Research presented at the American College of Surgeons (ACS) Clinical Congress 2020 detailed the beta-test of a program for older adults who received major surgery, which led to shorter hospital stays and less post-surgical delirium, reports News-Medical . The ACS Geriatric Surgery Verification program was assessed at the Aging Veterans Surgical Wellness (AVSW) program at the Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, Colo. Enrolled in the study were 186 patients, 158 of whom were matched according to age and type of procedure to a control group of 308 individuals from the national Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. "When we looked at the matched cohort from the VASQIP database, we found a decreased hospital length of stay of four days compared to five days, which is very significant," said the University of Colorado School of Medicine's Alexandra Kovar. "When we compared our outcomes to those reported in previously published research, two important postoperative outcomes in our patient population showed significant improvement: development of postoperative delirium and functional health postoperatively." The rate of post-surgical delirium in the AVSW cohort was 9.3 percent versus 12.1 percent reported in the ACS National Surgical Quality Improvement Program Geriatric Surgery Pilot study — and just 19.1 percent of the AVSW patients reported post-surgical functional cognitive decline compared with 42.9 percent in the pilot study. According to Kovar, "the implementation of the preoperative multidisciplinary conference where we talk about the patients prior to having surgery" were critical to the AVSW program's success.

Maryland Gov. Larry Hogan announced this past Friday that indoor visitation may resume at state nursing communities where no new COVID-19 cases have been reported in two weeks or more, reports the Southern Maryland Chronicle . Hogan said in accordance with new federal and state guidelines, nursing and assisted living communities can begin allowing limited indoor visitation, as well as compassionate care visits to support residents who may require emotional and spiritual aid. Qualifying communities must have no active cases in the last 14 days and no outbreak testing in progress. State health officials also are implementing new testing guidance expanding the use of rapid antigen tests — which could be used for visitor screening — while continuing to require regular diagnostic testing depending on local conditions. Maryland will allocate an additional $6 million to help communities cover the cost of staff testing. The state has so far committed nearly $102 million to testing and personal protective equipment for nursing communities.

McMaster University is leading a Canada-wide study on COVID-19's effect on aging Canadians as concerns over a second wave of the coronavirus mount, reports the Hamilton Spectator . Canada's federal government has apportioned $4 million to investigate COVID-19 infections in Canadians over the age of 50, who are considered to be at the highest risk for the most severe virus complications. "The point of our study is to understand how many people in this age group . . . were actually truly infected," explained study leader Parminder Raina, the scientific director of the McMaster Institute for Research on Aging. Researchers will collect blood samples and questionnaires from more than 19,000 participants through the Canadian Longitudinal Study on Aging (CLSA). Raina expects the study will yield a more accurate picture of the population of older Canadians infected by COVID-19, including asymptomatic individuals. He added that the researchers will seek antibodies in blood samples to determine the total number of people infected. By combining these findings with existing data from the CLSA, Raina said the study will help ascertain what factors cause some individuals to get more sick than others. "We don't know when the vaccine will come," he noted. "Until then, we have to understand how do we design and implement public health measures going forward."

A study in Biological Psychiatry found that abnormal amyloid (Aß) deposits were evident in fewer older adults with major depression compared to non-depressed controls, reports EurekAlert . "This insight is important, because tests — like the positron emission tomography (PET) scans that enable detection of deposited amyloid — may someday play a role in helping doctors to make this distinction," said Biological Psychiatry editor John Krystal. The investigators examined 119 older adults with major depression and 119 non-depressed participants, average age 71. The researchers collected blood and DNA samples, and detected Aß deposits in their brains with PET scans. "Surprisingly, we did not observe evidence of increased amyloid deposition in the participants with major depression," said University of California, San Francisco Professor Scott Mackin. "Instead, we saw decreased amyloid deposition when we compared the groups in several different ways." Significant Aß deposits were identified in just 19 percent of participants with depression, versus 31 percent of controls. Subjects with depression met expectations by performing worse on cognitive and memory tests than non-depressed subjects, while those with brain Aß deposits performed worse on the memory tests, regardless of whether they were depressed or not.

A Stanford Medicine study in JAMA Internal Medicine says virtual and human coaches can help sedentary older adults become more physically active, according to the Stanford Medicine News Center . The study focused on Latinos as they lean toward higher rates of obesity and diabetes, and because physical activity programs in the United States are often offered exclusively in English. The researchers tapped a virtual, computer-based adviser named Carmen previously tested in a smaller pilot study. They compared Carmen with a group of trained peer advisers, who coached 245 underactive Latino participants between the ages of 50 and 87 in the San Francisco Bay Area. Participants visited their local community centers for a year, where about half interacted with Carmen through a computer screen. The other half consulted with a human adviser. Carmen queried about their progress toward their walking goals, and those coached by the virtual adviser increased their activity significantly, walking about 154 minutes more per week on average — comparable to participants coached by a human, who reported about 132 minutes more walking per week. Moreover, both cohorts lost an average of about five pounds over the course of the study.

A study published in Science details the discovery of a rare genetic form of dementia, and a new mechanism for the accumulation of protein in the brain that could be targeted for new types of treatment, reports Technology Networks . Researchers found a unique mutation in the Valosin-containing protein (VCP) gene in the brain, an accrual of tau proteins in areas that were deteriorating, and neurons with gaps in them. The team christened this disorder Vacuolar Tauopathy (VT), a neurodegenerative condition now marked by the build-up of neuronal vacuoles and tau protein aggregates. The investigators said the tau protein they saw accumulating closely resembled the tau protein aggregates observed in Alzheimer's disease. They initially studied the proteins themselves, in addition to cells and an animal model, and learned that the build-up is underpinned by the VCP mutation. "Given that this mutation inhibits VCP activity, that suggest the converse might be true — that if you're able to boost VCP activity, that could help break up the protein aggregates," said University of Pennsylvania Professor Edward Lee. "And if that's true, we may be able to break up tau aggregates not only for this extremely rare disease, but for Alzheimer's disease and other diseases associated with tau protein aggregation."

The University of North Texas Health Science Center (HSC) will host one of the largest Alzheimer's disease research studies up to now, with researchers awarded a grant expected to total $45 million from the U.S. National Institute on Aging, reports NBC 5 Dallas-Fort Worth . The five-year grant will pursue insights into the biological framework of Alzheimer's disease in multi-ethnic populations and its divergence from that of non-Latino whites. "We are going to be looking at how Alzheimer's disease pathology in the brain, the basic underlying brain changes, what do they look like, how they progress, and how they impact people from diverse communities," said HSC Professor Sid O'Bryant. The HSC will establish an imaging center that will allow researchers to perform two positron emission tomography (PET) scans on every participant. Investigators will look for beta-amyloid or tau proteins, and two years later each participant will undergo two more PET scans for comparison. This will enable researchers to note differences in Mexican Americans and non-Latino whites. "The whole point of this study is to develop precision medicine for treating and preventing Alzheimer's disease among all communities," said O'Bryant. "It's not about treating this one group or other group, but we can't understand the disease if we can't understand it in everybody."

A recent U.S. study published in AIDS found HIV-positive men have a higher risk of dementia than their HIV-negative peers as they age, reports Aidsmap . The researchers analyzed retrospective data collected in the U.S. Veterans Health Administration System from 2005 to 2015. They included 1,114 veterans living with HIV at least 55 years old, and an equal number of HIV-negative veterans matched on age, sex, race, and substance use. In the group of 2,228 veterans, average age was 62.5 years at entry, with more than 98 percent of participants male, 52 percent non-Hispanic white, 38 percent non-Hispanic black, and 10 percent other. Health risk behaviors and noncommunicable diseases were common in the cohort at baseline, with 22 percent having a history of tobacco use, while about 18 percent had been diagnosed with alcohol/drug abuse; 17 percent diabetes, 34 percent high blood pressure, and 7 percent a history of stroke or transient ischemic attack. During the follow-up period of up to 11 years, 5.1 percent of cases of incident dementia were diagnosed among HIV-positive veterans, versus 3 percent among their HIV-negative counterparts. Out of the 57 cases affecting veterans with HIV, 19 percent were HIV-associated (HAD). Apart from HAD, the patterns of dementia subtypes, where recorded, were somewhat similar — four Alzheimer's disease (7 percent) and six vascular dementia (10 percent) in veterans with HIV versus four Alzheimer's disease (10 percent), six vascular dementia (18 percent), and two frontotemporal dementia in HIV-negative veterans.

The Caremerge electronic health record and engagement platform has announced a partnership with Spiro100, the leading video streaming wellness program provider for older adults and senior living communities in the United States, reports Globe Newswire . The partnership brings safe in-room physical activity to Caremerge communities and senior care providers in greatest need. Communities can now supplement in-person wellness activities with Spiro100's curated virtual fitness and wellness courses. "Adding Spiro100's streaming classes to the Caremerge platform solves the challenges senior community activities coordinators, residents, and management are facing," said Caremerge CEO Nancy Koenig. "This partnership is an important step toward fulfilling our Smart Aging vision to provide technology solutions that deliver personalized and empowered resident wellness." Community staffers and residents will be able to access Spiro100's library of more than 100 exercise and meditation classes, each created and led by nationally recognized senior wellness experts. "Now is the right time to bring senior living communities a digital fitness tool developed for aging adults of all ability levels," said Spiro100 co-founder Howard Rochestie. "Caremerge has led the way for technology innovation in senior living, and we are excited to combine our solutions to better address the senior living industry's needs and offer accessible fitness, wellness, and resident engagement technology to communities across the U.S."

U.S. President Donald Trump and First Lady Melania Trump have tested positive for COVID-19, reports the Wall Street Journal . Trump announced the diagnosis on Twitter early Friday morning, after confirmation that Hope Hicks, a top adviser who traveled with him earlier this week, had tested positive as well. The President's age of 74 places him at higher risk from the coronavirus, with the Centers for Disease Control and Prevention warning that people in their 60s and 70s are "at higher risk for severe illness than people in their 50s." Shortly after Trump's announcement, the White House issued an updated schedule for him, which consisted only of "a phone call on COVID-19 support to vulnerable seniors."