This fall, many older adults will be encouraged to get not one, not two, but three vaccines to protect against three common respiratory viruses that sicken millions of Americans each year and become increasingly dangerous with age.  

Most are familiar with the annual flu shot — roughly half of adults rolled up their sleeves for one last year. The same can be said for the COVID-19 booster, which is once again getting an update in time for fall.

New to the menu this year, however, is a vaccine for RSV, or respiratory syncytial virus, which is often associated with young kids, but sends as many as 160,000 adults 65 and older to the hospital each year, and kills as many as 10,000.

“We have learned over the last 20 years that year in and year out, [RSV] probably causes as much illness as influenza,” says William Schaffner, M.D., who is with the National Foundation for Infectious Diseases and is a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine.

RSV hit the U.S. especially hard last fall — right around the same time COVID-19 and flu cases gained steam. (Early estimates show the flu killed as many as 58,000 Americans in the 2022-2023 season; meanwhile, COVID-19 sent tens of thousands of people to the hospital each week during the fall of 2022.) This led some to dub the viral convergence a tripledemic.

“It was definitely really, really concerning to watch,” says Rachel Presti, M.D, an associate professor of medicine at Washington University School of Medicine in St. Louis.

This year, though, there’s a new tool to help fight back: a vaccine for RSV — the first ever. 

Two versions were approved by the Food and Drug Administration (FDA) in May and are expected to be available by the fall; both are for adults 60 and older.

When should you get the RSV vaccine?

Health officials are encouraging older adults to talk to their doctor to see whether the RSV vaccine is right for them. If that answer is yes, Presti says, there’s no need to delay.

The RSV season generally starts in the fall and peaks in the winter, but last year’s struck a bit early. “So, my recommendation would be to get the RSV vaccine as soon as it’s locally available,” Presti says. 

Pfizer, the manufacturer of one of the RSV vaccines, expects its shot will be available in the late summer or early fall; GlaxoSmithKline, the manufacturer of the other, is working on a similar timeline. (And there’s little difference between the two approved shots, Presti adds, so again, it comes down to what’s on hand.) 

One thing you will want to consider is spacing the RSV vaccine out from your flu and COVID vaccines. For one, Schaffner says, “I don’t think there are too many people who want to get three [shots] at the same time.”

And in studies, the influenza antibody response was better when the flu and RSV vaccines were given separately, Schaffner explains, though more information on RSV vaccine co-administration is expected soon.  That said, the COVID-19 boosters and flu shots can be given together — and last year, often were — so there’s no need to make separate trips for the clinic or pharmacy for those.

How often will you need the three vaccines?

The influenza vaccine is one you need every year, ideally by the end of October, the Centers for Disease Control and Prevention (CDC) says. And remember: Adults 65 and older should get the high-dose version for stronger protection. (The CDC estimates that 70 to 85 percent of flu-related deaths occur among adults 65 and older.)

The COVID-19 vaccine schedule is still in flux, though many experts are in favor of moving to an annual shot in the fall as the virus settles into a more seasonal pattern. For now, older adults should pay attention to recommendations from health officials and stay up to date on their boosters. The CDC recently gave the OK for adults 65 and older to go back for a second dose of the bivalent booster.

As for RSV, Schaffner says the duration of protection from the vaccine has yet to be determined. “Early data indicate that the protection may extend beyond one year,” he said, meaning an annual shot might not be necessary. “That said, stay tuned for further developments.”

If getting three shots this fall seems like a lot, consider the alternative, Presti says. A vaccine is “a whole lot less of a stress on your immune system” than getting infected and seriously ill from one, or all, of these common viruses. “I understand that people are tired of it, but it’s sort of something we should think about getting used to as just a way of preventing disease and keeping ourselves healthy.”

Reprinted from aarp.

It turns out there’s a mountain of scientific evidence that indicates walking — especially walking outdoors — is powerful medicine for your brain. Here’s what the data shows.

1. Walking may help you grow new brain cells.

Moderately paced walks stimulate the release of a protein called brain-derived neurotrophic factor, or BDNF, that is key to the survival of existing brain neurons and the generation of new ones. “Perhaps the most exciting finding is that aerobic forms of exercise [including walking] likely help facilitate the growth of new neurons,” says Patrick Smith, associate professor of psychiatry at the University of North Carolina at Chapel Hill.

2. Walking may boost your creativity.

Walking increases the flow of oxygen and nutrients to the brain, which can open the gates to enhanced creativity. The brain uses “about three times as much oxygen for healthy neuron function as muscles do” and is extremely sensitive to decreases in oxygen levels, according to Advanced Neurotherapy, a neurofeedback wellness clinic in Needham, Massachusetts. Creativity is a cognitive skill that is part of problem-solving. Studies show that the simple act of getting up from your desk and taking a short walk can help trigger ideas. A Stanford University study found “creative output increased 60 percent when participants were walking,” even on a treadmill facing a blank wall.

3. Walking may enhance your mood.

When you walk, increased blood flow to the brain initiates a “cascade of changes,” says Marie Pasinski, M.D., assistant professor of neurology at Harvard Medical School. “A cocktail of feel-good neurotransmitters — serotonin, dopamine, endorphins — is released.” Forty-two percent of American adults suffer a vitamin D deficiency. Our bodies manufacture vitamin D when exposed to sunlight, furthering the production of serotonin, a hormone benefiting memory and mood. Even on a cloudy day, “exposure to light elevates the mood,” says John Ratey, M.D., associate clinical professor of psychiatry at Harvard Medical School.

4. Walking may reduce the risk of cognitive decline.

Participants who walked more than 4,000 steps per day had healthier brain tissue in the area responsible for memory, learning and cognitive function than those who did not, one study found. That brain region, called the hippocampus, typically begins to shrink in late adulthood, leading not only to impaired memory but also an increased risk of dementia. The research revealed that aerobic exercise increases the size of the hippocampus

5. Walking may decrease brain-damaging stress.

Repeated exposure to stressful situations impairs memory, ­attention and cognitive flexibility. Walking in nature has been shown to be particularly effective at reducing stress levels. The impact of being outdoors may have to do with “optic flow” — the perception that objects are moving past us as we walk, which ­quiets the circuits responsible for stress, says Andrew Huberman, a neuroscientist in the Department of Neurobiology at Stanford Medicine.

“Self-generated optic flow — by walking, running or cycling — shifts the brain into a state of relaxation that’s not seen when you’re stationary,” he says. Scientists have seen walking reduce levels of cortisol, which surges during fight-or-flight situations. Elevated cortisol levels may damage cognition and contribute to Alzheimer’s disease, according to a 2019 ­review of studies in Frontiers in Aging Neuroscience. Just a 20-minute walk has been shown to reduce stress.

Reprinted from AARP.

FIRST STEPS

Take everything out of your wallet and sort it all, with an eye to paring it way back. Remove old receipts, shopping lists, business cards, single-store credit cards that rarely get used, coffee shop punch cards that you’ll likely never fill up, and so on. If it’s not something you’ll need often or in an emergency, keep it at home.

Create a safe and secure storage system at home for the occasional wallet items you’ve removed. You can put extra cash there, too. Grab cards or items when needed, and when done with your errand, return the cards to their secure spot.

Consumer advocates advise making photocopies (or taking smartphone photos) of the front and back of all your cards, so you know whom to contact if they go missing.

THINGS YOU SHOULDN’T KEEP IN YOUR WALLET

Here are the 10 things you should remove from your wallet and store in a safe place, depending on how often you need to access them:

• Social Security card. You do not need it for daily use, and criminals could use it to open lines of credit in your name or sell it to another criminal.
• Multiple credit cards and credit card receipts. Choose one credit card and one debit card you wish to use the most, and leave the others at home. Multiple credit cards are a gold mine for criminals. They can easily charge items online or send runners to different stores.
• Checkbook, or even one blank check. The days when you might need one for a purchase are mostly in the past.
• Work ID card.
• Passport or passport card.
• List of your passwords.
• Gift card not fully redeemed.
• Birth certificate.
• Library card. It sounds benign, but a crook can always check out lots of books and sell them for a buck or two apiece, Clay warns. 
• House key. Thieves could find your address from the contents of a stolen wallet.

Reprinted from AARP.