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Background: Physical function worsens with older age, particularly for sedentary and socially isolated individuals, and this often leads to injuries. Through reductions in physical activity, the COVID‐19 pandemic may have worsened physical function and led to higher fall‐related risks. Methods: A nationally representative online survey of 2006 U.S. adults aged 50–80 was conducted in January 2021 to assess changes in health behaviors (worsened physical activity and less daily time spent on feet), social isolation (lack of companionship and perceived isolation), physical function (mobility and physical conditioning), and falls (falls and fear of falling) since March 2020. Multivariable logistic regression was used to assess relationships among physical activity, social isolation, physical function, falls, and fear of falling. Results: Among respondents, 740 (36.9%) reported reduced physical activity levels, 704 (35.1%) reported reduced daily time spent on their feet since March 2020, 712 (37.1%) reported lack of companionship, and 914 (45.9%) social isolation. In multivariable models, decreased physical activity (adjusted risk ratio, ARR: 2.92, 95% CI: 2.38, 3.61), less time spent on one's feet (ARR: 1.95, 95% CI: 1.62, 2.34), and social isolation (ARR: 1.51, 95% CI: 1.30, 1.74) were associated with greater risks of worsened physical conditioning. Decreased physical activity, time spent daily on one's feet, and social isolation were similarly associated with worsened mobility. Worsened mobility was associated with both greater risk of falling (ARR: 1.70, 95% CI: 1.35, 2.15) and worsened fear of falling (ARR: 2.02, 95% CI: 1.30, 3.13). Worsened physical conditioning and social isolation were also associated with greater risk of worsened fear of falling. Conclusion: The COVID‐19 pandemic was associated with worsened physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social isolation. Public health actions to address reduced physical activity and social isolation among older adults are needed. [ABSTRACT FROM AUTHOR]

This JAMA Patient Page describes e-cigarettes and the potential health effects of vaping. [ABSTRACT FROM AUTHOR]

The article comments on the global surgery implications of a study which compared the efficacy of skin antiseptics povidone iodine in alcohol and chlorhexidine gluconate in alcohol in preventing surgical site infections after cardiac or abdominal surgery. It calls for a change in the World Health Organization's (WHO) World Surgical Safety Checklist and suggests future research in low- and middle-income countries to consider the current study as an evidence-based guide.

Objectives: Sexual health is an important component of overall health and well-being for older adults. Despite this, little is known about the importance of sex to quality of life, as part of romantic relationships for older adults, and potential drivers of interactions between healthcare providers and older adults about sexual health. In this study using a nationally representative population, we describe perceptions and experiences of sex among older adults. Methods: A nationally representative, cross-sectional sample of community-dwelling U.S. adults aged 65–80 was surveyed about their sexual health and interaction with their health care providers about sexual health. Results: The survey completion rate was 75% (N = 1,002). Overall, 50.9% of men and 30.8% of women reported being sexually active. In all, 17.3% of adults aged 65–80 reported speaking to their health care provider about sexual health in the past two years and of those, 60.5% of patients initiated the conversation. Multivariable logistic regression demonstrated that sexual activity (yes/no), interest in sex, and satisfaction with sex life are major drivers of sexual health conversations between patients and healthcare providers. Conclusions: Many adults aged 65–80 are interested in and engage in sexual activity. While the majority of older adults reported a willingness to discuss their sexual health with their health care providers, few had done so, and most conversations were initiated by patients. Iterest in sex and satisfaction with sex life may be targets for intervention and offer a segue for providers as they begin the conversation to engage with older adults about their sexual health. Clinical Implications: Providers may have conversations with older adults about sexual health and may need sexual health training to have effective discussions; age nor chronic conditions should preclude this essential conversation. Clinical gerontologists may be helpful in this training and in encouraging patients to bring up sexual health concerns during their medical appointments. [ABSTRACT FROM AUTHOR]

This JAMA Patient Page describes allergic skin reactions from contact with poison ivy, poison oak, and poison sumac plants, and how to treat rashes caused by these plants. [ABSTRACT FROM AUTHOR]

To the Editor: Infection by West Nile virus (WNV) was first recognized in the Western Hemisphere in 1999 in New York (1). Subsequently, this mosquito-borne flavivirus has spread westward and [...]