Frail patients after TAVI may gain most from dapagliflozin, and which multimorbidity clusters predict death

The edition in brief

Today's geriatrics edition. In a post hoc analysis of 1,222 patients in the DapaTAVI trial, nearly half were frail after transcatheter aortic valve implantation, and dapagliflozin was associated with a lower risk of death or worsening heart failure at one year in frail patients (HR 0.53) but not in prefrail or robust ones; subgroup findings like this need confirmation. In 16,095 Australians aged 70 and over followed for nearly 11 years, a cluster combining frailty, depressive symptoms and osteoporosis was associated with about 60% higher mortality in both sexes, and clusters involving gout, kidney disease and anaemia carried similar or higher risk. A meta-analysis of 17 trials found resistance training modestly improved working memory and cognitive flexibility in cognitively healthy older adults, with low certainty and no advantage over other exercise. A systematic review found delirium recovery interventions sparse, mostly confined to hospital, and rarely addressing emotional recovery. The pearl covers measuring frailty before procedures.