Geriatrics

Primary-prevention statins improve survival and coronary outcomes in adults aged 80 and older

Among 15,745 adults aged ≥80 years without prior CVD, persistent statin use was associated with lower all-cause mortality over 4 years. Statin therapy reduced mortality by 31% and incident coronary events by 20% compared with nonuse after adjustment. Rates of myopathy, new-onset diabetes, and dementia were not significantly different between statin users and nonusers. Patients who discontinued statins before age 80 did not experience these benefits, underscoring the value of continued therapy when tolerated. 1

Baseline plasma p-tau217 predicts 25-year risk of MCI and dementia in older women

In 2,766 cognitively unimpaired women aged 65-79 years, higher baseline plasma p-tau217 predicted incident MCI or dementia over up to 25 years. Each 1-SD increase in log2 p-tau217 was associated with markedly higher risk of MCI, dementia, and the combined outcome. Associations were stronger in women older than 70 years, APOE ε4 carriers, and White women, and in those on estrogen plus progestin. Combining p-tau217 with age provided similar discriminative performance for White and Black women despite different hazard ratios. 2

Sarcopenia, especially low strength, accelerates progression from robustness to frailty

In 4,621 Chinese adults aged ≥60 years, both possible and confirmed sarcopenia increased transition from robust to prefrail and prefrail to frail states. Confirmed sarcopenia modestly but significantly increased hazards of deterioration compared with nonsarcopenia after multivariable adjustment. Low muscle strength showed the strongest association with frailty worsening, followed by low physical performance components. These findings support early identification of sarcopenia and strength-focused interventions to slow frailty progression. 3