Reduction of Antihypertensive Treatment in Nursing Home Residents

Self-neglect is the most common reason for maltreatment of the elderly.

Malnutrition (undernutrition) is widespread among older adults and leads to disability, longer hospital stays, poorer recovery, lower quality of life, and higher medical costs.

Heart attacks and strokes remain the leading killers of people with type 2 diabetes. A large international trial found that the once‑daily tablet oral semaglutide cut those events by 14 percent versus placebo in high‑risk adults.

Low wealth shortens life: the poorer an older adult is, the higher their risk of dying—and the rich–poor survival gap is wider in the United States than anywhere in Europe.

Five common, modifiable factors — high blood pressure, high “bad” cholesterol, unhealthy weight (either too low or too high), diabetes, and smoking — account for roughly half of all cardiovascular disease worldwide. When all five are present at age 50, lifetime risk of heart attack or stroke jumps to 24 % in women and 38 % in men.

A two‑year course of the SGLT2 inhibitor empagliflozin continued to protect kidneys and hearts for up to a year after the drug was stopped, cutting the combined risk of kidney progression or cardiovascular death by about 20 %.

A major trial in adults ≥ 75 with non‑ST‑segment–elevation heart attacks (NSTEMI) found that routinely sending everyone for angiography and possible stent surgery did not lower the death rate compared with careful medical therapy alone.

What do I need to know?
In the SENIOR‑RITA study, only half of the patients assigned to the “invasive” arm actually received a stent, partly because the average wait for the procedure was five days. Still, the invasive strategy did cut non‑fatal heart‑attack recurrences but offered no survival edge. Decisions were highly individualized: doctors weighed bleeding risk, frailty, cognition, life expectancy, and patient preferences before choosing invasive or conservative care. Current guidelines now rate early (within 24 h) angiography in older NSTEMI patients as optional rather than essential because pooled data show no clear mortality benefit.

A recent trial in patients with severe resting hypoxemia showed that prescribing long‑term oxygen therapy (LTOT) for 24 hours a day did not reduce the combined risk of hospitalization or death within one year compared with 15 hours a day.

Extreme heat places older adults — especially those with heart disease — at high risk of dangerous spikes in heart rate and blood pressure. Simple cooling tactics such as electric fans and skin wetting have been debated, but their true benefits and harms were unclear.

Weekly injections of the weight‑loss drug semaglutide 2.4 mg relieved knee‑osteoarthritis pain far better than placebo while trimming body weight, with no extra serious side‑effects.

For adults ≥ 75 admitted with non‑ST‑segment‑elevation heart attack (NSTEMI), routinely taking everyone to the cath‑lab for angiography and possible stent placement did not improve survival compared with optimized drug therapy alone in the 1,518‑patient SENIOR‑RITA trial.

Frailty is a state of reduced physiologic reserve that becomes steadily more common with age: worldwide surveys show its prevalence climbs from ≈11 % in people aged 50–59 to over 50 % in those ≥ 90, especially among hospital or nursing‑home residents and the socially vulnerable.

Age‑related hearing loss is nearly universal and now affects more than two‑thirds of adults ≥ 60; beyond communication problems, it is the single largest potentially modifiable risk factor for dementia later in life.

Adding the anti‑CD38 antibody isatuximab to the standard bortezomib + lenalidomide + dexamethasone (VRd) regimen kept newly diagnosed, transplant‑ineligible multiple‑myeloma patients in remission far longer than VRd alone. After five years, 63 % of people on the four‑drug combination were still free of disease progression versus 45 % on VRd (hazard ratio 0.60).

Cardiac‑rehabilitation programs are lifesaving, but wide gaps in how exercise is prescribed and progressed mean many older adults miss out on the full benefit.

 A large international trial (FULL REVASC) found that giving heart‑attack patients multivessel stenting guided by fractional‑flow‑reserve (FFR) did not lower deaths, repeat heart attacks, or urgent revascularizations versus treating only the blocked “culprit” artery (19.0 % vs 20.4 %; hazard ratio 0.93, P = 0.53).

Wearable digital health technologies—everything from smartwatches and glucose sensors to fall‑alert pendants—offer unprecedented, real‑time insight into daily health, but six interlocking problems still block routine use: data ownership, patient trust and literacy, standards, clinical integration, patient empowerment, and reimbursement. If they aren’t solved, seniors may be left on the wrong side of a widening “digital divide.”

Treatment‑resistant depression (TRD) is common in later life and carries serious health and functional costs for older adults.

Device‑detected “silent” atrial fibrillation (episodes 6 minutes – 24 hours that the patient never feels) is common in people with heart implants and raises stroke risk. In the 4012‑patient ARTESIA trial, the oral blood thinner apixaban cut strokes and systemic emboli by about one‑third compared with aspirin (0.78 vs 1.24 events per 100 patient‑years) but nearly doubled major bleeding (1.71 vs 0.94 events per 100 patient‑years).