Geriatric Medicine
Physician insights on aging-related care, polypharmacy management, cognitive decline, and geriatric syndromes.
Recent Discussions
Given the "LDL Paradox", in which RA patients with the highest levels of inflammation can have ultra-low levels of LDL (<70), how do you approach initiation of statin therapy in these patients?
Evaluate lipids at the time of remission/low disease activity and if elevated and the patient is a good candidate for statin therapy, initiate a statin using criteria for the general population.
Do you still plan to offer tofacitinib to RA patients over 65 if they have one or more additional CV risk factors?
I would consider offering tofacitinib (or another JAK inhibitor) to patients over 65 with an additional CV risk factor, but only as a last resort after all other options have been exhausted.
Do you recommend performing cognitive testing in the clinic to determine the blood pressure target in patients 80 years or older?
SPRINT-MIND helps to answer this question. The total number of individuals developing dementia (the primary outcome in SPRINT-MIND) was fewer then expected after a median intervention period of only 3.3 years. This made SPRINT-MIND underpowered to detect the effects of intensive BP reduction on deve...