Geriatrics

Laromestrocel stem cell therapy improves walking distance in frail older adults

In a randomized phase 2b trial (N = 148), ambulatory adults with aging frailty received allogeneic MSCs (laromestrocel) or placebo. Laromestrocel produced dose- and time-dependent 6-minute walk test gains versus placebo, including +63.4 m at 9 months (95% CI 17.1–109.6; p = 0.0077). Six-minute walk improvements correlated with better PROMIS Physical Function scores, indicating concordant subjective functional gains. Higher laromestrocel doses were linked to reductions in soluble degraded TIE2, suggesting a candidate biomarker of responsiveness. 1

Frailty strongly predicts undertreatment and poor outcomes after acute myocardial infarction

A nationwide cohort of 931,133 AMI patients in England and Wales (median age 70; 34% female) was stratified by SCARF frailty index. Over one-third had moderate or severe frailty and were less likely to receive coronary angiography, dual antiplatelet therapy, or cardiac rehabilitation. Severe frailty carried threefold higher 1-year mortality versus fitness (adjusted HR 3.01, 95% CI 2.93–3.10), with graded risks across categories. Similar dose–response gradients were observed for cardiovascular death, MACE, heart failure readmission, and major bleeding. 2

Cumulative anticholinergic burden increases incident cardiovascular events

This cohort followed 508,273 Stockholm residents aged ≥45 years, free of major cardiovascular disease, for a median of 14 years. Anticholinergic exposure, quantified annually in DDDs using the Anticholinergic Cognitive Burden scale, was modeled as a time-varying variable. Cardiovascular risk rose dose-responsively: HR 1.16 for 1–89 DDDs, 1.31 for 90–364 DDDs, and 1.71 for ≥365 DDDs versus none. In the highest exposure group, risks were especially elevated for heart failure (HR 2.70), arrhythmias (HR 2.17), and myocardial infarction (HR 1.46). 3

Cannabinoids show uncertain benefit for agitation in dementia and no effect on overall NPS

This systematic review included 10 randomized controlled trials (328 participants) evaluating cannabinoids for neuropsychiatric symptoms in dementia. Cannabinoids did not significantly reduce total NPS scores versus placebo (SMD −0.18, 95% CI −0.48 to 0.12; p = 0.2). They modestly reduced agitation (SMD −0.52, 95% CI −1.00 to −0.05; p = 0.03), but heterogeneity was high (I² = 77.2%). After excluding high-risk-of-bias studies, the agitation benefit lost statistical significance, weakening confidence in a true effect. 4