Background: SARS-CoV-2 booster vaccination remains essential to prevent severe COVID-19, particularly in vulnerable populations such as older adults. This study evaluated the durability and dynamics of immune responses following booster vaccination(s) in >65-year-old individuals and examined their association with protection against new infections. Methods: Immune responses were evaluated at 3, 9, and 15 months post-booster, measuring SARS-CoV-2-specific IgG antibodies against spike [IgG(S)] and nucleocapsid [IgG(N)] proteins, neutralizing activity against the Omicron BA.2 variant, and cellular immunity. A subset of participants was tested before booster administration. Regression analyses examined the influence of clinical and immunological factors—including a bivalent fourth dose—on infection risk over time. Results: Booster vaccination significantly enhanced IgG(S) and neutralizing capacity, peaking at 3 months. Although a decline was observed by 9 months, responses remained above baseline. Individuals with prior SARS-CoV-2 infection exhibited higher IgG(S) levels and neutralizing titers, and significantly lower reinfection rates (15%), compared to uninfected individuals. A fourth vaccine dose further increased IgG(S) levels. While neutralizing capacity was not consistently enhanced by the fourth dose, recipients experienced a lower rate of new infections. Immune trajectory analyses revealed that breakthrough infections elicited strong humoral responses comparable to those seen in previously infected individuals, highlighting the role of hybrid immunity. Conclusions: In older adults, booster vaccination induces durable immune responses, with hybrid immunity offering enhanced protection. A fourth dose boosts antibody levels and reduces infection risk, supporting its use in this high-risk group. Continued monitoring is needed to determine the long-term effectiveness of boosters, particularly against emerging variants.

Diabetes mellitus (DM) has emerged as one of the leading global health concerns due to its increasing prevalence and significant impact on healthcare systems

Background/Objectives: With rising diabetes rates, early detection of complications such as diabetic retinopathy (DR), a leading cause of visual impairment, is crucial. Incorporating DR screening into primary care has shown positive results, and integrating technological advances and artificial intelligence (AI) into these processes offers promising potential. The overall study aims to evaluate the agreement between primary care physicians, ophthalmologists, and an AI system in DR screening and referral decisions within a real-world primary care setting. Methods: In this brief report, we present the study protocol and provide an initial overview and description of our sample. A total of 1517 retinographies, obtained by a non-mydriatic retinal camera, were retrospectively collected from 301 patients with diabetes. Results: Primary care physicians referred 34.5% of the patients to ophthalmology, primarily due to opacification, suspicion of DR, or other retinal diseases. Overall, 13.62% of the participants were suspected of having DR, with 9.63% having a definitive diagnosis. Conclusions: These initial descriptive findings will be further explored in the next phase of the study through the analysis of concordance between primary care physicians, the AI-based software, and ophthalmology specialists. Future results are expected to provide valuable insights into the reliability of DR screening across different evaluators and support the integration of effective DR screening strategies into real-world clinical practice.

Background/Objectives: Alcohol consumption and medication use have increased among older population, potentially increasing the risk of alcohol–drug interactions and adverse outcomes. Biological sex differences may further influence these effects. This study aimed to assess sex-related differences in medication use, comorbidities, and hepatic biomarkers among older adults with risky alcohol consumption. Methods: A cross-sectional, multicenter study was conducted in 455 adults aged ≥65 years. Sociodemographic and clinical characteristics, medication prescriptions, and hepatic biomarkers were collected. Results: Of the participants, 41% were women, with a mean age of 71 years. The median weekly alcohol consumption was 7 standard drink units. Overall, 90% were taking at least one medication, with antihypertensives being the most prescribed (62%). Significant sex differences were observed (p ≤ 0.01): men showed higher use of antidiabetic drugs (24%), anticoagulants (8%), and nitrates (4%), whereas women more frequently used anxiolytics (35%), non-steroidal anti-inflammatory drugs (22%), and antidepressants (18%). Although risky alcohol consumption was more prevalent among men, women had a higher overall medication use. Significant differences were also observed in hepatic biomarkers, with higher gamma-glutamyl transferase levels and a higher prevalence of elevated FIB-4 values among men (p ≤ 0.01). Conclusions: These findings highlight the importance of routinely assessing alcohol consumption and medication use in older adults and support incorporating a sex-specific perspective into clinical practice and future research.

Background/Objectives: Alcohol consumption and medication use have increased among the elderly population, raising the risk of alcohol–drug interactions and adverse outcomes. Sex-related biological differences may further influence these effects. This study aimed to assess sex-related differences among older adults with risky alcohol consumption, con-sidering medication use, comorbidities, and hepatic biomarkers. Methods: A cross-sectional, multicenter study was conducted in adults aged ≥65 years. A total of 455 participants with risky alcohol consumption were included. Sociodemographic and clini-cal characteristics, medication prescriptions, and blood analytical parameters were col-lected. Results: Of the participants, 41% were women, with a mean age of 71 years. The mean weekly alcohol consumption was 8.4 ± 8.3 standard drink units. Overall, 71.2% were taking at least one medication, with antihypertensives being the most commonly pre-scribed (62%). Significant sex differences were observed (p ≤ 0.01): men showed higher use of antidiabetic drugs (24%), anticoagulants (8%), and nitrates (4%), whereas women more frequently used anxiolytics (35%), non-steroidal anti-inflammatory drugs (22%), and anti-depressants (18%). Significant differences were also observed in hepatic biomarkers, with higher gamma-glutamyl transferase levels in men and a higher AST/ALT ratio in women (p ≤ 0.01). Although risky alcohol consumption was more prevalent among men, women had a higher overall medication use. Conclusions: A high proportion of older adults with risky alcohol consumption are exposed to concurrent pharmacological treatments, in-creasing the potential for clinically relevant alcohol–drug interactions. The observed sex differences in comorbidities, medication use, and hepatic biomarkers underscore the im-portance of incorporating a sex-based perspective in research and clinical practice.

Cognitive aging trajectories differ widely across individuals, and genetic factors such as APOE and BDNF polymorphisms may contribute to this variability. While APOE ε4 has been widely studied, the influence of APOE ε2, particularly in interaction with sex, remains underexplored. This study aims to examine the longitudinal trajectory of APOE ε2 individuals on cognitive performance, and their interactions with sex, age, and BDNF Val66Met polymorphism, in a population-based cohort of older adults with vascular risk. We analyzed data from 386 participants (mean age: 71.8) from the Barcelona-AsIA Neuropsychology Study, followed over a 7-year period. Verbal memory, verbal fluency, and visuospatial domains were assessed. Linear regression models tested associations between cognitive change and genotypes, controlling for age, sex, education, depression, and vascular risk. Interaction terms and permutation testing were applied. Regression to the mean (RTM) effects were assessed. BDNF showed no significant associations with cognitive performance. RTM effects were evident across subgroups, particularly among ε2 carriers, suggesting this phenomenon partly explains the divergent results over time. APOE ε2 does not confer a consistent protective effect on cognition over time. Our results highlight that APOE ε2 may be detrimental to verbal memory in aging males.