Geriatrics

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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ABSTRACT Background: Evidence supporting the use of statins for primary prevention of cardiovascular disease (CVD) in individuals aged≥ 80 years remains limited. This study aimed to evaluate the long-term clinical benefits and safety of statins for primary prevention in patients aged 80 years and older. Methods: We conducted a population-based retrospective cohort study using electronic medical records and pharmacy dispensing data from Clalit Health Services in Israel, covering the period from January 2015 to December 2020. Patients aged ≥ 80 years without prior CVD who were persistent statin users were compared with similar patients not receiving statins. Exclusions included prior CVD, dialysis, or death within 1 year of follow-up. Outcomes included all-cause mortality, new coronary events, myopathy, dementia, and diabetes mellitus. Cox proportional hazards models, adjusted for potential confounders, were used to assess the association between statin use and clinical outcomes. Results: Among 15,745 patients (mean age 84.5 years; 66% female), 8413 were statin users. Over a 4-year mean follow-up, statin use was associated with a 31% reduction in mortality (HR 0.69; 95% CI: 0.34–0.74; p < 0.001) and a 20% reduction in new coronary events (HR 0.80; 95% CI: 0.68–0.94; p = 0.008). No significant differences were observed in the incidence of myopathy, diabetes, or dementia. Benefits were not observed in patients who discontinued statins before age 80. Conclusions: In patients aged ≥ 80 years, statin therapy for primary prevention was associated with reduced all-cause mortality and coronary morbidity, without increased risk of adverse events. Early discontinuation diminished these benefits.

Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Nathan Hinkle — Mon, 09 Mar 2026 21:10:43 +0000

Date Added:

March 9, 2026

Journal/Publication:

Journal of the American Geriatrics Society

Publisher:

Wiley Periodicals LLC

Publication Date:

March 7, 2026

URL:

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1111/jgs.70375Digital Object Identifier (DOI)

Keywords

statin therapy

Geriatrics

cardiovascular disease

Adults Aged 80 years or older

MeSH

Cardiovascular Disease

Hydroxymethylglutaryl-CoA Reductase Inhibitors

follow-up studies

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Nathan Hinkle — Mon, 09 Mar 2026 21:10:39 +0000

Date Added:

March 9, 2026

Journal/Publication:

Journal of the American Geriatrics Society

Publisher:

Wiley Periodicals LLC

Publication Date:

March 7, 2026

URL:

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1111/jgs.70375Digital Object Identifier (DOI)

Keywords

statin therapy

Geriatrics

cardiovascular disease

Adults Aged 80 years or older

MeSH

Cardiovascular Disease

Hydroxymethylglutaryl-CoA Reductase Inhibitors

follow-up studies

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Cognitive Behavioral Therapy for Insomnia in People With Chronic Disease: A Systematic Review and Meta-Analysis

Megan George — Tue, 23 Sep 2025 14:04:10 +0000

Date Added:

September 23, 2025

Journal/Publication:

JAMA Internal Medicine

Publication Date:

September 22, 2025

URL:

Cognitive Behavioral Therapy for Insomnia in People With Chronic Disease: A Systematic Review and Meta-Analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamainternmed.2025.4610

Keywords

PMID (1):

40982264

MeSH

sleep

Adult

Humans

sleep initiation and maintenance disorders

chronic pain

Sleep Latency

quality of life

Irritable Bowel Syndrome

Neoplasms

stroke

chronic disease

Cognitive Behavioral Therapy

This systematic review/meta-analysis confirms the benefits of cognitive behavioral therapy for patients with insomnia in the face of chronic health challenges. James W. Mold, MD, MPH

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Importance: Insomnia is highly prevalent among individuals with chronic disease (eg, chronic pain, cardiovascular disease, and cancer) and results in poorer disease outcomes and quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as first-line treatment for insomnia. However, concerns remain about its applicability and efficacy in people with chronic disease.

Objective: To evaluate the nature, efficacy, and acceptability of CBT-I in adults with chronic disease, and to identify moderators of treatment outcomes.

Data sources: Systematic searches were conducted in PsycINFO, Medline, Embase, and CENTRAL from database inception to June 5, 2025. Additional records were identified from reference lists of relevant reviews and studies.

Study selection: Eligible studies were randomized clinical trials (RCTs) involving adults (aged ≥18 years) with chronic disease and insomnia. Studies using CBT-I with measured sleep outcomes were included.

Data extraction and synthesis: Two assessors extracted data from RCTs. Hedges g was used to calculate effect sizes, and random effects meta-analyses were conducted. Heterogeneity was assessed via I2. Subgroup analyses examined whether outcomes varied by delivery format, chronic condition type, or control group.

Main outcomes and measures: Primary outcomes included insomnia severity, sleep efficiency, and sleep onset latency. Secondary outcomes included treatment acceptability and adverse effects.

Results: Sixty-seven RCTs (5232 participants) met inclusion criteria, including chronic diseases such as cancer, chronic pain, irritable bowel syndrome, and stroke. CBT-I was associated with significantly improved outcomes for insomnia severity (g = 0.98; 95% CI, 0.81-1.16) and moderate effect sizes regarding sleep efficiency (g = 0.77; 95% CI, 0.63-0.91) and sleep onset latency (g = 0.64; 95% CI, 0.50-0.78). Subgroup analyses revealed some sample, treatment, and methodological moderators (eg, longer treatment yielded better outcomes for sleep efficiency and sleep onset latency). Satisfaction with CBT-I was high, with a mean dropout rate of 13.3%. Treatment-related adverse effects were rare.

Conclusions and relevance: This systematic review and meta-analysis showed that CBT-I demonstrated strong efficacy and acceptability in chronic disease populations, with moderate to large effect sizes that appear comparable to those in non-chronic disease populations. Efficacy of CBT-I was similar across a range of disease subgroups. Future research should explore the role and nature of treatment adaptations for specific populations and increase access to CBT-I in medical settings.

Author/s:

Amelia J. Scott, Ashleigh B. Correa, Madelyne A. Bisby

Olfactory Loss and Beyond: A Practical Review of Chemosensory Dysfunction

Saige Blanchard — Thu, 14 Apr 2022 05:00:00 +0000

Date Added:

April 14, 2022

Journal/Publication:

Journal of the American Board of Family Medicine

Publisher:

Journal of the American Board of Family Medicine

Publication Date:

April 4, 2022

Issue:

Volume:

Pages:

406-419

URL:

Olfactory Loss and Beyond: A Practical Review of Chemosensory Dysfunction

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2022.02.210373

Keywords

PMID (1):

35379730

MeSH

A summary of the prevalence, causes, detection, and treatment of olfactory and other chemosensory dysfunctions. James W. Mold, MD, MPH

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Background: Our ability to smell and taste is dictated by 3 chemosensory systems with distinct physiologic mechanisms - olfaction, gustation, and chemesthesis. Although often overlooked, dysfunction of these special senses may have broad implications on multiple facets of patients' lives -including safety, nutritional status, quality of life, mental health, and even cognitive function. As "loss of smell or taste" emerged as a common symptom of coronavirus disease 2019 (COVID-19), the importance of intact chemosensory function has been thrust into the spotlight. Despite the growing recognition of chemosensory dysfunction, this already highly prevalent condition will increasingly impact a larger and more diverse population, highlighting the need for improved awareness and care of these patients.

Methods: Comtemporary review of chemosensory function and assessments.

Conclusions: Although patient-reported chemosensory function measures highlight the ease of screening of chemosensory dysfunction, self-reported measures underestimate both the prevalence and degree of chemosensory dysfunction and do not adequately distinguish between olfaction, gustation, and chemesthesis. Meanwhile, psychophysical assessment tools provide opportunities for more accurate, thorough assessment of the chemosenses when appropriate. Primary care providers are uniquely situated to identify patients burdened by chemosensory dysfunction and raise patient and provider awareness about the importance of chemosensory dysfunction. Identification of chemosensory dysfunction, particularly olfactory dysfunction, may raise suspicion for many underlying medical conditions, including early detection of neurodegenerative conditions. Furthermore, identification and awareness of patients with chemosensory dysfunction may help primary care providers to identify those who may benefit from additional therapeutic and safety interventions, or consultations with specialists for more detailed evaluations and management.

Author/s:

Claus, L. E., Leland, E. M., Tai, K. Y., Schlosser, R. J., Kamath, V., Lane, A. P., Rowan, N. R.