Psychotropic Drug-Associated Pneumonia in Older Adults
AbstractThe use of psychotropic drugs (antipsychotics, benzodiazepines and benzodiazepine-related drugs, and antidepressants) is common, with a prevalence estimates range of 19 –29% among community dwelling older adults. These drugs are often prescribed for off-label use, including neuropsychiatric symptoms. The older adult population also has high rates of pneumonia and some of these cases may be associated with adverse drug events. In this narrative review, we summariz e the findings from current observational studies on the association between psychotropic drug use and pneumonia in older adults. In addition to stu...
Source: Drugs and Aging - February 28, 2020 Category: Geriatrics Source Type: research

Benzodiazepine Prescribing in People with Chronic Obstructive Pulmonary Disease: Clinical Considerations
AbstractBenzodiazepines, available clinically for almost six decades, are still one of the most widely prescribed classes of medication. The proportion of the population prescribed benzodiazepines increases with age, and harms also increase with age. The prevalence of prescribing in people  >  85 years of age is as high as one in three, including in people with chronic obstructive pulmonary disease (COPD). The prevalence of COPD also increases with age. In COPD, indications cited for prescribing a benzodiazepine include anxiety, sleep disorders, or chronic breathlessness. Each of thes e symptoms is pr...
Source: Drugs and Aging - February 28, 2020 Category: Geriatrics Source Type: research

The Evolving Complexity of Treating Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor-2 (HER2)-Negative Breast Cancer: Special Considerations in Older Breast Cancer Patients —Part I: Early-Stage Disease
AbstractThe median age for breast cancer diagnosis is 62  years, but a disproportionate number of patients are over the age of 75 years and the majority of those have hormone receptor-positive, human epidermal growth factor receptor-2 (HER2)-negative cancers. This review provides a logical algorithm to guide providers through the many complicated issue s involved in adjuvant systemic therapy decisions in older patients with hormone receptor-positive, HER2-negative breast cancer. For this subtype of breast cancer, the mainstay of treatment is surgery and adjuvant endocrine therapy with tamoxifen or an aromata...
Source: Drugs and Aging - February 26, 2020 Category: Geriatrics Source Type: research

Atopic Dermatitis in Older Adults: A Review of Treatment Options
AbstractAtopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments,...
Source: Drugs and Aging - February 21, 2020 Category: Geriatrics Source Type: research

Safety and Efficacy of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients with Chronic Non-Cancer Pain Receiving Opioid Therapy: A Subgroup Analysis of Patients  ≥ 65 Years of Age
AbstractBackgroundOpioid-induced constipation (OIC), the most common side effect of opioid treatment, is under-recognized and undertreated in older patients. Naldemedine, an oral, peripherally acting μ-opioid receptor antagonist (PAMORA), is approved in Japan, the United States, and the European Union for treatment of OIC in adult patients.ObjectiveThis integrated analysis of three phase 3 trials (COMPOSE-1, COMPOSE-2, and COMPOSE-3) evaluated the safety and efficacy of naldemedine for up to 12  weeks in a subgroup of patients aged ≥ 65 years.MethodsPatients aged 18 –80 years with c...
Source: Drugs and Aging - February 21, 2020 Category: Geriatrics Source Type: research

Adverse Drug Events in Patients with Chronic Kidney Disease Associated with Multiple Drug Interactions and Polypharmacy
ConclusionMultiple pharmacodynamic interactions related to QTc prolongation, hyperkalaemia and haemorrhage are frequently associated with a negative outcome in older adults with CKD and often require recurrent medical treatment or rehospitalization. (Source: Drugs and Aging)
Source: Drugs and Aging - February 13, 2020 Category: Geriatrics Source Type: research

Comment on: “Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide”
(Source: Drugs and Aging)
Source: Drugs and Aging - February 12, 2020 Category: Geriatrics Source Type: research

Authors ’ Reply to Comment on “Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide”
(Source: Drugs and Aging)
Source: Drugs and Aging - February 12, 2020 Category: Geriatrics Source Type: research

Risk of Cataract Surgery and Age-Related Macular Degeneration After Initiation of Denosumab vs Zoledronic Acid for Osteoporosis: A Multi-Database Cohort Study
ConclusionsIn this large population-based cohort study of 118,292 patients with osteoporosis, initiation of denosumab was associated with a modestly decreased risk of cataract surgery vs zoledronic acid. The risk of age-related macular degeneration was similar between the two drugs. (Source: Drugs and Aging)
Source: Drugs and Aging - February 6, 2020 Category: Geriatrics Source Type: research

Prevalence and Factors Associated with Analgesic Prescribing in Poly-Medicated Elderly Patients
ConclusionsIn our cohort of poly-medicated elderly patients, prescription of analgesic medications was common, and these patients are likely to have an increased rate of adverse drug reactions and falls compared with those who were not prescribed analgesic medications. (Source: Drugs and Aging)
Source: Drugs and Aging - February 4, 2020 Category: Geriatrics Source Type: research

Persistence on Anti-Tumour Necrosis Factor Therapy in Older  Patients with Inflammatory Bowel Disease Compared with Younger Patients: Data from the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD)
The objective of this study was to assess persistence on therapy and the safety of anti-TNF therapy in older patients (aged ≥ 60 years).MethodsWe retrospectively reviewed the database of the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD), extracting data regarding IBD patients aged ≥ 60 years and controls
Source: Drugs and Aging - February 4, 2020 Category: Geriatrics Source Type: research

Nursing Home Residents ’ Thoughts on Discussing Deprescribing of Preventive Medications
ConclusionThe interviewed nursing home residents could not imagine how they might discuss potential deprescribing of preventive medications with their physician, and what topics would be important. Future work should explore how nursing home residents can be encouraged to be part of such discussions and investigate ways to have residents share their goals and preferences regarding deprescribing. (Source: Drugs and Aging)
Source: Drugs and Aging - January 30, 2020 Category: Geriatrics Source Type: research

Correction to: Interventions to  Reduce Adverse Drug Event-Related Outcomes in Older Adults: A Systematic Review and Meta-analysis
Unfortunately, the co-author name was incorrectly published as ‘ ‘Lamona’’ instead of ‘ ‘Lamorna’’ in the original article (Source: Drugs and Aging)
Source: Drugs and Aging - January 27, 2020 Category: Geriatrics Source Type: research

Adverse Effects of Anticholinergic Drugs on Cognition and Mobility: Cutoff for Impairment in a Cross-Sectional Study in Young –Old and Old–Old Adults
ConclusionsDrugs with anticholinergic (antimuscarinic) properties are associated with cognitive impairment in individuals as young as 55  years, and only one such drug per day, regardless of its anticholinergic burden, is associated with both impaired cognition and impaired mobility in old–old adults. Therefore, wherever possible, clinicians should avoid prescribing drugs with anticholinergic properties. (Source: Drugs and Aging)
Source: Drugs and Aging - January 13, 2020 Category: Geriatrics Source Type: research

The Safety and Tolerability of Statin Therapy in Primary Prevention in Older Adults: A Systematic Review and Meta-analysis
ConclusionsThis meta-analysis of RCTs found no excess incidence of muscle-related symptoms, total AEs, serious AEs and treatment discontinuations attributable to statin treatment compared with placebo among older adults without CVD. (Source: Drugs and Aging)
Source: Drugs and Aging - January 10, 2020 Category: Geriatrics Source Type: research

Utilization Patterns of Amantadine in Parkinson ’s Disease Patients Enrolled in the French COPARK Study
ConclusionsIn this cohort, amantadine was used in 10% of patients. Its use increased during follow-up, despite the fact that one-third of patients who received amantadine at baseline stopped taking it. Amantadine prescription was mainly correlated with the presence of dyskinesia. (Source: Drugs and Aging)
Source: Drugs and Aging - January 10, 2020 Category: Geriatrics Source Type: research

Interventions to Reduce Adverse Drug Event-Related Outcomes in Older Adults: A  Systematic Review and Meta-analysis
ConclusionsNo significant benefit was gained from any of the interventions in terms of the outcomes considered. New approaches are required to reduce ADEs in older adults. (Source: Drugs and Aging)
Source: Drugs and Aging - January 10, 2020 Category: Geriatrics Source Type: research

Clinical Pharmacy Services in Older Inpatients: An Evidence-Based Review
ConclusionsThree powered randomized controlled trials were identified that found a significant association between a pharmacist-led intervention in older adults and a reduction in post-discharge hospital visits. In clinical practice, an intervention consisting of medication reconciliation, review, counseling, and post-discharge follow-up should be provided to such high-risk inpatients. Regarding research priorities, large, multi-center randomized controlled trials should be performed to generate more evidence on the impact of clinical pharmacy interventions on the patient trajectory and economic outcomes. (Source: Drugs and Aging)
Source: Drugs and Aging - January 10, 2020 Category: Geriatrics Source Type: research

The Association Between Drug Burden Index (DBI) and Health-Related Outcomes: A Longitudinal Study of the ‘Oldest Old’ (LiLACS NZ)
ConclusionsUsing data from LiLACS NZ, a higher DBI was significantly associated with a greater risk of mortality (in M āori and non-Māori) and impaired cognitive function (in non-Māori). This highlights the importance of employing strategies to manage the prescribing of medications with a DBI >  0 in older adults. (Source: Drugs and Aging)
Source: Drugs and Aging - January 10, 2020 Category: Geriatrics Source Type: research

Topical Treatment of Localized Neuropathic Pain in the Elderly
AbstractThe prevalence of neuropathic pain in the older population has been reported to be very high and is most commonly localized to a circumscribed area. Treatment failure is frequent in neuropathic pain and is accompanied by central side effects with recommended oral drugs acting on the central nervous system. A number of topical pharmaceuticals are available on prescription and also sold over the counter. This review in persons aged older than 60  years shows the efficacy of lidocaine 5% and capsaicin 8% for localized neuropathic pain while results with other pharmaceuticals are rather inconsistent. Local applica...
Source: Drugs and Aging - January 9, 2020 Category: Geriatrics Source Type: research

Informing Medication Discontinuation Decisions among Older Adults with Relapsing-Onset Multiple Sclerosis
ConclusionThe benefits of DMDs may not be substantial among older adults with relapsing-onset MS. Direct clinical evidence remains limited and the decision of whether to discontinue a DMD should also take into account patient preferences. It is important to gain a better understanding of how age-related changes in the trajectory of relapsing-onset MS affect treatment effectiveness among older adults. (Source: Drugs and Aging)
Source: Drugs and Aging - January 9, 2020 Category: Geriatrics Source Type: research

Opioid Use After Hospital Care due to Hip Fracture Among Community-Dwelling Persons With and Without Alzheimer ’s Disease
ConclusionsFrequent opioid use after hospital care due to hip fracture may indicate increased attention to pain among persons with AD. Nevertheless, the benefits and harms of opioid use should be evaluated regularly in community-dwelling older persons. (Source: Drugs and Aging)
Source: Drugs and Aging - December 27, 2019 Category: Geriatrics Source Type: research

Patient-Reported Barriers and Facilitators to Deprescribing Cardiovascular Medications
ConclusionWe adapted a new framework of patient-reported barriers and facilitators specific to deprescribing cardiovascular medications. In addition to addressing barriers previously described, future deprescribing interventions targeting cardiovascular medications must also address uncertainty and conflicting attitudes. (Source: Drugs and Aging)
Source: Drugs and Aging - December 16, 2019 Category: Geriatrics Source Type: research

The Prevalence and Factors Associated with Antiepileptic Drug Use in US Nursing Home Residents
ConclusionsAED use was common in nursing homes, with gabapentin most commonly used (presumably for pain). That multiple comorbidities were associated with AED use underscores the need for future studies to investigate the safety and effectiveness of AED use in nursing home residents. (Source: Drugs and Aging)
Source: Drugs and Aging - December 16, 2019 Category: Geriatrics Source Type: research

Use of Medications with Anticholinergic Properties and the Long-Term Risk of Hospitalization for Falls and Fractures in the EPIC-Norfolk Longitudinal Cohort Study
This study was conducted to evaluate the relationship between anticholinergic cognitive burden (ACB) and the long-term risk of hospitalization with falls and fractures in a large population study. The dataset comprised information from 25,639 men and women (aged 40 –79 years) recruited from 1993 to 1997 from Norfolk, United Kingdom into the European Prospective Investigation into Cancer (EPIC)-Norfolk study. The time to first hospital admission with a fall with or without fracture was obtained from the National Health Service hospital information system. Co x-proportional hazards analyses were conducted to adjus...
Source: Drugs and Aging - December 5, 2019 Category: Geriatrics Source Type: research

Calcium Channel Blockers Co-prescribed with Loop Diuretics: A Potential Marker of Poor Prescribing?
AbstractPrescribing cascades are where a drug adverse reaction is wrongly attributed to the emergence of a new condition, which leads to further drug prescribing. This promotes polypharmacy, adverse drug reactions and therapeutic burden. An example of a prescribing cascade is the co-prescribing of loop diuretics to treat the peripheral oedema caused by calcium channel blocker (CCB) drugs. Although well recognised, this is still a combination of medications taken by millions of people worldwide. CCBs have no prognostic benefit in heart failure and have an absolute risk increase for oedema of around 8 –18% (number need...
Source: Drugs and Aging - December 4, 2019 Category: Geriatrics Source Type: research

Frequency and Predictors of Polypharmacy in US Medicare Patients: A Cross-Sectional Analysis at the Patient and Physician Levels
ConclusionsPatterns of high prescribing to older patients is common and measurable at the physician level. Addressing high outlier prescribers may represent an opportunity to reduce avoidable harm and excessive costs. (Source: Drugs and Aging)
Source: Drugs and Aging - November 29, 2019 Category: Geriatrics Source Type: research

Reducing Inappropriate Drug Use in Older Patients by Use of Clinical Decision Support in Community Pharmacy: A Mixed-Methods Evaluation
ConclusionWhen community pharmacists implemented CDSS alerts to reduce inappropriate drug use in older patients, they registered a persistent drug therapy change in 8.7% of the cases. Alerts triggered by a first prescription were two times more likely to be associated with a persistent drug therapy change than alerts triggered by repeat prescriptions. This study found that clinical rules can be used to detect inappropriate drug use in older patients and that drug therapy can change based on the alerts. This suggests that CDSS alerts are a useful tool for implementing guidelines on PIM in older patients in daily practice. (...
Source: Drugs and Aging - November 29, 2019 Category: Geriatrics Source Type: research

Interstitial Lung Disease in Elderly Rheumatoid Arthritis Patients
AbstractThe increase in life expectancy together with better care of rheumatoid arthritis (RA) has led to higher proportions of elderly individuals with RA. This has challenged the treatment of the disease in older aged patients, usually characterized by comorbid conditions and polypharmacy. Overall, the lung involvement in RA is present in up to 80% of patients, depending on the assessment tools used, and interstitial abnormalities are among the most common; when present, interstitial lung disease (ILD) worsens the prognosis of RA, and is the second most common cause of mortality. The aged lung undergoes functional and st...
Source: Drugs and Aging - November 26, 2019 Category: Geriatrics Source Type: research

Efficacy of Aspirin in the Primary Prevention of Cardiovascular Diseases and Cancer in the Elderly: A Population-Based Cohort Study in Korea
ConclusionAspirin reduced the risks of MACCE and cancer without increasing the bleeding risk in elderly Koreans with hypertension, T2DM, or dyslipidemia. Moreover, the benefits of the long-term use of aspirin in reducing the risks of MACCE were demonstrated. However, the decision of using aspirin for primary prevention must be carefully made on an individual basis, while estimating the benefit –risk balance of aspirin. (Source: Drugs and Aging)
Source: Drugs and Aging - November 22, 2019 Category: Geriatrics Source Type: research

Analysis by Age Group of Disease Outcomes in Patients with Psoriatic Arthritis: A Cross-Sectional Multicentre Study
In this report, we have analysed disease outcomes in PsA by age groups.MethodsThis cross-sectional, multicentre study included 227 PsA patients under biological and non-biological systemic therapies. The study population was divided into four categories by age:    65 years. Physical functioning, disease activity, remission rates and disease impact were compared.ResultsThirty-one patients (13.7%) were under 40  years, 26.9% (n = 61) were 40–49 years, 26.4% (n = 60) were 50–65 years and 33.0% (n = 75) were patients >  65&...
Source: Drugs and Aging - November 20, 2019 Category: Geriatrics Source Type: research

Clinical Outcomes of Rate vs Rhythm Control for Atrial Fibrillation in Older People: A Systematic Review and Meta-Analysis
ConclusionAll collected data were observational, which precluded making strong recommendations. Furthermore, all CIs were wide, increasing the uncertainty of the observed effects. As such, evidence was insufficient to recommend rhythm or rate control as the first-line therapy for AF in older adults. As AF is particularly prevalent in older people, more randomized controlled trials are needed in this population. (Source: Drugs and Aging)
Source: Drugs and Aging - November 20, 2019 Category: Geriatrics Source Type: research

Acknowledgement to Referees
(Source: Drugs and Aging)
Source: Drugs and Aging - November 14, 2019 Category: Geriatrics Source Type: research

An Analysis of Real-World Data on the Safety of Etanercept in Older Patients with Rheumatoid Arthritis
ConclusionsIn patients with RA, the relative increase in etanercept-associated risk of experiencing congestive heart failure, serious infection, non-melanoma skin cancer, or interstitial lung disease was similar between elderly and non-elderly. (Source: Drugs and Aging)
Source: Drugs and Aging - November 11, 2019 Category: Geriatrics Source Type: research

Temporal Trends in the Use of Anticholinergic Drugs Among Older People Living in Long-Term Care Facilities in Helsinki
ConclusionsDespite increased knowledge of the harms of DAPs, they remain widely used. Physicians seem to be aware of the harms of DAPs among people with dementia, and some other favorable trends in prescribing were also observed. Clinicians should especially consider the indications behind the use of DAP antidepressants and antipsychotics, and carefully weigh their potential benefits and harms. (Source: Drugs and Aging)
Source: Drugs and Aging - November 9, 2019 Category: Geriatrics Source Type: research

Assessing the Importance of Factors Associated with Cost-Related Nonadherence to Medication for Older US Medicare Beneficiaries
ConclusionsThese findings can help policy makers understand the relative importance of factors affecting CRN and identify the most important areas for intervention to improve CRN. (Source: Drugs and Aging)
Source: Drugs and Aging - November 5, 2019 Category: Geriatrics Source Type: research

Correction to: Cost –Utility and Budget Impact Analysis for Stopping the Inappropriate Use of Proton Pump Inhibitors After Cessation of NSAID or Low‑Dose Acetylsalicylic Acid Treatment
Errors were subsequently identified in the article, and the following corrections should be noted. (Source: Drugs and Aging)
Source: Drugs and Aging - November 5, 2019 Category: Geriatrics Source Type: research

Local Anesthetic Toxicity in the Geriatric Population
This article provides a concise overview of local anesthetic systemic toxicity, its history, mechanisms, risk factors, prevention, clinical presentation, and treatment, with a special emphasis on issues specific to the geriatric population. The authors used MEDLINE, Scopus, and Google Scholar to search for original research articles (human and animal studies), registries data, case reports, review articles, and pertinent online publications using the combinations of the following search terms: local anesthetics, local anesthetic systemic toxicity, intralipid, lipid emulsion, Exparel, ultrasound-guidance, regional anesthesi...
Source: Drugs and Aging - October 9, 2019 Category: Geriatrics Source Type: research

Does Deprescribing Improve Quality of Life? A Systematic Review of the Literature
ConclusionBased on a limited number of studies with varying methodological rigor, deprescribing may not significantly improve QOL or SWC; however, it may not contribute to additional ED visits and hospitalizations. Future controlled studies are needed. (Source: Drugs and Aging)
Source: Drugs and Aging - October 9, 2019 Category: Geriatrics Source Type: research

Is Testosterone Replacement Therapy in Older Men Effective and Safe?
AbstractThe number of older adults over 65 years of age is expected to increase to almost 100 million in the US by 2050, more than double the current figure of 46 million. Advanced age is associated with increased frailty among older Americans and often leads to increased disability, hospitalization, institutionalization, and, eventually, mortality. In search of means to improve age-related risks for adverse health outcomes, the question of restoring diminishing sex hormones has gathered much interest and has led to the practice of sex hormone replacement therapies in older men. Recent data suggest that androgen prescripti...
Source: Drugs and Aging - October 8, 2019 Category: Geriatrics Source Type: research

Suitable Use of Injectable Agents to Overcome Hypoglycemia Risk, Barriers, and Clinical Inertia in Community-Dwelling Older Adults with Type 2 Diabetes Mellitus
AbstractThe management of type 2 diabetes mellitus in older adults requires a comprehensive understanding of the relationship between the disease (medical) and the functional, psychological/cognitive, and social geriatric domains, to individualize both glycemic targets and therapeutic approaches. Prevention of hypoglycemia is a major priority that should be addressed as soon as its presence or risk is detected, adjusting the target and therapeutics accordingly. Nonetheless, treatment intensification should not be neglected when applicable, consistent with recommendations from organizations such as the American Geriatrics S...
Source: Drugs and Aging - September 30, 2019 Category: Geriatrics Source Type: research

Cost –Utility and Budget Impact Analysis for Stopping the Inappropriate Use of Proton Pump Inhibitors After Cessation of NSAID or Low-Dose Acetylsalicylic Acid Treatment
ConclusionsA substantial number of patients inappropriately continue to use a PPI after cessation of NSAID or LDASA treatment. Because adverse effects and their detrimental consequences are avoided, interventions to stop inappropriate PPI use, particularly in older patients, are likely to pay for themselves. (Source: Drugs and Aging)
Source: Drugs and Aging - September 27, 2019 Category: Geriatrics Source Type: research

Prescription Synthetic Oral Cannabinoid use Among Older Adults with Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study
AbstractBackgroundSynthetic oral cannabinoids (nabilone and dronabinol) may have adverse respiratory effects. Our purpose was to describe the scope, pattern, and patient characteristics associated with incident off-label synthetic oral cannabinoid use among older adults with chronic obstructive pulmonary disease (COPD) compared to older adults without COPD.MethodsThis was a retrospective, population-based, cohort study using Ontario, Canada, heath administrative data. Individuals aged 66  years or older were included, and physician-diagnosed COPD was identified using a previously validated, highly specific algorithm. ...
Source: Drugs and Aging - September 24, 2019 Category: Geriatrics Source Type: research

Management of Gastroesophageal Reflux Disease in the Elderly Patient
AbstractGastroesophageal reflux disease (GERD) is an especially common disorder in the elderly population. Its presentation in this population is often different  from that in younger patients. A greater proportion of patients experience atypical GERD symptoms rather than heartburn or regurgitation, increasing the likelihood the diagnosis will be missed or overlooked. Elderly patients more commonly present with severe erosive esophagitis and GERD complicati ons compared with younger patients, and thus may require more aggressive therapy. While diagnostic work-up and management of GERD in elderly patients is similar to...
Source: Drugs and Aging - September 21, 2019 Category: Geriatrics Source Type: research

Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide
AbstractRheumatoid arthritis (RA) is a chronic disabling disease that is associated with increased localized and generalized osteoporosis (OP). Previous studies estimated that approximately one-third of the RA population experience bone loss. Moreover, RA patients suffer from a doubled fracture incidence depending on several clinical factors, such as disease severity, age, glucocorticoid (GC) use, and immobility. As OP fractures are related to impaired quality of life and increased mortality rates, OP has an enormous impact on global health status. Therefore, there is an urgent need for a holistic approach in daily clinica...
Source: Drugs and Aging - September 21, 2019 Category: Geriatrics Source Type: research

Patients ’ Attitudes Towards Deprescribing Alpha-Blockers and Their Willingness to Participate in a Discontinuation Trial
ConclusionsAlthough men who use alpha-blockers are generally satisfied with their current therapy, most will participate in a discontinuation trial. (Source: Drugs and Aging)
Source: Drugs and Aging - September 13, 2019 Category: Geriatrics Source Type: research

Age-Related Resistance to Thyroid Hormone Action
AbstractThe age-related resistance to thyroid hormones (THs) explains the paucity of symptoms and signs of hyperthyroidism in older adults and may partly explain the myriad of symptoms and signs of hypothyroidism in biochemically euthyroid older people. This review considers the available data on the mechanisms underlying TH resistance with aging and compares these physiologic changes with the changes observed in congenital TH resistance syndromes. Aging is associated with alterations in TH economy along with a host of changes in the responsiveness of various tissues to THs. The age-related resistance to THs can be attribu...
Source: Drugs and Aging - September 12, 2019 Category: Geriatrics Source Type: research

Blockade of Renin –Angiotensin–Aldosterone System in Elderly Patients with Heart Failure and Chronic Kidney Disease: Results of a Single-Center, Observational Cohort Study
The objective of this study was to assess the role of treatment consisting of ACEi/ARBs and MRAs in patients  ≥ 75 years of age with CKD.MethodsFrom January 2008 to July 2014, 390 consecutive patients  ≥ 75 years of age with an ejection fraction ≤ 35% and a glomerular filtration rate (GFR) ≤ 60 mL/min/1.73 m2 were included. We analyzed the relationship between treatment with ACEi/ARBs and MRAs and mortality or cardiovascular events.ResultsThree hundred and ninety patients were included, with a mean age of 82.6  ± 4....
Source: Drugs and Aging - September 6, 2019 Category: Geriatrics Source Type: research

Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica
AbstractPolymyalgia rheumatica is an inflammatory rheumatic disease of the elderly characterised by pain and stiffness in the neck and pelvic girdle, and is the second most common inflammatory rheumatic condition in this age group, after rheumatoid arthritis. Polymyalgia rheumatica can occur independently or in association with giant cell arteritis, which is the most common form of primary vasculitis. The diagnosis of polymyalgia rheumatica is usually based on clinical presentation and increase of inflammatory markers. There are no pathognomonic findings that can confirm the diagnosis. However, different imaging techniques...
Source: Drugs and Aging - September 6, 2019 Category: Geriatrics Source Type: research

Burden of Inappropriate Prescription of Direct Oral Anticoagulants at Hospital Admission and Discharge in the Elderly: A Prospective Observational Multicenter Study
AbstractIntroductionDirect oral anticoagulants (DOACs) were developed to overcome some of the limitations associated with vitamin K antagonists (VKAs), such as interindividual variability or the need for therapeutic drug monitoring. However, the complexity of DOAC dose regimens can still lead to dosing errors and potential bleeding-related or thromboembolic adverse events, especially in the elderly.ObjectiveOur objective was to evaluate the rate of inappropriate preadmission DOAC prescriptions at hospital and to evaluate the ability of hospitals to correct them.MethodsAn observational prospective study was conducted in eld...
Source: Drugs and Aging - September 5, 2019 Category: Geriatrics Source Type: research