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Grand RoundsWeekly Evidence Brief

Geriatrics

Edition

30-Second Takeaway

  • Age meaningfully alters treatment response and disability progression in treated MS patients.
  • Most hospital-initiated deprescribed medications remain stopped at 90 days, but restarts are common.

Week ending June 13, 2026

Grand Rounds: Selected evidence on aging, care interventions, and treatment durability

Age alters relapse risk and disability progression on disease-modifying MS therapies

JOURNAL OF NEUROLOGYJun 12, 2026

Registry analysis of 2,117 treated MS patients compared those <50 years (n=1,459) and ≥50 years (n=658). Younger patients had higher relapse risk (ARR 0.12 vs 0.09; HR 1.34, 95% CI 1.12–1.60). Older patients had greater risk of sustained EDSS progression at 12 and 24 weeks (HRs 0.76 and 0.70 favoring younger). Findings reflect real-world DMT use over mean follow-up of 6.0 versus 7.8 years and support age-informed treatment decisions.

App-based interventions for family caregivers show promise but inconsistent evidence

JMIR AGINGJun 11, 2026

Scoping review identified 49 studies (44 unique apps) targeting caregiver burden, well-being, and mental health. Most interventions reported perceived benefits but study designs and reporting were heterogeneous. Authors call for clearer intervention components, behavioral frameworks, and more inclusive samples. Current evidence supports cautious adoption and structured evaluation when recommending apps to caregivers.

Many deprescribed medications are restarted within 90 days after SNF discharge

JAMA NETWORK OPENJun 8, 2026

Cohort of 598 older adults discharged to SNF after hospital deprescribing found 69.7% restarted at least one medication. Of 8,734 deprescribed medications, 15.9% were restarted across 1,461 episodes; 84% remained discontinued at 90 days. Restarts concentrated during SNF stay and the first 90 days and associated with SNF restart timing and higher baseline prescribing complexity. Longer interventions and higher health literacy were linked to fewer restarts, highlighting targets for transitional-care interventions.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • For MS, weigh relapse risk versus progression risk when choosing DMTs for patients ≥50 years.
  • Reinforce transitional medication plans after SNF discharge and target high-risk patients for follow-up.
  • Treat app-based caregiver supports and social prescribing as promising but evidence-limited.