December 2023: Efficacy and Safety of an mRNA-Based RSV PreF Vaccine in Older Adults
Respiratory syncytial virus (RSV) causes serious lung infections in older adults. In a 35‑thousand–person trial, a single 50 µg dose of the mRNA‑1345 vaccine cut RSV lower‑respiratory disease by about 84 % and acute respiratory illness by 68 %, with no new safety concerns.
November 2023: Thalidomide for Recurrent Bleeding Due to Small-Intestinal Angiodysplasia
Recurrent bleeding from small‑intestinal angiodysplasia (SIA) is difficult to control and is responsible for 5–10 % of all gastrointestinal bleeds in older adults.
October 2023: The Syndrome of Inappropriate Antidiuresis
Hyponatremia — a low blood‑sodium level — is the most common electrolyte problem, affecting about 5 % of all adults and 35 % of people in the hospital. In older in‑patients, 25 – 40 % of hyponatremia is caused by the syndrome of inappropriate antidiuresis (SIAD), in which excess antidiuretic hormone makes the kidneys retain water even though the body is already well hydrated.
September 2024: Invasive Treatment Strategy for Older Patients with Myocardial Infarction
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.
September 2023: Trial of Solanezumab in Preclinical Alzheimer’s Disease
In the 4.5‑year A4 phase‑3 trial, the anti‑amyloid antibody solanezumab did not slow cognitive or functional decline in cognitively normal older adults who had elevated brain amyloid, performing no better than placebo on all major outcomes
August 2023: Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction
For heart‑attack patients ≥ 75 with multivessel coronary disease, cardiologists have debated whether to stent only the blocked “culprit” artery or go on to treat additional narrowings. In the FIRE trial, physiology‑guided complete revascularization lowered the 1‑year risk of death, new heart attack, stroke, or repeat procedures to 15.7 % versus 21.0 % with culprit‑only stenting (hazard ratio 0.73; number‑needed‑to‑treat 19).
July 2023: Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons
A three‑year randomized trial of the MIND diet — a Mediterranean + DASH hybrid created to protect brain health — found no meaningful advantage over a standard, calorie‑restricted control diet in preventing cognitive decline or brain‑scan changes in older adults at elevated dementia risk.
June 2023: Over-the-Counter Hearing Aids — Using Regulatory Policy to Improve Public Health
On October 17 2022 the U.S. FDA created a new class of over‑the‑counter (OTC) hearing aids that adults can buy without seeing a professional, aiming to fix the long‑standing problem that most older Americans with hearing loss never receive treatment.
May 2023: Medicare Part D Coverage of Antiobesity Medications — Challenges and Uncertainty Ahead
Medicare is legally barred from covering weight‑loss drugs under Part D, yet newer anti‑obesity injections such as semaglutide (Wegovy) now achieve 15–20 % weight loss in trials and have generated intense demand. These medications cost about $13,600 per year — roughly 20 × older pills — raising fears that mandatory coverage could add tens of billions of dollars to the Part D budget. If just 10 % of Medicare beneficiaries with obesity used semaglutide, annual spending might top $27 billion, or ≈ 18 % of current Part D outlays, while full uptake could exceed the entire program budget.
April 2023: Air Pollution and Mortality at the Intersection of Race and Social Class
Fine‑particle air pollution (PM₂.₅) shortens older adults’ lives, but a new Medicare study shows that Black seniors and low‑income seniors gain even more years when PM₂.₅ is reduced than wealthier White peers. Lowering annual exposure from 12 µg/m³ to 8 µg/m³ cut the death risk by just 4 % for higher‑income White beneficiaries — yet by 6–7 % for higher‑income Black, low‑income Black, and low‑income White seniors.
March 2023: Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression
Treatment‑resistant depression (TRD) — failure to improve after two adequate antidepressant trials — is common in late life and worsens well‑being, function, and cognition. A large OPTIMUM trial asked whether adding a new drug (augmentation) or switching drugs works better.
February 2023: Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults
A single‑dose prefusion‑F RSV vaccine (RSVPreF3 OA) cut laboratory‑confirmed RSV lower‑respiratory‑tract disease in adults ≥ 60 by 82.6 % and severe cases by 94.1 % compared with placebo during one season; it also reduced any RSV acute respiratory infection by 71.7 %.
January 2023 Bonus: Lecanemab in Early Alzheimer’s Disease
In the 18‑month, 1,795‑patient Clarity AD trial, the anti‑amyloid antibody lecanemab slowed early‑Alzheimer progression: Clinical Dementia Rating–Sum of Boxes scores rose 1.21 points on lecanemab versus 1.66 on placebo — a 27 % smaller decline (difference –0.45). Key cognitive and daily‑function scales all favored the drug, and brain‑amyloid PET fell by 59 centiloids relative to placebo.
January 2023: Bivalent Omicron BA.1–Adapted BNT162b2 Booster in Adults Older than 55 Years
Older adults already boosted with the original Pfizer‑BioNTech vaccine begin to lose protection as immune‑escape Omicron strains circulate. A phase‑3 trial in 1 ,846 people over 55 found that a bivalent Omicron BA.1–adapted booster (15 µg ancestral + 15 µg BA.1, 30 µg total) raised neutralising activity against BA.1 56 % higher than another 30‑µg dose of the original vaccine, and the 60‑µg bivalent and 60‑µg monovalent BA.1 shots performed even better. The adapted boosters maintained responses to the ancestral strain and broadened coverage to BA.4/5 and BA.2.75 sub‑variants.
December 2022: Choice of Admitting Services for Older Adults with Hip Fracture
When an older adult breaks a hip, deciding which hospital service “owns” the admission — medicine or orthopedic surgery — can affect speed of surgery, complication rates, and even survival. A New England Journal of Medicine Clinical Decisions article lays out the debate, citing evidence that medical teams are better at managing complex comorbidities, while surgical teams can get patients to the operating room hours sooner.
November 2022: Trial of an Intervention to Improve Acute Heart Failure Outcomes
A Canadian stepped‑wedge trial tested a hospital strategy that (1) uses the EHMRG30‑ST bedside score to label emergency‑department heart‑failure patients as low, intermediate, or high risk and (2) sends low‑risk cases home within ≤ 3 days with a rapid cardiology clinic visit. Among 5,452 patients, this approach cut 30‑day death‑or‑cardiovascular‑readmission from 14.5 % to 12.1 % (hazard ratio 0.88) and kept high‑risk patients safely in hospital.
October 2022: Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults
A large U.S. trial (VITAL) gave 25,871 generally healthy adults ≥ 50 yrs either vitamin D₃ 2000 IU/day or placebo for a median 5.3 yrs and found no reduction in total, non‑vertebral, or hip fractures (hazard ratio for any fracture 0.98; 95 % CI 0.89–1.08).
