COVID-19 pandemic experiences of older adults with dementia in community and residential care settings: Results from a US national survey.

Introduction: Investigations into consequences of the US COVID-19 pandemic for older adults with dementia have been limited. Methods: We used the National Health and Aging Trends Study to examine self-reported COVID-19 infection; measures taken to limit its spread; social, behavioral, and emotional responses to the pandemic; and changes in health-care use and provider communication. We compared adults aged ≥70 with and without dementia in community and residential care settings. Results: In residential care settings, infection was substantially higher and social contact less common for those with dementia. In community and residential care settings, those with dementia had 2 to 3 times the odds of reporting sleeping more often. In residential care settings, those with dementia were less likely to put off care and more likely to start telehealth. Discussion: Findings highlight the disproportionate social and behavioral consequences of the COVID-19 pandemic for those living with dementia, particularly in residential care settings. HIGHLIGHTS: Data are from the nationally representative National Health and Aging Trends Study.COVID-19 infection was higher in residential care settings for those with dementia.Social contact was less common for those with dementia in residential care.Pandemic-related coping behaviors differed by dementia and residential status.In residential care, those with dementia were less likely to delay health care.

Opportunities to improve cardiovascular health in the new American workplace.

Adult working-class Americans spend on average 50% of their workday awake time at their jobs. The vast majority of these jobs involve mostly physically inactive tasks and frequent exposure to unhealthy food options. Traditionally, the workplace has been a challenging environment for cardiovascular prevention, where cardiovascular guidelines have had limited implementation. Despite the impact that unhealthy lifestyles at the workplace may have on the cardiovascular health of U.S. workers, there is currently no policy in place aimed at improving this. In this review, we discuss recent evidence on the prevalence of physical inactivity among Americans, with a special focus on the time spent at the workplace; and the invaluable opportunity that workplace-based lifestyle interventions may represent for improving the prevention of cardiovascular disease. We describe the current regulatory context, the key stakeholders involved, and present specific, guideline-inspired initiatives to be considered by both Congress and employers to improve the "cardiovascular safety" of US jobs. Additionally, we discuss how the COVID-19 pandemic has forever altered the workplace, and what lessons can be taken from this experience and applied to cardiovascular disease prevention in the new American workplace. For many Americans, long sitting hours at their job represent a risk to their cardiovascular health. We discuss how a paradigm shift in how we approach cardiovascular health, from focusing on leisure time to also focusing on work time, may help curtail the epidemic of cardiovascular disease in this country.

Physical Function Impairment and Frailty in Middle-Aged People Living With Human Immunodeficiency Virus in the REPRIEVE Trial Ancillary Study PREPARE

BACKGROUND: People with human immunodeficiency virus (PWH) are at risk for accelerated development of physical function impairment and frailty;both associated with increased risk of falls, hospitalizations, and death. Identifying factors associated with physical function impairment and frailty can help target interventions. METHODS: The REPRIEVE trial enrolled participants 40-75 years of age, receiving stable antiretroviral therapy with CD4+ T-cell count >100 cells/mm3, and with low to moderate cardiovascular disease risk. We conducted a cross-sectional analysis of those concurrently enrolled in the ancillary study PREPARE at enrollment. RESULTS: Among the 266 participants, the median age was 51 years;81% were male, and 45% were black, and 28% had hypertension. Body mass index (BMI;calculated as weight in kilograms divided by height in meters squared) was 25 to <30 in 38% and ≥30 in 30%, 33% had a high waist circumference, 89% were physically inactive, 37% (95% confidence interval, 31%, 43%) had physical function impairment (Short Physical Performance Battery score ≤10), and 6% (4%, 9%) were frail and 42% prefrail. In the adjusted analyses, older age, black race, greater BMI, and physical inactivity were associated with physical function impairment;depression and hypertension were associated with frailty or prefrailty. CONCLUSIONS: Physical function impairment was common among middle-aged PWH;greater BMI and physical inactivity are important modifiable factors that may prevent further decline in physical function with aging. CLINICAL TRIALS REGISTRATION: NCT02344290.