A report from financial technology company SmartAsset named U.S. cities where seniors are the most financially secure, according to Fox Business . Florida's retirement community, The Villages, ranked first on the list, while Hialeah, also in Florida, is the least-financially secure city for older Americans. The Villages has an average senior retirement income of $65,995, while the poverty rate for seniors is just 4.4 percent. Meanwhile, the average senior retirement income in Hialeah is $27,886 and its poverty rate for seniors is 30.2 percent. The four most financially secure U.S. cities after The Villages include Surprise, Ariz.; Huntsville, Ala.; Anchorage, Alaska; and Lexington, Kent. For its findings, SmartAsset compared the 100 U.S. cities with the largest population of people 65 and older based on seven measurements, including the percentage of seniors who own their own homes and average senior retirement income.

A new report from the U.S. Government Accountability Office (GAO) found most U.S. nursing communities had recurrent COVID-19 outbreaks during the pandemic, with about 94 percent experiencing multiple infection surges among residents or staff through January, according to Fierce Healthcare . Only 0.5 percent of a sample of 13,380 communities reported no COVID-19 cases to the Centers for Disease Control and Prevention. One outbreak was reported among 761 homes (6 percent) while 5,943 (44 percent) disclosed four or more outbreaks over eight months, with communities averaging a collective three outbreaks per community. Moreover, the bulk of the nursing communities had great difficulty containing the outbreaks. GAO added that the longer outbreaks peaked during October, November, and December, and generally mirrored higher case numbers among communities. Communities with outbreaks lasting five weeks or more averaged 56 cases, whereas those reporting outbreaks shorter than five weeks averaged 13 cases per outbreak. The findings suggested that staffers were a common source of initial infection, with 8,720 communities (66 percent) reporting an outbreak started with a staff member who tested positive for COVID-19.

A study in Nature Communications analyzed the mechanisms of microglia that consume amyloid plaques in Alzheimer's disease as a potential channel for therapeutic intervention, reports ScienceDaily . The researchers investigated differences in gene expression underpinning microglia's ability to ingest particles and identified associated regulatory molecules. Microglia that have not ingested amyloid possess gene expression patterns most similar to aged microglia, which are known to be dysfunctional and a major factor in Alzheimer's disease pathogenesis. Furthermore, microglia that engulf the plaques associated with Alzheimer's disease develop a characteristic gene expression signature partly induced by a gene called Hif1a. This boosts the ability of microglia to consume proteins such as amyloid, while lowering Hif1a concentrations has the opposite effect. "This relationship between Hif1a and cognitive decline in Alzheimer's disease is yet to be comprehensively uncovered," explained Duke-National University of Singapore Medical School Ph.D student Gabriel Chew. "Future work could focus on using gene editing tool CRISPR to test the impact of manipulating Hif1a on symptom severity and disease progression."

An Ohio State University (OSU) study in the Journals of Gerontology Series A suggests that a high body mass index (BMI) later in life does not necessarily elevate the risk of developing Alzheimer's disease, reports Ohio State News . The investigators compared data from two groups of people who had been diagnosed with mild cognitive impairment, of whom half developed Alzheimer's in 24 months and half did not deteriorate further. Analysis indicated that a higher genetic risk plus a lower BMI was linked to a higher likelihood for progression to Alzheimer's, and that the association was strongest in men. The researchers suspect that lower BMI in these patients was likely an effect of neurodegeneration. "We think there's interaction between the genetics and lower BMI, and having both of these risk factors causes more degeneration in certain brain regions to increase the likelihood of developing Alzheimer's disease," said OSU's Jena Moody.

A proof-of-concept study published in Scientific Reports suggests virtual reality (VR) might help older people remember facts and events based on specific details, reports Scientific American . The study involved 42 healthy older adults from the San Francisco Bay Area, half of whom spent 12 hours over four weeks playing a VR game called Labyrinth in which they walked in place, completing errands in virtual neighborhoods. The control half used tablets to play games that did not require navigating or recalling details. After 15 sessions, the control group performed approximately the same as before on a long-term memory test based on picking out objects they had viewed about 60 minutes earlier — while the Labyrinth cohort's scores rose, and they were less frequently fooled by objects that resembled ones they had seen. The University of California, San Francisco's Peter Wais said these improvements "brought them back up to the level of another group of younger adults who did the same memory tests." The VR game's designers think the game likely stimulates the hippocampus, a brain region key to long-term memory. The Massachusetts Institute of Technology's Meredith Thompson said following this study, "it would be great to actually follow people over time and see what this type of game does for long-term memory."

Physicians, physical therapists, and health plan leaders warn that the prolonged inactivity of U.S. seniors during the pandemic has raised the prospect of increased impairment and frailty in the older population, reports the Desert Sun . Professor Lauren Jan Gleason at the University of Chicago said many older patients have lost muscle mass and strength this past year and are having issues with mobility and balance they previously lacked. Some health plans have been reaching out to older members to evaluate their needs. Members of Massachusetts' Commonwealth Care Alliance, which serves seniors who are poor and qualify for both Medicare and Medicaid, tend to have more medical requirements than similarly aged seniors on average. The plan's staffers conducted phone-based "wellness outreach assessments" every two weeks between March and September 2020, asking about ongoing medical care, new physical and emotional challenges, and the adequacy of available help. Now, calls are made monthly and staffers have resumed in-person consultations. "We've had physical therapists digitally engage with members to coach them through strength and balance training," said Commonwealth Care Chief Medical Officer Robert MacArthur. "And when that didn't work, we sent therapists into people's homes."

KPBS reports that yearly inspections of California's 1,100 nursing communities have been reinstated after a year-long suspension due to the pandemic. "Conditions in many communities across the state have grown incredibly dire over the course of the pandemic and if anything, are as bad as they've ever been right now," said Mike Dark, staff lawyer with California Advocates for Nursing Home Reform. He blamed this state of affairs on the absence of family members of residents, who were not allowed in the communities for nearly a year. The California Department of Public Health (Cal DPH) halted routine surveys of communities in March 2020, as directed by the U.S. Centers for Medicare and Medicaid Services. At the time, advocates were concerned that the moratorium on family visits plus the stoppage of annual inspections would exacerbate care. "There were not enough staff to make sure people are clean and bathed," Dark said. "There's not enough staff to make sure people aren't developing bed sores. These are problems that have spread across the state and it's going to take a long time for Cal DPH to really get on top of this problem." Cal DPH stated that it still sent inspectors to investigate the most severe complaints over the past year.

A study in the New England Journal of Medicine found COVID-19 vaccinations appear to confer significant protection upon nursing community residents, reports the New York Times . The researchers noted that inoculation also appeared to protect residents who did not themselves get vaccinated, suggesting that unvaccinated residents benefit when others around them are immunized. After receiving an initial dose, 4.5 percent of residents still contracted the virus, although most cases were asymptomatic. Of the group receiving the second dose, just 0.3 percent got the virus after two weeks. Unvaccinated residents' rate of infection fell to 0.3 percent from 4.3 percent, and most infections were asymptomatic among all groups, with both symptomatic and asymptomatic infection rates declining over time. These findings track with recent guidance from the U.S. Centers for Disease Control and Prevention, which stated that people who get inoculated face much lower risk, while significant risk remains for unvaccinated individuals. "Robust vaccine coverage among residents and staff, together with the continued use of face masks and other infection-control measures, is likely to afford protection for a small number of unvaccinated residents," the researchers concluded.

CNN reports that a year of isolation from the pandemic has taken a toll on older Americans' physical, emotional, and cognitive health. Experts warn that they face the prospect of poorer health and more frailty unless they address these issues, and their suggestions to avoid such outcomes include reconnecting with physicians. Robert MacArthur of the Commonwealth Care Alliance in Massachusetts recommends that seniors — most of whom are now vaccinated — schedule visits with primary care providers and for preventive care screenings, like mammograms, dental cleanings, eye exams, and hearing checks. Jonathan Bean at the New England Geriatric Research, Education, and Clinical Center urges older adults to undergo an assessment of physical function. James Nussbaum at New York City-based ProHealth & Fitness advises getting a referral to a physical or occupational therapist. Older adults also should take a gradual approach to recovery. The experts' top recommendation for seniors is to engage regularly in some kind of physical activity. Also recommended is to have realistic expectations, follow a nutritious diet, and reconnect socially.

The U.S. National Institutes of Health's National Institute on Aging has awarded a five-year, $10.7 million grant to the University of Pittsburgh's Graduate School of Public Health and Washington University's School of Medicine in St. Louis to explore the genetic roots of Alzheimer's disease, reports Alzheimer's News Today . The researchers will use the grant to perform the first comprehensive genetic study of Alzheimer's via whole genome sequencing. The collaborators intend to find the genes, and their variants, associated with the formation of plaques and tangles. They hope to study up to 5,000 individuals at a high risk for Alzheimer's disease, and for whom biomarker data is available. Washington University Professor Carlos Cruchaga explains, "We plan to use the genetic information to create individual-level predictions to determine the risk of someone developing Alzheimer's disease." The goal is to uncover underlying mechanisms of Alzheimer's and ultimately discover potential drug targets.