Prisoner advocates are warning of the potential for a catastrophic coronavirus outbreak among senior inmates, as older adults are most vulnerable and the U.S. inmate population is aging, reports the Tucson Sentinel . Jails and prisons are so crowded as to make social distancing nearly unworkable. "I don't think people understand the gravity of what's going to happen if this runs in a prison, and I believe it's inevitable," said Rick Raemisch, a former executive director at the Colorado Department of Corrections. State prisons have refused to release inmates, but several large county and municipal jurisdictions have freed hundreds of jail inmates deemed low-risk, including seniors. Prisoner advocacy groups in more than six states have urged governors to release state prisoners, especially older inmates, through compassionate release or medical furlough. Aging baby boomers constitute nearly 15 percent of the more than 140,200 men and women in Texas prisons, and almost 12 percent of inmates in state and federal prisons nationwide are older than 55. Older prisoners also comprise the bulk of healthcare costs, which is straining government budgets.

The U.S. Labor Department estimates that almost 25 percent of retail workers are 55 or older and 7 percent are over 65, which means that the demographic most vulnerable to the coronavirus is increasingly on the front lines of the crisis, reports the Washington Post . Supermarkets across the nation have made few concessions for their 4.4 million employees who are 55-plus, with many workers saying they lack access to protective equipment like gloves or enough disinfectant to wipe down cash registers. According to Walmart spokesperson Lorenzo Lopez, the retailer is letting employees take unpaid time off if they feel uncomfortable at work. Walmart has also been adding hand sanitizer dispensers and other sanitary gear to its stores and has stopped requiring workers to check customer receipts at the door "to help with social distancing." Employees who test positive for the virus also are being offered as much as two weeks of paid leave. Many older Americans saw their retirement accounts hemorrhage during the last recession and took part-time service-sector jobs so they could ease into retirement. Amid the worsening pandemic, grocery chains and pharmacies have announced plans to hire hundreds of thousands of new workers, and add incentives like wage hikes and bonuses. However, many older workers say these measures fall short of protecting them from the virus, which is increasingly life-threatening with age.

Rush University Medical Center Professor Alexander Sasha Rackman writes in The Hill that the COVID-19 pandemic is causing more problems for older adults than just illness and death. He warns that "the implications of widespread social distancing and cancellation of routine home-based medical care will be profound and potentially devastating" for seniors. With the pandemic causing serious disruptions to critical home care services, Rackman notes that "home health agencies hesitate to continue skilled nursing or therapy services for homebound seniors at the risk of potentially infecting them." With some in-home services serving the homebound population suggesting that they may suspend operations, seniors may have to travel to a lab or clinic instead of having the convenience of in-home phlebotomist visits. "Blood tests to monitor blood thinners or kidney function for people on high-risk medications may not be routinely available until this crisis subsides," Rackman adds. Moreover, nursing community care is apparently harder to find, with hospitals filling up beyond capacity. "When a senior is hospitalized, they can become weaker during the process and are often recommended to go to a short-term rehab or skilled nursing facility to regain their function and strength before going home," Rackman says. With such services becoming more stringent on which applicants they accept, "a cascade of bad outcomes" potentially looms, he laments.

University of Alabama pre-med student Michael Arundel has launched a free volunteer shopping delivery service for seniors in Chicago, reports WBRC . He and about 20 friends are picking up groceries or medical supplies for high-risk seniors afraid to leave the house due to the coronavirus. Arundel's "Leave it to Us" service is drawing dozens of daily shopping requests throughout the Windy City suburbs. In the week since its rollout, it has spread nationwide with chapters launching in California, Florida, New York, and soon in Alabama. "All of us purchase the groceries ourselves at the grocery store," Arundel said. "Once we get the list from the seniors themselves and upon delivery, we just ask to be reimbursed for the groceries, but there's no fee involved." Arundel added, "I believe our generation has the greatest chance to make a huge impact on this crisis, to flatten the curve, and what we stand for is to provide a small step towards flattening the curve to help our senior population."

President Trump changed his earlier position on Sunday by extending national social-distancing guidelines to April 30 in effort to prevent the coronavirus death toll in the United States from realizing a worst-case scenario, reports CNBC . He previously stated that he wanted the country to reopen for business by April 12. But public health experts warned that this would lead to unnecessary death and further economic damage. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said at the same Sunday briefing that it remains possible 100,000-200,000 Americans will die as a result of the virus. "What we're trying to do is not let that happen," he said, calling the extension of social-distancing guidelines "a wise and prudent decision." States have strongly recommended that residents — especially seniors — stay indoors except for essential reasons.

A study in JAMA Network Open found 10 percent of older adults hospitalized for common medical conditions are discharged with intensified diabetes medications, even though almost half are unlikely to benefit, reports Medical Xpress . The researchers analyzed 16,178 people 65 or older, mostly men, with diabetes not previously requiring insulin who were hospitalized in a Veterans Health Administration hospital for common medical conditions from 2012 to 2013. One out of 10 subjects were released with intensified diabetes medications, including 5 percent with new insulins and 3 percent with intensified sulfonylureas. However, 49 percent of those receiving intensification were unlikely to benefit on account of limited life expectancy or already being at their goal hemoglobin A1c (HbA1c). Twenty percent were expected to have potential benefit from intensification, and release with intensified diabetes medications was associated with both preadmission HbA1c level and inpatient blood glucose recordings. The predicted likelihood of receiving an intensification was 4 percent among subjects with a preadmission HbA1c level of less than 7 percent without elevated inpatient blood glucose levels, and 21 percent for those with severely elevated inpatient blood glucose levels. "During hospitalization, consideration of long-term diabetes control is needed in addition to inpatient blood glucose recordings to reduce potentially nonbeneficial medication changes when older adults are discharged home," the authors concluded.

Washington University in St. Louis Professor Brian Carpenter offers tips to help older adults cope with the coronavirus pandemic, reports the Wall Street Journal . He notes that while many older adults stay connected with technologies like group chat and videoconferencing, there is a subset who lack access to or do not know how to use such products. "I would love it if family members would ask their parents: How do you want to stay in touch? How often? What time? By what mode? What do you want to talk about? What do you not want to talk about?" Carpenter says. "Just asking can be informative and empowering." Carpenter adds that from a therapeutic standpoint, video therapy is better to older adults than telephone therapy, and telephone therapy is more effective than e-mail. He also thinks that local communities — like social service organizations, institutions, and groups of neighbors — have a responsibility to help older adults who have no family. "If older adults can keep their focus on what they can do to promote their physical and mental well-being, that can help reduce anxiety," Carpenter suggests. "It can also be helpful for older adults to think about what they can do for other people — make a phone call, send an email, yell down the hall to another friend who is self-quarantining."

A study published in Experimental Brain Research explored how playing three-dimensional (3D)-platform video games can boost executive function in older adults, reports PsyPost . The researchers tested this setup on an "antisaccade task," which assesses the ability of participants to properly ignore a stimulus — inhibition of the reflexive saccade — and execute a saccade, or rapid eye movement, in the opposite direction. Decreased performance correlates with reduced executive function and signals loss of inhibitory control. The investigators theorized that playing games like "Super Mario 64" — which require players to inhibit distractions to reach objectives — would correlate with better antisaccade test scores and higher gray matter volume in the Frontal Eye Fields (FEF), a brain area responsible for directing eye movement. The team recruited 33 participants ages 55 to 75 years old, divided into a cohort that received training in the game, one that received piano lessons, and one with zero intervention. When retested, participants in the game training group exhibited significant improvements in inhibition of reflexive saccades and increases in the right FEF. The implication is that frontal inhibitory processes, a key component of executive function, can be enhanced by training with 3D-platform games.

A study from Lund University in Sweden and Synchrotron SOLEIL in France published in Advanced Science details an infrared imaging method for examining the molecular structures in neurons affected by Alzheimer's disease, reports Technology Networks . The optical photothermal infrared spectroscopy technique is designed to study the protein structures within nerve cells, without resorting to chemical processing of neurons typical of other imaging procedures. "The structure of the protein changes in different ways depending on where in the nerve cell it is," said Lund University's Oxana Klementieva. "So far, there have been no methods that can produce these types of images, giving us insight into what the first molecular changes in neurons actually look like in Alzheimer's disease." The researchers previously demonstrated that early structural changes of beta-amyloid occur before amyloid plaques appear. They have applied the new method to image neurons impacted by early-stage Alzheimer's in mice before they die, which is vital when mapping the disease mechanisms. Klementieva thinks this also can be employed to study protein structures associated with other diseases that target the brain, including Parkinson's disease, Lewy Body dementia, and frontal lobe dementia.

The Alzheimer's Foundation of America (AFA) announced the launch of a new hotline that will be available to answer coronavirus questions in more than 90 languages via live chat, reports KKTV . The helpline, which will be wholly staffed by licensed social workers, is accessible seven days a week through the AFA website. The helpline is open from 9 a.m. to 9 p.m. ET on weekdays and 9 a.m. to 3 p.m. ET on weekends. "Language should not be a barrier to getting help," said AFA Chief Executive Charles J. Fuschillo Jr. "Families of all different ethnicities and languages are affected by Alzheimer's disease and the added challenges the coronavirus poses in caring for their loved ones. We want them to know there is a place to turn for help and answers to their questions. The helpline can be a great resource for professionals as well."