionate-care visits, while all visitors must have proof of a negative COVID test result within 72 hours beforehand. The Maryland Department of Health (MDH) also has ordered mandatory, twice-weekly testing for all staff at nursing communities, and weekly testing for all residents. Weekly data from MDH on Wednesday estimated 7,007 resident COVID-19 cases and 1,337 deaths in nursing communities. Meanwhile, 3,548 staff cases and 14 deaths were posted last week, while this week saw 5,046 staff cases and 26 deaths. Nursing communities began allowing indoor visits to resume with precautions in October, but now they must take more aggressive action as further health measures are effected on Friday. "We're seeing 15 of the counties in Maryland below the 5 percent positivity rate, and nine are between 5 percent and 10 percent," said LeadingAge Maryland CEO Allison Ciborowski. "So we're definitely seeing increases."

A mouse study in Nature Neuroscience found that the fatal chain reaction that triggers Alzheimer's disease commences much earlier than commonly assumed, reports News-Medical . This also occurs in humans, and the researchers have singled out an antibody that might prevent the chain reaction. They sifted through already known antibodies that target misfolded beta-amyloid proteins, looking for antibodies that can identify and possibly eliminate these early, overlooked seeds of beta-amyloid aggregation. The only effective antibody was aducanumab, and transgenic mice that were treated for just five days before the first protein deposits cropped up later exhibited half the typical amount of deposits in their brains. Aducanumab can recognize protein aggregates, but not individual beta-amyloid chains. The investigators hope to use it as a lure to isolate and better describe these seeds of aggregation.