Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Methods. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Results. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering “using no VKA” as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). Conclusions. Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.

The COVID-19 pandemic affects older adults particularly severely. Our objective was to identify from the international literature the symptoms most commonly experienced by older adults infected with SARS-CoV-2. This systematic literature review was conducted using MEDLINE between 1 December 2019 and 13 April 2020. The methodological quality analysis used a method dedicated to case series and case reports. Of the 260 articles initially identified, only two studies were ultimately included in the qualitative analysis. The mean age was relatively low, between 71 and 74 years on average. COVID-19 symptoms were as follows: fever, dry cough, dyspnoea, asthenia, anorexia, chest tightness, diarrhoea and, to a lesser extent, myalgia, pharyngitis, nausea, dizziness, headache, abdominal pain, and vomiting. Lymphopenia was noted from complete blood counts. In conclusion, this systematic review of the international literature reveals a lack of data about the semiology of COVID-19 in older adults, especially in very elderly frail people, who are normally considered to constitute the geriatric population. The national survey conducted by the Société Française de Gériatrie et Gérontologie will help bridge this semiological gap.

Introduction: Specific short‐stay Post‐Emergency Geriatric Units (PEGUs) might reduce length of stay and iatrogenic loss of independence without increasing the risk of early readmission. The aim of this study was to evaluate the rate and risk factors at emergency admission for early rehospitalization in a PEGU. Methods: The BACK‐UPUG study is a retrospective observational study conducted at a Post‐Emergency Geriatric Unit (University Hospital of Angers) over nearly 1 year, including patients hospitalized in the unit and discharged home. The early readmission rate within 30 days after discharge was calculated, and statistical descriptive, univariate, and multivariate analyses were carried out. Results: A total of 450 patients were included in the analysis (mean age 88 years; 39.3% men, 60.7% women). Of these, 75 patients (16.6%) were readmitted within 1 month after home discharge. Early readmission rate was significantly associated with excessive polypharmacy (odds ratio [OR] = 1.95; p = 0.014), being known by our geriatric team (OR = 2.36; p = 0.001), a history of recent hospitalization (OR = 2.00; p = 0.038), and initial severity criteria such as respiratory failure (OR = 1.94; p = 0.049) or hemodynamic disorders (OR = 3.91; p = 0.029). An initial hospital admission diagnosis of infectious disease was a protective factor (OR = 0.45; p = 0.023). Conclusion: Excessive polypharmacy, geriatric team follow‐up, recent hospitalization, and initial severity criteria are risk factors for early rehospitalization after emergency PEGU admission, while infectious pathology appears protective.

Objective: Calcium supplementation is widely used in older adults, but its long‐term effects on cognitive function remain unclear. This study assessed the association between pharmacological calcium supplementation and cognitive decline over 7 years in cognitively healthy older women. Methods: This prospective cohort study included 227 women (mean age 79.9 ± 3.6 years) from the Toulouse centre of the EPIDOS study. Cognitive function was assessed using the Short Portable Mental Status Questionnaire (SPMSQ) at baseline and after 7 years. Cognitive decline was defined as a decrease of at least one point in SPMSQ score. Calcium supplement use at baseline was recorded. Multivariable logistic regression was used to evaluate the association between supplementation and cognitive decline, adjusted for age, obesity, physical activity, instrumental activities of daily living (iADL) score, education level, dietary calcium and vitamin D intake, number of comorbidities and selected chronic conditions. Results: Cognitive decline occurred in 26% of participants. Calcium supplementation was reported by 12% of patients and was independently associated with an increased risk of cognitive decline (OR = 3.64; 95% CI: 1.47–9.01; p = 0.005). Obesity and comorbidity burden were also significant risk factors. Conclusions: Calcium supplementation was associated with a threefold increased risk of cognitive decline in older women over a 7‐year follow‐up. These results suggest caution in prescribing calcium supplements and underscore the need for further research on their neurological safety in ageing populations.