Cardiovascular Safety of Anti-CGRP Monoclonal Antibodies in Older Adults or Adults With Disability With Migraine.

Importance: Monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP mAbs) offer effective migraine-specific preventive treatment. However, concerns exist about their potential cardiovascular risks due to CGRP blockade.

Objective: To compare the incidence of cardiovascular disease (CVD) between Medicare beneficiaries with migraine who initiated anti-CGRP-mAbs vs onabotulinumtoxinA in the US.

Feasibility of a Low-Intensity Intervention to Influence Antibiotic Prescribing Rates Use in Outpatient Settings: A Cluster Randomized Controlled Clinical Trial.

Background: Primary care providers (PCPs) may modify their antibiotic prescription practices if aware of their potentially damaging impact.

Methods: We conducted a cluster randomized controlled trial at 12 Veterans Affairs community-based outpatient clinics. PCPs at clinics randomized to the intervention group received quarterly antibiotic use reports with feedback about antibiotics prescribed for acute respiratory infections and adverse event letters alerting about infection or antibiotic-resistant gram-negative bacteria among their patients.

Beyond continuous positive airway pressure for cardiovascular risk reduction in patients with obstructive sleep apnea.

An accumulating body of evidence suggests a bidirectional relationship between sleep and cardiovascular (CV) health. A high level of evidence has linked obstructive sleep apnea (OSA) with cardiovascular disease (CVD). Accordingly, clinical sleep medicine emphasizes the diagnosis and treatment of OSA in the context of promoting CV health.

Adherence to institutional stroke alert criteria in an academic adult emergency department population.

Background: Timely recognition of acute ischemic stroke (AIS) is essential to identify patients who may be eligible for acute intervention. Protocols to streamline systems-based care, such as "stroke alerts" in the emergency department (ED) can safely reduce time-to-care while enhancing safety. However, clinician adherence to stroke alert criteria is poorly described.

Updated Geriatrics Competencies for Graduating Medical Students: Training Physicians to Provide Age-Friendly Care.

Purpose: Medical student education in geriatrics is a critical need for every doctor-in-training as the population ages, with fewer than 7,000 geriatricians, and older patients, who now approach 20% of the U.S. population, having unique health care needs.

Antihypertensive Deprescribing and Functional Status in VA Long-Term Care Residents With and Without Dementia.

Background: Deprescribing antihypertensives is of growing interest in geriatric medicine, yet the impact on functional status is unknown. We emulated a target trial of deprescribing antihypertensive medications compared with continued use on functional status measured by activities of daily living (ADL) in a long-term care population.

Methods: We included 12,238 Veteran Affairs long-term care residents age 65+ who had a stay ≥ 12 weeks between 2006 and 2019.

The Cumulative Burden of Social Risk Factors and 10-Year Change in Quality of Life.

Background: Social risk factors are linked to adverse health outcomes, but their total impact on long-term quality of life is obscure. We hypothesized that a higher burden of social risk factors is associated with greater decline in quality of life over 10 years.

Methods: We examined associations between social risk factors count and decline >5 points in (i) physical component summary, and (ii) mental component summary scores from the Short Form-12 among Black and White participants in the Reasons for Geographic and Racial Differences in Stroke study (n = 14 401).

Inequities in Physical Therapy Receipt of US Service Members and Veterans With Low Back Pain.

Objective: To investigate inequities in time to physical therapy (PT) for patients with low back pain (LBP).

Design: Retrospective observational study using data from the Department of Defense and Veterans Health Administration clinical and administrative data repositories derived from medical records, claims, and enrolment data.

Setting: Military Health System, Veterans Health Administration, and civilian health care facilities.

Development of a physical performance summary score in middle age: Findings from the CARDIA Function study.

Few physical performance batteries exist that appropriately evaluate physical limitations in middle-aged adults. We aimed to develop a physical performance summary score that is appropriate for use in epidemiology studies of middle-aged adults using data from the Coronary Artery Risk Development in Young Adults (CARDIA) Function study, which assessed self-reported function (PROMIS-SF20a) and physical performance measures (gait speed, balance, lower-body strength, grip strength, and cardiovascular endurance). The CARDIA Physical Performance (CAPP) score was developed using sex-specific quartiles, assigning points based on these quartiles (0 for not attempted, 1-4 for each quartile), and summing points across all performance measures (0-20, higher scores reflect greater performance).

Whole genome methylation sequencing in blood from persons with mild cognitive impairment and dementia due to Alzheimer's disease identifies cognitive status.

Introduction: Whole genome methylation sequencing (WGMS) in blood identifies differential DNA methylation in persons with late-onset dementia due to Alzheimer's disease (AD) but has not been tested in persons with mild cognitive impairment (MCI).

Methods: We used WGMS to compare DNA methylation levels at 25,244,219 CpG loci in 382 blood samples from 99 persons with MCI, 109 with AD, and 174 who are cognitively unimpaired (CU).

Results: WGMS identified 9756 differentially methylated positions (DMPs) in persons with MCI, including 1743 differentially methylated genes encoding proteins in biological pathways related to synapse organization, dendrite development, and ion transport.

Adverse effects of late sleep on physical health in a large cohort of community-dwelling adults.

Aims: Sleep timing, influenced by chronotype, behavior, and circadian rhythms, is critical for human health. While previous research has linked chronotype to various health outcomes, the impact of aligning sleep timing with chronotype on physical health remains underexplored. The objective of this study is to investigate the association between chronotype, actual sleep timing, and their alignment with a spectrum of physical health outcomes.

Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research.

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain psychedelics are effective and safe in the treatment of major depressive disorder, treatment-resistant depression, and posttraumatic stress disorder. Preliminary evidence also supports efficacy in other psychiatric disorders (e.

Patient- and Family-Centered Outcomes After Intensive Care Unit Admission.

Background: Family satisfaction with intensive care is a measure of patient experience and patient-centered care. Among the factors that might influence family satisfaction are the timing of patient admittance to the intensive care unit (ICU), the ICU environment, and individual health care providers.

Objective: To evaluate family satisfaction with the ICU and to explore associations between satisfaction and specific characteristics of the ICU stay.

Social Engagement and Neurocognition in Latino and Non-Latino White Older Persons with HIV.

The present study investigated differences in the quantity and quality of social engagement, and their associations with neurocognition among older Latino and non-Latino White persons with HIV (PWH). Participants were age 50 + community-dwelling PWH living in southern California (n = 116; 50% Latino [53% Spanish-speaking], 50% non-Latino White; Age: M = 58.03; Education: M = 13.