A top priority for researchers who study aging is how to identify and treat frailty, even though there are no established therapeutic interventions for the condition.
Geriatric Surgery Program Enhances Care Coordination, Promotes Safer Surgeries for Older Veterans
A program developed to address the challenges that older adults experience when undergoing surgery has improved the coordination of care for older veterans and promoted safer, more goal-aligned surgery for older adults, according to a recent study.
Molecular Profiling Now Guides Every Major CRC Treatment Decision
A veteran sits across from his or her VA oncologist with a new diagnosis of metastatic colorectal cancer. Ten years ago, the conversation followed a well-traveled path: Treatment included a chemotherapy doublet, maybe with a biologic. CRC was no less molecularly complex, but fewer biomarkers had been identified or targeted.
Colorectal Cancer in Veterans: Keeping Pace With a Rapidly Changing Disease
Colorectal cancer (CRC) is, at first glance, a public health success story. Incidence among adults over 50 has fallen nearly 50% since the mid-1980s, driven by the steady expansion of colonoscopy screening and the removal polyps before they can progress. Mortality rates in the over-50 population similarly have declined.
The CRC Map Is Complete. How to Use It?
In the mapping of colorectal cancer for much of the past three decades the dominant question has been “which molecular features of this tumor matter?” Now, the question shifts to “how can veterans benefit?”
Potentially Inappropriate CNS-Active Medications Continue to Be Prescribed to Older Adults in the United States
For decades, clinical guidelines have cautioned against the use of high-risk central nervous system (CNS)—active medications because of the increased risk of delirium, falls and hospitalizations, especially for older adults with cognitive impairment.
Why Older Male Veterans Face a Higher Risk of Multiple Myeloma
Multiple myeloma (MM) occurs about twice as often in men as in women, but until recently the biologic and clinical drivers of that disparity have been poorly understood.
As Benign Prostatic Hyperplasia Care Evolves, TURP Shows Fewer Complications but More Retreatment
For decades, transurethral resection of the prostate (TURP)—a surgical procedure that removes excess prostate tissue through the urethra to relieve urinary obstruction—has been regarded as the gold standard surgical treatment for benign prostatic hyperplasia (BPH).
Hospital Discharge Leaves Many Older Adults Vulnerable to Medication Errors
Hospital discharge represents a critical transition point for older adults, particularly for those managing chronic cardiovascular and metabolic conditions.
Ways to Improve Management of Orthostatic Hypotension in Parkinson’s Disease
Treatments for orthostatic hypotension, a common, disabling symptom of Parkinson’s disease, can affect many therapeutic targets, so healthcare providers must coordinate care and optimize the sequence of treatment for those patients, particularly those with coexisting comorbidities, according to a recent review article.
Debate Continues on Whether Antithrombotics Increase Fall Risk for Older Adults
Antiplatelet and anticoagulant medications often are prescribed for older adults who suffer atherosclerotic and thromboembolic disease.
Long COVID Looks Different in Older Adults, Sometimes in Unexpected Ways
Long COVID looks different in older adults, according to a study evaluating how aging affects the frequency and prevalent symptoms of post-acute sequelae of SARS-CoV-2.
Combined Measurements Can Identify Frailty Risk in Veteran HF Patients
Veteran heart failure patients who are at increased risk of frailty can be identified by combining data on their cross-sectional frailty status and frailty trajectories, which offer a comprehensive assessment, according to a recent study.
Cannabis-Use Disorder Increasing in Older Veterans Despite Medicinal Use
VA clinicians should regularly screen older veterans for cannabis use, according to a new study that pointed out that the prevalence of past 30-day cannabis use was close to tobacco use prevalence in a cohort aged 65 to 84.
Hall Helped Develop Frailty Survey to Improve VA Surgery Outcomes
Daniel Hall, MD, MDiv, MHSc, noticed what many surgeons also have over the course of their careers: There was a small number of patients (5-10%) who, despite their surgeries going perfectly, experienced poor outcomes.
Arthritis Linked to Higher Risks of CVD, Mortality in Postmenopausal Women
Arthritis is a common chronic condition that increases with age, but it may pose greater health risks than previously recognized, particularly for those who did not serve in the military, a new study has suggested.
Gout Largely Treatable, but a Considerable Burden in Older Veterans
One of the earliest recorded and most intensely painful diseases, gout was historically called the “disease of kings.” For centuries, it was thought to affect only the wealthy and aristocratic.
VHA Nursing Home Residents Have More Fractures With Antihypertensive Use
Starting an antihypertensive treatment is associated with a significant increase in fracture risk in older long-term VHA nursing home residents, according to a recent study.
Frailty in Older Veterans Increases Their Risk for Long COVID Symptoms
Older veterans diagnosed with frailty are at much greater risk of developing long COVID after acute infection with SARS-CoV-2, according to a new study. Making that especially significant is that so many older VHA patients, including those living in the community, meet the criteria for frailty.
Healthy Older Veterans Not Getting CRC Screening That Could Benefit Them
Even though clinical guidelines recommend that clinicians selectively offer colorectal cancer (CRC) screening to older adults aged 76 to 85 years, taking into account their life expectancy, values, and preferences.
Rheumatoid Arthritis Raises the Risk of Aortic Stenosis Development
For rheumatoid arthritis patients, cardiovascular disease (CVD) is the most frequent cause of death and leads to much of the excess mortality associated with the condition.
Surgery for Cervical Disc Disease Can Be Safely Performed in Overseas MTFs
Surgical procedures for cervical degenerative disc disease, including anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA), are safe and effective therapies for active duty servicemembers in overseas military medical facilities, according to a recent study.
COVID Mortality Rates Higher for Older Veterans Hospitalized in the Community
Veterans 65 and older with COVID-19 had lower survival rates when cared for in community hospitals than in VHA facilities. Contributing to the higher mortality rates, according to a recent study, is that so many older, rural veterans were treated by necessity in nearby hospitals.
Frailty in Older Veterans Associated With Greater Suicide Attempt Risk
Veterans who are 65 and older and have symptoms of frailty are at increased risk of attempting suicide, and those with lower levels of frailty were found to have greater risk of suicide death, according to a new study.
Diabetes Drug Metformin Shows Promise for Reducing Incident Osteoarthritis
Metformin is recommended as first-line therapy for Type 2 diabetes at the VA and elsewhere. Among the benefits, according to the VA PBM, is that the drug, which has been in use for decades, is low-cost and safe to initiate in most patients, even those with moderate renal dysfunction.
Choosing the Appropriate Treatment for Fragile Patients with RCC
Targeted therapies have vastly improved survival in renal cell carcinoma (RCC), despite not offering a cure for many patients. More problematically, patients often develop resistance to the drugs.
Treatment Quandary Continues for Non-metastatic Castration-resistant PCa
While most men with non-metastatic prostate cancer respond to androgen-deprivation therapy initially, many later experience rising prostate-specific antigen levels that indicate they have developed castration resistance.
What Matters in Survival, Treatment of Lymphoid Cancers?
Oncologists balance the most effective treatment against the likelihood of adverse effects for every patient with cancer. Generally, the assumption is that older patients and those with more comorbidities and poorer performance status will experience more negative effects, including potentially fatal toxicity, from aggressive treatment. A study presented at the American Society of Clinical Oncology annual meeting in June calls into question this assumption for at least some patients and specific malignancies.
Choosing the Right Regimen for Elderly Patients with Advanced RCC
Most clinical trials provide limited guidance on the appropriate treatment of patients seen in clinical practice. Particularly in oncology, participants in trials tend to be significantly younger and in substantially better health than the average patient. Renal cell carcinoma (RCC) provides a clear example of the challenge.
