Influenza Vaccination in Older Adults: Recent Innovations and Practical Applications
AbstractInfluenza can lead to serious illness, particularly for older adults. In addition to short-term morbidity and mortality during the acute infection, recovery can be prolonged and often incomplete. This may lead to persistent declines in health and function, including catastrophic disability, which has dramatic implications for the well-being and support needs of older adults and their caregivers. All of this means that prevention of infection and effective treatment when illness has occurred are of paramount importance. In this narrative review, we discuss the effectiveness of influenza vaccines for the prevention o...
Source: Drugs and Aging - November 9, 2018 Category: Geriatrics Source Type: research

Serum Concentrations and Elimination Rates of Direct-Acting Oral Anticoagulants (DOACs) in Older Hip Fracture Patients Hospitalized for Surgery: A Pilot Study
ConclusionThis pilot study indicates that older patients prone to hip fracture are at risk of being exposed to therapeutic serum concentrations of DOACs during surgery due to reduced drug elimination rates. The observation that almost 50% of the patients had therapeutic concentrations at surgery should be investigated further regarding safety of DOAC use in this frail elderly population. (Source: Drugs and Aging)
Source: Drugs and Aging - November 9, 2018 Category: Geriatrics Source Type: research

Safety, Tolerability and Efficacy of Eslicarbazepine Acetate as Adjunctive Therapy in Patients Aged  ≥ 65 Years with Focal Seizures
ConclusionESL taken once daily (400 –1200 mg) as adjunctive therapy in patients aged ≥ 65 years was found to be safe, well tolerated and efficacious (EudraCT number: 2009-012587-14). (Source: Drugs and Aging)
Source: Drugs and Aging - November 1, 2018 Category: Geriatrics Source Type: research

Is the Drug Burden Index Related to Declining Functional Status at Follow-up in Community-Dwelling Seniors Consulting for Minor Injuries? Results from the Canadian Emergency Team Initiative Cohort Study
AbstractBackgroundThe Canadian Emergency Team Initiative (CETI) cohort showed that minor injuries like sprained ankles or small fractures trigger a downward spiral of functional decline in 16% of independent seniors up to 6  months post-injury. Such seniors frequently receive medications with sedative or anticholinergic properties. The Drug Burden Index (DBI), which summarises the drug burden of these specific medications, has been associated with decreased physical and cognitive functioning in previous research.ObjectivesWe aimed to assess the contribution of the DBI to functional decline in the CETI cohort.MethodsCE...
Source: Drugs and Aging - October 31, 2018 Category: Geriatrics Source Type: research

Recombinant Zoster Vaccine (Shingrix ® ): A Review in Herpes Zoster
AbstractShingrix® is a recombinant zoster vaccine (RZV) that contains a varicella zoster virus glycoprotein  E antigen and the AS01B adjuvant system. The subunit vaccine is approved for the prevention of herpes zoster (HZ) [EU, USA, Japan, Canada and Australia] and postherpetic neuralgia (PHN) [EU and Australia] in adults aged  ≥ 50 years. In the pivotal trials in adults aged ≥ 50 years (ZOE-50) and ≥ 70 years (ZOE-70), RZV significantly reduced the risk of HZ and PHN. Its protective efficacy waned minimally over 4 years and was well preserved in ...
Source: Drugs and Aging - October 29, 2018 Category: Geriatrics Source Type: research

Authors ’ Reply to Stefani: “Efficacy and Safety of Analgesic Treatment for Depression in People with Advanced Dementia: Randomised, Multicentre, Double-Blind, Placebo-Controlled Trial (DEP.PAIN.DEM)”
(Source: Drugs and Aging)
Source: Drugs and Aging - October 27, 2018 Category: Geriatrics Source Type: research

Comment on: “Efficacy and Safety of Analgesic Treatment for Depression in People with Advanced Dementia: Randomised, Multicentre, Double-Blind, Placebo-Controlled Trial (DEP.PAIN.DEM)”
(Source: Drugs and Aging)
Source: Drugs and Aging - October 27, 2018 Category: Geriatrics Source Type: research

Adherence of Elderly Patients with Cardiovascular Disease to Statins and the Risk of Exacerbation of Chronic Obstructive Pulmonary Disease: Evidence from an Italian Real-World Investigation
ConclusionsIn a real-world setting, we observed evidence that adherence to statin therapy markedly reduced the risk of chronic obstructive pulmonary disease exacerbations in elderly patients with co-existing chronic obstructive pulmonary disease and cardiovascular disease. Given the limited and controversial evidence from trials, more randomised controlled trials are urgently needed to better examine the potential benefits of statins as adjunct therapy in chronic obstructive pulmonary disease. (Source: Drugs and Aging)
Source: Drugs and Aging - October 26, 2018 Category: Geriatrics Source Type: research

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly
AbstractDrug-induced parkinsonism (DIP) and tardive dyskinesia (TD) are iatrogenic consequences of antidopaminergic drugs. Both are particularly prevalent among the elderly and those with dementia. However, despite their prevalence, these disorders are often overlooked. Both entities share risk factors, physiopathological mechanisms and, to some degree, therapeutic approaches. Withdrawing the causal agent, reducing the dose or switching to a less potent antidopaminergic drug should be the first therapeutic options. Here we review both entities and emerging therapies including the recently approved drugs deutetrabenazine an...
Source: Drugs and Aging - October 25, 2018 Category: Geriatrics Source Type: research

Efficacy of a Standardized Oral Vitamin D Dosing Regimen in Nursing Home Residents
AbstractBackgroundThe prevalence of vitamin D deficiency in nursing home residents ranges from 79% to 98%.ObjectivesThe aim of this cross-sectional observational study in somatic and psychogeriatric nursing home residents was to determine the efficacy of a standardized oral vitamin D dosing regimen (VDDR) consisting of a loading dose (LD) of cholecalciferol 200,000  IU followed by a maintenance dose (MD) of 100,000 IU every 13 weeks in obtaining and maintaining an adequate and safe vitamin D trough level (VDTL), defined as 75–220 nmol/L (reference range).MethodsBlood samples of nursing home reside...
Source: Drugs and Aging - October 22, 2018 Category: Geriatrics Source Type: research

Adjunctive Therapies in Parkinson ’s Disease: How to Choose the Best Treatment Strategy Approach
AbstractEnd-of-dose motor fluctuations are regarded as one of the core troublesome symptoms by patients with Parkinson ’s disease (PD). Treatment of levodopa (l-dopa)-induced motor fluctuations is still an unmet medical need.l-dopa is the gold standard in the treatment of motor PD symptoms; notwithstanding, a wide range of adjunct therapies are currently available for the treatment of end-of-dose motor fluctuations. Additionally, device-aided therapies, such as deep brain stimulation,l-dopa-carbidopa intestinal gel infusion, and on-demand injection or continuous apomorphine infusion, may be considered when oral treat...
Source: Drugs and Aging - October 15, 2018 Category: Geriatrics Source Type: research

Systemic Estrogen Use and Discontinuation After Alzheimer ’s Disease Diagnosis in Finland 2005–2012: A Nationwide Exposure-Matched Cohort Study
This study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005 –2011 (N = 46,116; index cases) and an equally sized matched comparison cohort without AD. Follow-up began on the matching date (date of the AD diagnosis of the index case). Data on systemic estrogen use were obtained from the prescription register. Use initiation and discontinuation were assessed.ResultsAltogether 3.1% of women with AD and 4.3% of women without AD used estrogen during the follow-up period. Only  
Source: Drugs and Aging - October 13, 2018 Category: Geriatrics Source Type: research

Effect of Exercise on Drug-Related Falls Among Persons with Alzheimer's Disease: A Secondary Analysis of the FINALEX Study
We examined the incidence rate ratios (IRRs) for falls among both non-users and users of various FRDs (antihypertensives, psychotropics, drugs with anticholinergic properties [DAPs]) in both control and combined intervention groups.ResultsBetween the intervention and control groups, there was no difference in the number of falls among those without antihypertensives or psychotropics. In the intervention group taking antihypertensives, the IRR was 0.5 falls/person-year (95% confidence interval [CI] 0.4 –0.6), while in the control group, the IRR was 1.5 falls/person-year (95% CI 1.2–1.8) [p 
Source: Drugs and Aging - October 13, 2018 Category: Geriatrics Source Type: research

Evidence-Based Management of Diabetes in Older Adults
AbstractThe number of older adults with diabetes is rapidly increasing worldwide. A variety of factors contribute to the age-related increase in the incidence of diabetes. The lack of empiric evidence in the field has limited the management guidelines to mostly expert opinion. Given uncertainty over the rate at which to lower blood glucose levels and the optimal method of doing so, the goals of diabetes control in older people must be individualized. If the patient requires insulin therapy, the newer insulins, with their improved pharmacodynamic consistency and reduced risk of hypoglycemia, should be preferred. Several ora...
Source: Drugs and Aging - October 10, 2018 Category: Geriatrics Source Type: research

Hematopoietic Cell Transplant (HCT) in the Elderly: Myths, Controversies and Unknowns
AbstractThe incidence of most hematological malignancies increases with age. Despite the higher incidence of hematological malignancies in the elderly, the geriatric population is poorly represented in the early oncology clinical trials that established the current standards of care. Hematopoietic cell transplant (HCT), either upfront or at relapse, provides a potentially life-prolonging, often curative option for many patients with hematological malignancies and is considered the standard of care, at least for younger patients. Historically, the concern that older adults undergoing HCT may experience higher morbidity and ...
Source: Drugs and Aging - October 9, 2018 Category: Geriatrics Source Type: research

The Role of Deprescribing in Older Adults with Chronic Kidney Disease
AbstractOlder adults with chronic kidney disease (CKD) often experience polypharmacy, a recognized predictor of prescribing problems including inappropriately dosed medications, drug –drug and drug–disease interactions, morbidity and mortality. Polypharmacy is also associated with nonadherence, which leads to recurrent hospitalizations and poorer hemodialysis outcomes in CKD patients. Further complicating medication management in this vulnerable population are the physiologi c changes that occur with both age and CKD. This guide for pharmacists and prescribers offers considerations in medication evaluation and ...
Source: Drugs and Aging - October 4, 2018 Category: Geriatrics Source Type: research

Correction to: How Common is Statin Use in the Oldest Old?
In Section  4.3 “Factors Associated with Statin Use in the Oldest Old”. (Source: Drugs and Aging)
Source: Drugs and Aging - October 3, 2018 Category: Geriatrics Source Type: research

Frailty Status Affects the Decision for Long-Term Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation
ConclusionA high percentage of the elderly AF patients did not receive AT, even at discharge. Patients who did not receive AT at discharge had higher bleeding and frailty scores. In the 1-year follow-up period after hospital discharge, high all-cause mortality and a high number of hospital readmissions were recorded. (Source: Drugs and Aging)
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Commonly Initiated Opioids and Risk of Fracture Hospitalizations in United States Nursing Homes
ConclusionsThe lower rate of fractures that we documented among tramadol initiators compared with hydrocodone initiators is consistent, albeit attenuated compared with prior studies among community-dwelling older adults. However, overall fracture rates were lower than in community settings, potentially due to the limited risk of falling in this population with limited mobility. (Source: Drugs and Aging)
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

A Review of the Pharmacological and Clinical Profile of Newer Atypical Antipsychotics as Treatments for Bipolar Disorder: Considerations for Use in Older Patients
AbstractBipolar disorder prevalence rates vary in the older adult population (defined as age ≥ 65 years), ranging from 1% in community dwellers to as high as 8–10% in hospital inpatients. Although older agents, including lithium and valproic acid, offer significant antimanic efficacy, as supported by a recent randomized controlled trial (RCT), there is growing interest in using atypi cal antipsychotics to treat bipolar disorder in older adults. Newer atypical antipsychotics are of interest based on their tolerability and efficacy in the general adult bipolar population. The aim of this review was to sy...
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management
AbstractMedication-induced xerostomia and hyposalivation will increasingly become oral health issues for older and geriatric patients because of the likely high prevalence of medication intake and polypharmacy, with a complex negative impact on other symptoms such as dysphagia, caries incidence, malnutrition, and quality of life. All healthcare professionals are encouraged to investigate dry mouth symptoms among their patients, since diagnosis can easily be performed within daily clinical practice. This practical article also provides a review of available treatment options, which include medication changes towards product...
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Factors Related to the Use of Topical vs. Oral NSAIDs for Sprains, Strains, and Contusions in a Senior Population: A Retrospective Analysis of Administrative Claims Data
The objective of the study was to identify factors associated with the use of a prescription topical NSAID or a prescription oral NSAID for the treatment of sprains, strains, and contusions among patients aged 65 –89 years enrolled in the Medicare Advantage with Prescription Drug plan.MethodsThe study sample was selected from the Humana Research Database (Louisville, KY, USA). Study subjects were identified as patients enrolled in Medicare Advantage with Prescription Drug plans, aged 65 –89 years, having a medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modific...
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Lower Prescription Rates in Centenarians with Heart Failure and Heart Failure and Kidney Disease Combined: Findings from a Longitudinal Cohort Study of Very Old Patients
AbstractBackgroundCentenarians are considered as models of successful aging and represent a special group of patients. The aim of this study was to analyze heart failure epidemiology and treatment trajectories in centenarians compared to nonagenarians (90 –99 years of age) and octogenarians (80–89 years of age) with heart failure and with heart failure and kidney disease combined.MethodsThis cohort study used quarterly structured routine data from 1398 German insurants over 6 years prior to death (398 centenarians were compared with 500 nonagenarians and 500 octogenarians). Of those, 525 individuals were diagno...
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Association of Anticholinergic Drug Burden with Cognitive and Functional Decline Over Time in Older Inpatients: Results from the CRIME Project
ConclusionsACB and ARS have only a moderate degree of correlation. Use of drugs with anticholinergic properties in elderly patients is independently associated with cognitive and functional decline. (Source: Drugs and Aging)
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Treating Fatigue in Rheumatoid Arthritis: Does Patient Age Matter?
AbstractClinically relevant fatigue is common in patients with rheumatoid arthritis (RA) and might be expected to be related to patient age and disease severity. This review provides a brief introduction to fatigue as a patient-reported outcome that contributes significantly to burden of disease, with a focus on the evidence in elderly patients, and gives an overview of our current understanding of the factors that contribute to fatigue. We summarize the evidence for the effects of pharmacological (disease-modifying anti-rheumatic drugs, DMARDs) and non-pharmacological interventions for fatigue. The underlying pathophysiol...
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Frailty Status Affects the Decision for Long-Term Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation
ConclusionA high percentage of the elderly AF patients did not receive AT, even at discharge. Patients who did not receive AT at discharge had higher bleeding and frailty scores. In the 1-year follow-up period after hospital discharge, high all-cause mortality and a high number of hospital readmissions were recorded. (Source: Drugs and Aging)
Source: Drugs and Aging - September 11, 2018 Category: Geriatrics Source Type: research

Factors Related to the Use of Topical vs. Oral NSAIDs for Sprains, Strains, and Contusions in a Senior Population: A Retrospective Analysis of Administrative Claims Data
The objective of the study was to identify factors associated with the use of a prescription topical NSAID or a prescription oral NSAID for the treatment of sprains, strains, and contusions among patients aged 65 –89 years enrolled in the Medicare Advantage with Prescription Drug plan.MethodsThe study sample was selected from the Humana Research Database (Louisville, KY, USA). Study subjects were identified as patients enrolled in Medicare Advantage with Prescription Drug plans, aged 65 –89 years, having a medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modific...
Source: Drugs and Aging - September 11, 2018 Category: Geriatrics Source Type: research

Medication Exposure and Health Outcomes in Older Patients with End-Stage Kidney Disease: A Prospective Study Undertaken in New Zealand
ConclusionsMultiple medication exposure was prevalent in this older ESKD population, and was associated with an increased risk of mortality and hospitalisation. While this study is not able to determine the cause of these relationships, review of medication use is warranted in this population.Trial RegistrationACTRN12611000024943. (Source: Drugs and Aging)
Source: Drugs and Aging - September 8, 2018 Category: Geriatrics Source Type: research

Antihypertensive Treatment Patterns and Blood Pressure Control in Older Adults: Results from the Berlin Aging Study II
AbstractBackgroundHypertension is highly prevalent in older adults and represents a major public health issue since recognition, awareness, treatment and control are insufficient. Analyses of prescription patterns in conjunction with clinical parameters can provide novel insights into the current practice of hypertension management and help to identify barriers to sufficient hypertension control.MethodsA cross-sectional analysis was conducted. Prevalence of hypertension, patterns of antihypertensive therapy, and determinants of blood pressure (BP) control were examined in the Berlin Aging Study II cohort, including 1654 co...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Pharmacy-Based Approach to Improving Heart Failure Medication Use by Older Adults with Limited Health Literacy: Learning from Interdisciplinary Experience
AbstractHeart failure is a chronic disease requiring careful attention to self-care. Patients must follow instructions for diet and medication use to prevent or delay a decline in functional status, quality of life, and expensive care. However, there is considerable heterogeneity in heart failure patients ’ knowledge of important care routines, their cognition, and their health literacy, which predict the ability to implement self-care. Our interdisciplinary team of cognitive scientists with health literacy expertise, pharmacists, and physicians spent 18 years designing and testing protocols and m aterials to as...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Commonly Initiated Opioids and Risk of Fracture Hospitalizations in United States Nursing Homes
ConclusionsThe lower rate of fractures that we documented among tramadol initiators compared with hydrocodone initiators is consistent, albeit attenuated compared with prior studies among community-dwelling older adults. However, overall fracture rates were lower than in community settings, potentially due to the limited risk of falling in this population with limited mobility. (Source: Drugs and Aging)
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Antihypertensive Treatment Patterns and Blood Pressure Control in Older Adults: Results from the Berlin Aging Study II
AbstractBackgroundHypertension is highly prevalent in older adults and represents a major public health issue since recognition, awareness, treatment and control are insufficient. Analyses of prescription patterns in conjunction with clinical parameters can provide novel insights into the current practice of hypertension management and help to identify barriers to sufficient hypertension control.MethodsA cross-sectional analysis was conducted. Prevalence of hypertension, patterns of antihypertensive therapy, and determinants of blood pressure (BP) control were examined in the Berlin Aging Study II cohort, including 1654 co...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

A Review of the Pharmacological and Clinical Profile of Newer Atypical Antipsychotics as Treatments for Bipolar Disorder: Considerations for Use in Older Patients
AbstractBipolar disorder prevalence rates vary in the older adult population (defined as age ≥ 65 years), ranging from 1% in community dwellers to as high as 8–10% in hospital inpatients. Although older agents, including lithium and valproic acid, offer significant antimanic efficacy, as supported by a recent randomized controlled trial (RCT), there is growing interest in using atypi cal antipsychotics to treat bipolar disorder in older adults. Newer atypical antipsychotics are of interest based on their tolerability and efficacy in the general adult bipolar population. The aim of this review was to sy...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management
AbstractMedication-induced xerostomia and hyposalivation will increasingly become oral health issues for older and geriatric patients because of the likely high prevalence of medication intake and polypharmacy, with a complex negative impact on other symptoms such as dysphagia, caries incidence, malnutrition, and quality of life. All healthcare professionals are encouraged to investigate dry mouth symptoms among their patients, since diagnosis can easily be performed within daily clinical practice. This practical article also provides a review of available treatment options, which include medication changes towards product...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Lower Prescription Rates in Centenarians with Heart Failure and Heart Failure and Kidney Disease Combined: Findings from a Longitudinal Cohort Study of Very Old Patients
AbstractBackgroundCentenarians are considered as models of successful aging and represent a special group of patients. The aim of this study was to analyze heart failure epidemiology and treatment trajectories in centenarians compared to nonagenarians (90 –99 years of age) and octogenarians (80–89 years of age) with heart failure and with heart failure and kidney disease combined.MethodsThis cohort study used quarterly structured routine data from 1398 German insurants over 6 years prior to death (398 centenarians were compared with 500 nonagenarians and 500 octogenarians). Of those, 525 individuals were diagno...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Association of Anticholinergic Drug Burden with Cognitive and Functional Decline Over Time in Older Inpatients: Results from the CRIME Project
ConclusionsACB and ARS have only a moderate degree of correlation. Use of drugs with anticholinergic properties in elderly patients is independently associated with cognitive and functional decline. (Source: Drugs and Aging)
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Treating Fatigue in Rheumatoid Arthritis: Does Patient Age Matter?
AbstractClinically relevant fatigue is common in patients with rheumatoid arthritis (RA) and might be expected to be related to patient age and disease severity. This review provides a brief introduction to fatigue as a patient-reported outcome that contributes significantly to burden of disease, with a focus on the evidence in elderly patients, and gives an overview of our current understanding of the factors that contribute to fatigue. We summarize the evidence for the effects of pharmacological (disease-modifying anti-rheumatic drugs, DMARDs) and non-pharmacological interventions for fatigue. The underlying pathophysiol...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Pharmacy-Based Approach to Improving Heart Failure Medication Use by Older Adults with Limited Health Literacy: Learning from Interdisciplinary Experience
AbstractHeart failure is a chronic disease requiring careful attention to self-care. Patients must follow instructions for diet and medication use to prevent or delay a decline in functional status, quality of life, and expensive care. However, there is considerable heterogeneity in heart failure patients ’ knowledge of important care routines, their cognition, and their health literacy, which predict the ability to implement self-care. Our interdisciplinary team of cognitive scientists with health literacy expertise, pharmacists, and physicians spent 18 years designing and testing protocols and m aterials to as...
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

The Role of Targeted Agents and Immunotherapy in Older Patients with Non-small Cell Lung Cancer
AbstractLung cancer is predominantly a disease of the elderly. This subgroup of patients poses many challenges and an appropriate geriatric assessment is crucial for treatment personalisation in order to reduce the risk of over- or under-treatment. Whilst cytotoxic chemotherapy has been the backbone of advanced non-small cell lung cancer (NSCLC) treatment for decades, the development of targeted agents for driver mutations such asEGFR,ALK,BRAF andROS1 has changed the treatment paradigm and natural history of this disease. More recently, the development of immune checkpoint inhibitors has revolutionised treatment for a larg...
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Invasive Candidiasis in the Elderly: Considerations for Drug Therapy
AbstractCandida infections in the elderly are an important and expanding clinical problem, with significantly higher mortality in this group than in younger patients. The increasing problem of invasiveCandida infections may be related to higher prevalence of immunocompromised older people and the emergence of treatment resistance. Older people, especially the frail and critically ill, are at higher risk of medication-related harmful effects due to changes in pharmacokinetics and pharmacodynamics, which may be further complicated by organ dysfunction, diminished homeostatic control, co-morbidities and polypharmacy. Here, we...
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Insomnia in Elderly Patients: Recommendations for Pharmacological Management
AbstractChronic insomnia affects 57% of the elderly in the United States, with impairment of quality of life, function, and health. Chronic insomnia burdens society with billions of dollars in direct and indirect costs of care. The main modalities in the treatment of insomnia in the elderly are psychological/behavioral therapies, pharmacological treatment, or a combination of both. Various specialty societies view psychological/behavioral therapies as the initial treatment intervention. Pharmacotherapy plays an adjunctive role when insomnia symptoms persist or when patients are unable to pursue cognitive behavioral therapi...
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Effectiveness and Safety of Direct-Acting Antiviral Combination Therapies for Treatment of Hepatitis C Virus in Elderly Patients: Results from the German Hepatitis C Registry
ConclusionDirect-acting antiviral therapies were well tolerated in patients older than 70  years. SVR12 rates in the elderly patient group were similar to those observed in younger patients. Differences in the prevalence of comorbidities between age groups warrant individualized attention with respect to drug–drug interactions and therapy adherence.The study was registered in the German Clinical Trials Register, DRKS-ID: DRKS00009717. (Source: Drugs and Aging)
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Anticholinergics for Overactive Bladder in Frail and Medically Complex Older People: The Case For
This article discusses the evidence for OAB treatment in the frail or medically complex elderly, outlines where caution should be exercised, giving examples from the recent literatu re, and advocates for an active approach for this group, who are often left without any treatment. (Source: Drugs and Aging)
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Anticholinergic Drugs for Overactive Bladder in Frail Older Patients: The Case Against
This article reviews evidence for the efficacy and safety of these drugs, especially when prescribed for frail older people. Although ADs have a small but statistically significant benefit for UI in non-frail people, the vast majority choose to discontinue treatment because they feel that the beneficial effects do not outweigh the burden of taking the medication. Not only are the most frail older people more likely to experience adverse effects but there is also no evidence that these drugs are effective for UI. In addition, there is a mounting body of evidence that they impair cognitive function. The continued use of ADs ...
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study
ConclusionAnticholinergic burden is associated with greater decline in objectively measured physical activity over time in older people, a finding not seen with hypnotic or opioid use. (Source: Drugs and Aging)
Source: Drugs and Aging - September 1, 2018 Category: Geriatrics Source Type: research

The Role of Targeted Agents and Immunotherapy in Older Patients with Non-small Cell Lung Cancer
AbstractLung cancer is predominantly a disease of the elderly. This subgroup of patients poses many challenges and an appropriate geriatric assessment is crucial for treatment personalisation in order to reduce the risk of over- or under-treatment. Whilst cytotoxic chemotherapy has been the backbone of advanced non-small cell lung cancer (NSCLC) treatment for decades, the development of targeted agents for driver mutations such asEGFR,ALK,BRAF andROS1 has changed the treatment paradigm and natural history of this disease. More recently, the development of immune checkpoint inhibitors has revolutionised treatment for a larg...
Source: Drugs and Aging - August 14, 2018 Category: Geriatrics Source Type: research

Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study
ConclusionAnticholinergic burden is associated with greater decline in objectively measured physical activity over time in older people, a finding not seen with hypnotic or opioid use. (Source: Drugs and Aging)
Source: Drugs and Aging - August 14, 2018 Category: Geriatrics Source Type: research