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Drugs & Aging

Aysu Selcuk, Kai Zhen Yap, Chee Liang Wong, Jing Xi Yang, Pei Chean Yong, Sui Yung Chan, Christine B Teng
BACKGROUND: Inappropriate antimicrobial use is a major cause for the development of antimicrobial resistance in nursing homes (NHs); however, little is known about antimicrobial use at NHs in Singapore compared with NHs in other countries. OBJECTIVES: The aim of this study was to determine the prevalence, practice and challenges of antimicrobial prescribing in Singapore NHs compared with those in other countries. METHODS: A point prevalence survey (PPS) was conducted from August to October 2017...
April 10, 2019: Drugs & Aging
Mehnaz Ahmed, Marlene Malik, Johannes Teselink, Krista L Lanctôt, Nathan Herrmann
Behavioral and psychological symptoms associated with dementia are highly prevalent and are associated with an increased risk of institutionalization and mortality. Current pharmacological treatments for these symptoms include cholinesterase inhibitors, antipsychotics, and selective serotonin reuptake inhibitors. When used for treating behavioral and psychological symptoms associated with dementia, they are associated with limited efficacy and/or serious adverse events. As such, there has been extensive research into novel agents with varying mechanisms of action targeting behavioral and psychological symptoms associated with dementia...
April 8, 2019: Drugs & Aging
Benoit Lattuca, Mathieu Kerneis, Michel Zeitouni, Guillaume Cayla, Paul Guedeney, Jean-Philippe Collet, Gilles Montalescot, Johanne Silvain
Large registries and epidemiologic studies have demonstrated that elderly patients (≥ 75 years old) represent a growing proportion of the acute coronary syndrome (ACS) population and are exposed to a high risk of both bleeding and ischemic events. In this setting, most of the randomized trials excluded elderly patients while evaluating therapeutic strategies in ACS and only few trials specifically dedicated their design to the elderly population, leading to a paucity of data. Elderly patients are less likely to be treated with an invasive strategy or potent antithrombotic drugs compared with younger patients, while they are exposed to a greater risk of mortality...
April 5, 2019: Drugs & Aging
Alvin Lee Day, Jasvinder A Singh
The prevalence of rheumatoid arthritis (RA), the most common autoimmune inflammatory arthritis, is increasing, partly due to the aging of the general population. RA is an independent risk factor for the development of cardiovascular disease (CVD). Older adults and elderly patients with RA develop CVD at a younger age compared with their general population peers. Both the traditional cardiovascular risk factors (age, sex, smoking, diabetes mellitus, hypertension), and systemic inflammation (i.e. high disease activity) are contributors to accelerated CVD in people with RA...
April 5, 2019: Drugs & Aging
Natali Jokanovic, Hannu Kautiainen, J Simon Bell, Edwin C K Tan, Kaisu H Pitkälä
BACKGROUND: One quarter of residents in long-term care facilities (LTCFs) have a diagnosis of CHD or stroke and over half use at least one preventative cardiovascular medication. There have been no studies that have investigated the longitudinal change in secondary preventative cardiovascular medication use in residents in LTCFs over time. OBJECTIVE: The aim of this study was to investigate the change in cardiovascular medication use among residents with coronary heart disease (CHD) and prior stroke in nursing homes (NHs) and assisted living facilities (ALFs) in Finland over time, and whether this change differs according to dementia status...
April 5, 2019: Drugs & Aging
Tal Frenkel Rutenberg, Abdelazeez Bdeir, Benaya Rozen-Zvi, Yoav Rosenthal, Steven Velkes, Avraham Weiss, Yichayaou Beloosesky
BACKGROUND: The use of renin-angiotensin-aldosterone system inhibitors has increased over the past few years. There are conflicting data as to their relationship with acute kidney injury following surgery. OBJECTIVES: The objective of the article was to evaluate the risk of acute kidney injury in diabetic older patients treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and their medical outcomes following fragility hip fracture surgery...
April 4, 2019: Drugs & Aging
Andrew H Ford, Osvaldo P Almeida
BACKGROUND: Vitamin B deficiency and elevated total plasma homocysteine have been associated with cognitive impairment and dementia in later life, although it is unknown if treatment with these vitamins improves cognitive outcomes. OBJECTIVES: The objectives of this study were to examine the efficacy of treatment with vitamin B12 , vitamin B6 , or folic acid in slowing cognitive decline amongst older adults with and without cognitive impairment. METHODS: We summarized findings from previous systematic reviews of clinical trials and performed a new systematic review and meta-analysis of 31 English-language, randomized placebo-controlled trials of B-vitamin supplementation of individuals with and without existing cognitive impairment...
April 4, 2019: Drugs & Aging
Farhad Pazan, Christel Weiss, Martin Wehling
No abstract text is available yet for this article.
April 2, 2019: Drugs & Aging
Onnita Thancharoen, Chulaporn Limwattananon, Onanong Waleekhachonloet, Thananan Rattanachotphanit, Phumtham Limwattananon, Panita Limpawattana
BACKGROUND: Cholinesterase inhibitors (ChEIs) and memantine have been reported to provide modest benefits for cognition and aspects of functioning in Alzheimer's disease (AD). Ginkgo biloba extract (EGb761), a phytomedicine, is widely used and expected to be well-tolerated. A few trials have compared EGb761 with ChEIs, and the results were inconclusive. OBJECTIVE: A network meta-analysis was conducted to evaluate the therapeutic benefits and tolerability of EGb761, three ChEIs (donepezil, galantamine, and rivastigmine), and memantine in mild-to-moderate AD patients...
April 2, 2019: Drugs & Aging
Martin Klietz, Stephan Greten, Florian Wegner, Günter U Höglinger
Parkinson's disease is a chronic neurodegenerative movement disorder affecting people mainly beyond their 50s. Geriatric patients with Parkinson's disease experience a specific profile of comorbidities. Multimorbidity and resulting polypharmacotherapy are frequent at this age. Comorbid diseases, widely spread, involve arterial hypertension, ischemic heart disease, heart failure, atrial fibrillation, polyneuropathy, diabetes mellitus, cerebrovascular disease, sarcopenia, and frailty. Following years of drug development, levodopa is still the most effective drug for the treatment of motor symptoms...
April 2, 2019: Drugs & Aging
Jessie Sellers, R Ryan Darby, Alma Farooque, Daniel O Claassen
BACKGROUND: Psychosis is common in Parkinson's disease-related disorders and is associated with significant morbidity. Pimavanserin is a newly approved treatment for Parkinson's disease psychosis, but real-world experience with pimavanserin has been limited by small sample sizes and limited assessment of longitudinal outcomes. OBJECTIVE: The aim was to summarize the clinical experience with pimavanserin in a large cohort of patients with Parkinson's disease-related psychosis...
March 29, 2019: Drugs & Aging
Julie Bobitt, Sara H Qualls, Melissa Schuchman, Robert Wickersham, Hillary D Lum, Kanika Arora, Gary Milavetz, Brian Kaskie
BACKGROUND: Although the rate of cannabis use by older adults is increasing more quickly than all other age groups, little is known about the reasons why older adults use cannabis and the outcomes they experience. OBJECTIVE: The objective of this study was to identify the most salient themes concerning the use of medical and recreational cannabis by older adults living in Colorado. Specifically, we sought to (1) characterize perceptions of cannabis use by users and non-users, (2) determine how older adults access cannabis, and (3) explicate both positive and negative outcomes associated with cannabis use...
March 28, 2019: Drugs & Aging
Shao-Hsien Liu, Jacob N Hunnicutt, Christine M Ulbricht, Catherine E Dubé, Anne L Hume, Kate L Lapane
OBJECTIVES: Our objective was to describe the prevalence of adjuvants to opioid therapy and changes in these agents for pharmacologic management in nursing home residents with cancer. METHODS: We included Medicare beneficiaries with cancer and documented opioid use at nursing home admission in 2011-2013 (N = 3268). The Minimum Data Set 3.0 provided information on sociodemographic and clinical characteristics. Part D claims provided information on opioid and adjuvant use during the 7 days after admission and 90 days later...
March 28, 2019: Drugs & Aging
Peter M Odor, Alison G Cavalier, Neal D Reynolds, King S Ang, Simon J Parrington, Hua Xu, Atholl Johnston, Frederic J Sage
BACKGROUND: Fascia iliaca compartment block (FICB) is an increasingly popular analgesic technique in elderly patients with hip fracture. Despite requiring large volumes of local anaesthetic, there are no plasma pharmacokinetic data on FICB in elderly patients. OBJECTIVES: The objective of this study was to determine the pharmacokinetic profile of a levobupivacaine 75 mg (30 mL 0.25%) FICB dose in patients aged ≥ 80 years with fractured femur. METHODS: This was a single-arm descriptive pilot study...
March 28, 2019: Drugs & Aging
Gillian E Caughey, Sepehr Shakib, John D Barratt, Elizabeth E Roughead
BACKGROUND: Multimorbidity is common in older patients with heart failure (HF), complicating therapeutic management and increasing the risk of harm. OBJECTIVE: This study sought to examine the prevalence of medicines for the treatment of comorbid conditions potentially associated with harm in older people, before and after HF hospitalization. METHODS: A retrospective cohort study of older people hospitalized with a primary diagnosis of HF over a 12-month period was conducted using administrative health claims data from the Department of Veterans' Affairs (DVA) Australia...
March 14, 2019: Drugs & Aging
Richard J Hewitt, Toby M Maher
Idiopathic pulmonary fibrosis (IPF) is a progressive and debilitating, scarring lung disease with a worse prognosis than some cancers. The incidence of IPF is increasing and while current antifibrotic therapies slow disease progression, they do not offer a cure. The pathobiology of IPF is complex and is driven by aging-associated cellular dysfunction, epithelial injury, and an aberrant wound-healing response characterised by fibroblast activation and extracellular matrix accumulation (ECM) in the interstitium...
March 12, 2019: Drugs & Aging
Mary E Walsh, Fiona Boland, Frank Moriarty, Tom Fahey
BACKGROUND: There is strong evidence that potentially inappropriate prescribing is associated with falls in older adults. Fall-related hospitalizations should trigger medication review. OBJECTIVES: The aim of this before-and-after cohort study was to explore patterns of relevant potentially inappropriate prescribing in older people with fall-related hospitalizations. METHODS: Data on older adults with hospitalizations for falls, fractures and syncope between 2012 and 2016 were collected from 44 general practices in Ireland...
March 5, 2019: Drugs & Aging
John Esther, Peter Hale, Andrew W Hahn, Neeraj Agarwal, Benjamin L Maughan
Given the underrepresentation of older patients in registration trials for metastatic renal cell carcinoma (mRCC), data to support the use of any particular systemic therapy over others, based on age, is limited. This is further complicated by clinical trials not commonly reporting adverse events by age. Thus, recommendations on treatment of older patients with mRCC are generally extrapolated from data on younger patients enrolled in these trials, which may not be ideal as many older patients are frail, have age-related organ dysfunction, or have multiple medical co-morbidities...
February 20, 2019: Drugs & Aging
L J Seppala, N van der Velde, T Masud, H Blain, M Petrovic, T J van der Cammen, K Szczerbińska, S Hartikainen, R A Kenny, J Ryg, P Eklund, E Topinková, A Mair, L Laflamme, H Thaler, G Bahat, M Gutiérrez-Valencia, M A Caballero-Mora, F Landi, M H Emmelot-Vonk, A Cherubini, J P Baeyens, A Correa-Pérez, A Gudmundsson, A Marengoni, D O'Mahony, N Parekh, F E Pisa, C Rajkumar, M Wehling, G Ziere
Falls are a major public health concern in the older population, and certain medication classes are a significant risk factor for falls. However, knowledge is lacking among both physicians and older people, including caregivers, concerning the role of medication as a risk factor. In the present statement, the European Geriatric Medicine Society (EuGMS) Task and Finish group on fall-risk-increasing drugs (FRIDs), in collaboration with the EuGMS Special Interest group on Pharmacology and the European Union of Medical Specialists (UEMS) Geriatric Medicine Section, outlines its position regarding knowledge dissemination on medication-related falls in older people across Europe...
February 11, 2019: Drugs & Aging
Nicola Veronese, Brendon Stubbs, Lee Smith, Stefania Maggi, Sarah E Jackson, Pinar Soysal, Jacopo Demurtas, Stefano Celotto, Ai Koyanagi
INTRODUCTION: Angiotensin-converting enzyme inhibitors (ACEI) may have several pleiotropic effects, but the literature regarding a possible relationship between ACEI use and frailty is limited. We investigated whether ACEI use is associated with lower risk of frailty in a cohort of North American individuals. METHODS: Data from the Osteoarthritis Initiative, a cohort study with 8 years of follow-up including community-dwelling adults with knee osteoarthritis or at high risk for this condition, were analyzed...
February 9, 2019: Drugs & Aging
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