Inflamm-aging at the time of COVID-19
Severe COVID-19 is associated with overproduction of pro-inflammatory cytokines. The ensuing cytokine storm contributes to the development of severe pneumonia and, possibly, to long-term symptom persistence (long COVID). The chronic state of low-grade inflammation that accompanies aging (inflamm-aging) might predispose older adults to severe COVID-19. Inflamm-aging may also contribute to symptom persistence following acute COVID-19. Anti-inflammatory drugs and immunomodulatory agents can achieve significant therapeutic gain during acute COVID-19. Lifestyle interventions (e.g., physical activity, diet) may be proposed as st...
Source: Clinics in Geriatric Medicine - March 20, 2022 Category: Geriatrics Authors: Maria Beatrice Zazzara, Andrea Bellieni, Riccardo Calvani, H élio Jose Coelho-Junior, Anna Picca, Emanuele Marzetti Source Type: research
The Impact of Long COVID-19 on Muscle Health
Coronavirus disease 2019 (COVID-19) negatively impacts several organs and systems weeks or months after initial diagnosis, a condition defined as post-acute sequelae of COVID-19 or long COVID. Skeletal muscle can be affected, leading to fatigue, lower mobility, weakness, and poor physical performance. Older adults are at increased risk of developing musculoskeletal symptoms during long COVID. Systemic inflammation, physical inactivity, and poor nutritional status are some of the mechanisms leading to muscle dysfunction in individuals with long COVID. Current evidence suggests that long COVID negatively impacts body composi...
Source: Clinics in Geriatric Medicine - March 20, 2022 Category: Geriatrics Authors: Montserrat Montes-Ibarra, Camila L.P. Oliveira, Camila E. Orsso, Francesco Landi, Emanuele Marzetti, Carla M. Prado Source Type: research
Long COVID-19: The Need for an Interdisciplinary Approach
Long COVID-19 is characterized by persistent COVID-19 symptomatology that lasts for, at least, two months. In old population, apart from the typical symptoms (fatigue, cough, or dyspnea), coexist unspecific symptoms (functional deterioration, cognitive impairment, or delirium) that could apparently mitigate the prevalence of this syndrome in this age group. Its main consequence is the functional decline, leading to a development of sarcopenia, frailty, and disability, without forgetting the nutritional and cognitive disorders. Thus, a multicomponent and individualized program (exercise, diet, cognitive stimulation) should ...
Source: Clinics in Geriatric Medicine - March 20, 2022 Category: Geriatrics Authors: Isabel Rodriguez-Sanchez, Leocadio Rodriguez-Ma ñas, Olga Laosa Source Type: research
COVID-19 Vaccines in Older Adults: Challenges in Vaccine Development and Policy-Making
This article further conducts comparisons between different COVID-19 vaccine platforms based on their technology, production requirement, immune response, advantages and disadvantages. Efficacy and safety of COVID-19 vaccines in frail older people in long-term care settings have been reviewed. Challenges of COVID-19 vaccine development and policy-making for vaccination strategies in older adults have been addressed. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 20, 2022 Category: Geriatrics Authors: Chih-Kuang Liang, Wei-Ju Lee, Li-Ning Peng, Lin-Chieh Meng, Fei-Yuan Hsiao, Liang-Kung Chen Source Type: research
Screening for and Management of Opioid Use Disorder in Older Adults in Primary Care
Opioid use disorder (OUD) is commonly seen in older adults in primary care offices. OUD when left untreated, often leads to overdose deaths, emergency department visits, and hospitalizations due to opioid-related adverse effects, especially respiratory and central nervous system depression. Primary care providers are on the front lines of efforts for its prevention, early detection, and treatment. This includes using the lowest doses of opioids for the shortest possible time for management of pain, routine screening, brief intervention, opioid withdrawal management, prescription of naloxone to prevent overdose death, and t...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Rajat Duggirala, Sunil Khushalani, Todd Palmer, Nicole Brandt, Abhilash Desai Source Type: research
Illicit Drug Use in Older Adults
Illicit drug use/misuse among older adults is understudied, although current trends point to older adults being the fastest-growing segment in the United States and other developed countries. There is a need for further insight into drug use patterns in older adults, who face their own set of socioeconomic, medical, and psychiatric problems. We reviewed the literature for data related to use/misuse of heroin and stimulants (cocaine, amphetamines, and methamphetamines) among people over the age of 40 years. We focused on prevalence rates of use/misuse of these substances, comorbidities, diagnostic challenges, screening tool...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Ziad Ghantous, Victoria Ahmad, Rita Khoury Source Type: research
Cannabis Use and Misuse in Older Adults
Cannabis is the most frequently used illegal psychoactive substance by older adults. With population aging, legalization and medicalization of cannabis, and changes in perceptions of older adults toward its use, recreational and medical cannabis use/misuse is on the rise in seniors. Although there are solid data related to the adverse events of cannabis in older adults, efficacy data are lacking. Older adults are at increased risk of developing cannabis use disorder alongside other medical and psychiatric comorbidities. We review the benefits and risks associated with cannabis use, and screening and management strategies f...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Rita Khoury, Peter Maliha, Roy Ibrahim Source Type: research
Over-The-Counter Remedies in Older Adults
Over-the-counter (OTC) products such as pharmaceuticals, dietary supplements, vitamins, and herbal remedies are widely available and copiously used by older adults for health maintenance and symptom management. Owing to physiology, multimorbidity, and polypharmacy, this population is particularly vulnerable to inappropriate use of OTC products, adverse effects, and drug interactions. While OTC pharmaceuticals are bound by FDA-approved standards, dietary supplements are regulated differently, resulting in variable quality and increased possibility for adulteration. Internationally, standards for OTC products vary widely. Ac...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Delavar Safari, Elisabeth C. DeMarco, Lillian Scanlon, George T. Grossberg Source Type: research
Alcohol Use Disorder in Older Adults
As the number of older adults worldwide continues to grow, we observe a proportional growth of substance use. Despite the myriad of complications alcohol use disorder (AUD) has on the body with regards to organ systems and mental health, the topic has been underresearched in the older adult population. Thus, it is important to create awareness about the growing problem of AUD among older adults. In this way, we can mitigate the long-term complications and side effects observed with alcohol abuse in this vulnerable population. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Gabriela Fenollal-Maldonado, Derek Brown, Heidi Hoffman, Chanchal Kahlon, George Grossberg Source Type: research
Hallucinogen Use and Misuse in Older Adults
Hallucinogens, or psychedelics, are substances/drugs that have been used for over a millennium. The most well known are LSD, psilocybin, mescaline, and PCP. These substances may induce hallucinations as well as cause somatic and psychological symptoms. Because of the Controlled Substances Act of 1970, there has been very little research done to determine the long-term consequences or perhaps potential benefit of misuse and abuse of hallucinogens. Typically, these drugs are not abused but more often misused. Recently, there has been a renewed interest in these compounds, which may lead to possible therapeutic options. (Sour...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Wm Maurice Redden, Saif-Ur-Rahman Paracha, Quratulanne Sheheryar Source Type: research
Nicotine Use Disorder in Older Adults
Nicotine is one of the most abused substances worldwide. Just as in adolescence and adulthood, tobacco use is also problematic in the elderly. Older people are more vulnerable to smoking consequences because of the additive effects of smoke. Cardiovascular diseases are the most common health problems associated with smoking; however, other systems are also affected, including the respiratory, nervous, integumentary, and many other systems. Smoking cessation is a difficult task especially in the elderly; therefore, physicians should encourage older patients to quit with every patient-physician encounter by offering counseli...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Nazem K. Bassil, Marie Lena K. Ohanian, Theodora G. Bou Saba Source Type: research
A Brewed Awakening
This article provides a current review of the literature examining caffeine use in older adults. Caffeine use is prevalent among older adults; thus, providers need to be aware of the prevalence and diagnostic criteria of caffeine use disorder versus nonproblematic use. The relationship between caffeine and various neuropsychiatric disorders, including Parkinson's disease, Alzheimer's disease, insomnia, and late-life depression, is reviewed. The neurobiological effects of caffeine are described, along with clinically relevant interactions between caffeine and common psychotropic medications. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Ellen Kim, Neil M. Robinson, Brianne M. Newman Source Type: research
Substance Misuse and the Older Offender
This article reviews different types of offenses among older offenders, their association with substance misuse, and available treatment services. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Samer El Hayek, Bernadette Mdawar, Elias Ghossoub Source Type: research
Prevention Strategies of Alcohol and Substance Use Disorders in Older Adults
This article reviews the latest trends of substance use in older adults, impact on health, and the best practice approaches for the clinical assessment of substance use disorders in this age group. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Samer El Hayek, Luna Geagea, Hussein El Bourji, Tamara Kadi, Farid Talih Source Type: research
Applying Geriatric Principles to Hazardous Drinking in Older Adults
Older adults continue to drink as they age. Aging changes alcohol kinetics just as with any other drug. Older adults have increased sensitivity to acute alcohol intake that accounts for the increased risk of falls, traffic accidents, and other injury. The Annual Medicare Wellness Exam is an excellent opportunity to introduce screening for unsafe drinking along with accumulated risks and deficits of aging. Older adults have responded well to brief interventions for unhealthy drinking. In the presence of alcohol use disorder or serious comorbidity including psychiatric illness, referral to specialized multidisciplinary care ...
Source: Clinics in Geriatric Medicine - November 16, 2021 Category: Geriatrics Authors: Miriam B. Rodin Source Type: research
