Pharmacological Pain Treatment in 2012 and 2017 Among Older People with Major Neurocognitive Disorder
ConclusionsThe results indicate that on a population level, pharmacological drug treatment has changed in line with guidelines between 2012 and 2017, with an increase in paracetamol and strong opioids and a decrease in non-steroidal anti-inflammatory drugs and tramadol. The relatively high prevalence of opioids warrants concern given the significant risk of adverse effects among older people with major neurocognitive disorder. (Source: Drugs and Aging)
Source: Drugs and Aging - October 19, 2021 Category: Geriatrics Source Type: research

Efficacy and Safety of Oral P2Y12 Inhibitors in Older Patients with Acute Coronary Syndrome: A Frequentist Network Meta-Analysis
ConclusionsNo significant difference is observed between the three P2Y12 inhibitors in study-defined MACE. Ranking byp-score suggests prasugrel as the best P2Y12 inhibitor to reduce the risk of MACE while clopidogrel is a better alternative than ticagrelor in older patients with acute coronary syndrome to decrease the risk of major bleeding. Because of a lack of individual-patient data analysis and heterogeneity amongst studies, future studies representing older patients with acute coronary syndrome are required to strengthen evidence regarding optimal antithrombotic therapy in this cohort. (Source: Drugs and Aging)
Source: Drugs and Aging - October 19, 2021 Category: Geriatrics Source Type: research

Clinical Considerations for Insulin Therapy in Older Adults with Type 1 Diabetes
AbstractType 1 diabetes represents an autoimmune condition with a strong inherited background, and its incidence is increasing worldwide. About 25% of such cases are diagnosed in adulthood, some even as late as the ninth decade of life. The number of older adults with type 1 diabetes is increasing due to improvements in care and decreased mortality rate. However, there is a lack of clinical trials in people older than 70 years of age with type 1 diabetes complicated with comorbidities, frailty, and dependency. The management of type 1 diabetes and the goals of therapy should be individualized based on the patient's health ...
Source: Drugs and Aging - October 19, 2021 Category: Geriatrics Source Type: research

Prevalence and Factors Associated with Potential Drug-Drug Interactions in Older Community-Dwelling Adults: A Prospective Cohort Study
This study aimed to determine the prevalence and factors associated with potential ‘severe’ cardiovascular and CNS DDIs among older (≥ 70 years) community-dwellers.MethodsThis was a prospective cohort study using linked data from a national pharmacy claims database and waves 1 and 2 of The Irish LongituDinal study on Ageing (TILDA). ‘Severe’ cardiovascular and CNS DDIs were identified using the British National Formulary 77 and Stockley’s Drug Interactions. The prevalence of ‘severe’ DDIs (any DDI vs. none) was calculated. Logistic regression was used to examine the associa...
Source: Drugs and Aging - October 11, 2021 Category: Geriatrics Source Type: research

Diagnostic and Management Strategies for Patients with Chronic Prostatitis and Chronic Pelvic Pain Syndrome
AbstractChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common and often heterogenous condition that can have severe consequences on patient quality of life. In this review, we describe the pathophysiology, diagnostic work-up, and treatment of patients with CP/CPPS incorporating the most recent literature. Studies have demonstrated that CP/CPPS involves a complex pathophysiology, including infectious, immunologic, neurologic, endocrinologic, and psychologic etiologies, with frequent intersections between the different entities. Despite robust research assessing a variety of therapeutics targeting these etio...
Source: Drugs and Aging - September 29, 2021 Category: Geriatrics Source Type: research

Impact of Pharmacotherapy on Insomnia in Patients with Alzheimer ’s Disease
The objective of this review was to provide the clinician with an overview of treatment strategies that may have value in the treatment of disturbed sleep in Alzheimer’s disease. Nonpharmacological approaches to treatment should be exhausted foremost; however, pharmacotherapy may be needed in certain clinical scenarios, which can be a challenge for clinicians given the paucity of evidence and guidelines for treatment in the subpopulation of Alzheimer’s disease. Agents such as sedating antidepressants, melatonin, and site-spe cific γ-aminobutyric acid agonists are often employed based on historical usage b...
Source: Drugs and Aging - September 27, 2021 Category: Geriatrics Source Type: research

Clinical Safety Considerations of Integrase Strand Transfer Inhibitors in the Older Population  Living with HIV
AbstractThere are approximately 40 million people living with HIV globally, and 21% (7.9 million) are older adults (aged>  50 years) as of 2019. The average age of HIV-positive patients is predicted to increase to 58 by 2035. The favorable clinical efficacy of integrase strand transfer inhibitors has led to high rates of viral suppression and have now become the preferred agents by the AIDS guideline when initiating antiretroviral therapy. There are concerns of increasing adverse effects from HIV medications, such as integrase strand transfer inhibitors, as a result of changes in pharmacodynamic and pharmacokinet...
Source: Drugs and Aging - September 8, 2021 Category: Geriatrics Source Type: research

Problematic Opioid Use Among Older Adults: Epidemiology, Adverse Outcomes and Treatment Considerations
AbstractWith the aging population, an increasing number of older adults (>  65 years) will be affected by problematic opioid use and opioid use disorder (OUD), with both illicit and prescription opioids. Problematic opioid use is defined as the use of opioids resulting in social, medical or psychological consequences, whereas OUD is a form of problematic use that meets di agnostic criteria as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Problematic use of opioids by older adults is associated with a number of pertinent adverse effects, including sedation, cognitive impairment, ...
Source: Drugs and Aging - September 7, 2021 Category: Geriatrics Source Type: research

Direct Oral Anticoagulants and Non-valvular Atrial Fibrillation: Compliance with Dose Level Guidelines in Patients Aged 80  Years and Over
ConclusionsAmong patients with non-valvular atrial fibrillation aged 80 years and over, about 40% of DOAC prescriptions feature inappropriate dose levels. It might be possible to reduce inappropriate dosing by raising awareness among hospital-based and private-practice prescribers, providing prescription support tools for DOACs, and performing medication reconciliations and reviews at hospital and in private practice. (Source: Drugs and Aging)
Source: Drugs and Aging - September 6, 2021 Category: Geriatrics Source Type: research

Evaluation of Renal Function Testing in Older Australian Veterans Dispensed Medicines that Require Renal Function Monitoring
AbstractIntroductionRenal function testing should be performed prior to initiating medicines that require dose adjustment in renal impairment, with ongoing monitoring in continued use, particularly in older people. There is little evidence regarding the extent to which renal function monitoring is performed in older Australians dispensed medicines requiring renal function monitoring.ObjectiveThe aim of this study was to determine the extent of renal function testing in older people dispensed medicines requiring renal function monitoring.MethodsA retrospective analysis of administrative claims data from the Australian Gover...
Source: Drugs and Aging - September 6, 2021 Category: Geriatrics Source Type: research

Targeted Agents for HER2-Positive Breast Cancer: Optimal Use in Older Patients
AbstractThe human epidermal growth factor-2 (HER2) gene is overexpressed in 15 –20 % of all breast cancers. HER2 overexpression is a predictive factor in breast cancer and is associated with high rates of disease recurrence and death in the absence of adjuvant systemic therapy. With the advent of HER2-directed therapies, there has been a significant improvement in the outcom e of HER2-positive (HER2+) breast cancer in all clinical settings. Patients aged>  65 years remain under-represented in most clinical trials. Existing literature suggests that older patients with HER2+ disease derive a similar benefit fro...
Source: Drugs and Aging - August 23, 2021 Category: Geriatrics Source Type: research

Sex Differences in Association Between Anti-Hypertensive Medications and Risk of COVID-19 in Middle-Aged and Older  Adults
ConclusionsThe study suggested sex differences in the risk of death from COVID-19 with the use of ACEI and ARB among middle-aged and older adults. Sex differences in the risk of hospitalization for COVID-19 with the use of CCB was observed as well. It is of clinical importance that clinicians adopt different CVD treatment approaches for female and male patients with COVID-19. (Source: Drugs and Aging)
Source: Drugs and Aging - August 18, 2021 Category: Geriatrics Source Type: research

Prevalence of Musculoskeletal Pain and Analgesic Treatment Among Community-Dwelling Older Adults: Changes from 1999 to 2019
ConclusionsPain remains undertreated in the community-dwelling older population, although the use of regular prescribed analgesics increased between 1999 and 2019. The use of NSAIDs has decreased, while the use of paracetamol has increased. Daily opioid use has remained modest. (Source: Drugs and Aging)
Source: Drugs and Aging - August 13, 2021 Category: Geriatrics Source Type: research

Anticholinergic Burden and Associated Healthcare Resource Utilization in Older Adults with Overactive Bladder
ConclusionsIn older adults with OAB, higher anticholinergic burden before initiating OAB drugs is associated with higher HRU and costs. When making treatment decisions in older adults, consideration should be given to assessing the existing anticholinergic burden and using OAB treatments that do not add to this burden. (Source: Drugs and Aging)
Source: Drugs and Aging - August 13, 2021 Category: Geriatrics Source Type: research

Use of Hormone Therapy in Postmenopausal Women with Alzheimer ’s Disease: A Systematic Review
ConclusionBoth observational and controlled clinical trials had methodological issues and discrepancies in inclusion criteria and HT protocols. These inconsistencies made it difficult to establish an association between HT and AD. (Source: Drugs and Aging)
Source: Drugs and Aging - August 3, 2021 Category: Geriatrics Source Type: research

Management of the Older Patient with Myelodysplastic Syndrome
AbstractNo two diagnoses of myelodysplastic syndrome are genuinely alike, owing to differing and dynamic mutational topography and epigenetic aberrancy. Consequently, no two patients with myelodysplastic syndrome are identical and disease-specific and patient-specific factors are considered in formulating the optimal treatment, which includes few that are disease modifying. Age itself should not be an absolute contraindication to therapy, including intensive therapy such as allogeneic hematopoietic stem cell transplantation, which is the only curative therapy. However, age associates with an increased prevalence of frailty...
Source: Drugs and Aging - August 3, 2021 Category: Geriatrics Source Type: research

Hormone Treatment and Alzheimer ’s Disease: Déjà Vu or Confused All Over Again?
(Source: Drugs and Aging)
Source: Drugs and Aging - August 3, 2021 Category: Geriatrics Source Type: research

Non-steroidal Anti-inflammatory Drug Use and Risk of Age-Related Macular Degeneration in the California Teachers Study
ConclusionThe decrease in risk of intermediate- or late-stage AMD among women who reported regular use of low-dose aspirin or specific COX-2 inhibitors suggests a possible protective role for medications with COX-2 inhibitory properties or aspirin at doses used for cardiovascular disease prevention. (Source: Drugs and Aging)
Source: Drugs and Aging - July 26, 2021 Category: Geriatrics Source Type: research

MediQuit, an Electronic Deprescribing Tool for Patients on Polypharmacy: Results of a Feasibility Study in German General Practice
DiscussionMediQuit assists in identifying concrete deprescribing opportunities, patient involvement, and shared decision making. The three-step deprescribing procedure is well-accepted once initial organizational efforts are overcome. After revision, further studies are needed to enhance the quality of evidence on acceptance and effectiveness. (Source: Drugs and Aging)
Source: Drugs and Aging - July 12, 2021 Category: Geriatrics Source Type: research

Impact of Fall Risk and Direct Oral Anticoagulant Treatment on Quality-Adjusted Life-Years in Older Adults with Atrial Fibrillation: A Markov Decision Analysis
ConclusionsOlder adults with atrial fibrillation benefit from stroke protection of anticoagulants, especially direct oral anticoagulants, even if they are at high risk of falls. Clinicians should not consider fall risk as a deciding factor for withholding anticoagulation in this population of patients. (Source: Drugs and Aging)
Source: Drugs and Aging - July 8, 2021 Category: Geriatrics Source Type: research

Safety and Tolerability of Natural and Synthetic Cannabinoids in Older Adults: A Systematic Review and Meta-Analysis of Open-Label Trials and Observational Studies
ConclusionsAlthough cannabinoid-based medications were generally safe and acceptable to adults aged over 50 years, these estimates are limited by the lack of a control condition and considerable heterogeneity. Nevertheless, they complement and are consistent with comparable evidence from randomised controlled trials. (Source: Drugs and Aging)
Source: Drugs and Aging - July 8, 2021 Category: Geriatrics Source Type: research

Fibromyalgia in Older Individuals
AbstractFibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmaco...
Source: Drugs and Aging - July 8, 2021 Category: Geriatrics Source Type: research

What Makes Deprescription of Psychotropic Drugs in Nursing Home Residents with Dementia so Challenging? A Qualitative Systematic Review of Barriers and Facilitators
ConclusionsDeprescribing psychotropic drugs used for behavioral and psychological symptoms of dementia in nursing home residents is challenging. Resources need to be in place for deprescribing, as well as there being a focus on the positive patient-related outcomes of doing so. Managerial support, staff routines, and interprofessional collaboration are some factors facilitating the process, in addition to there being routines and systematic procedures in place allowing for operationality and a common understanding. Addressing these barriers and facilitators is necessary to ensure that deprescribing can be understood as mea...
Source: Drugs and Aging - July 7, 2021 Category: Geriatrics Source Type: research

A Propensity Score Matched Approach to Assess the Associations of Commonly Prescribed Medications with Fall Risk in a Large Harmonized Cohort of Older Ambulatory Persons
ConclusionMany commonly prescribed medication classes showed no associations with fall risk in a relatively healthy population of community-dwelling older persons. However, the treatment effects and risks can be heterogeneous between individuals. Therefore, focusing on identification of individuals at risk is warranted to optimize personalized falls prevention. (Source: Drugs and Aging)
Source: Drugs and Aging - July 5, 2021 Category: Geriatrics Source Type: research

Pulmonary Tuberculosis in Older Adults: Increased Mortality Related to Tuberculosis Within Two Months of Treatment Initiation
AbstractBackgroundThe proportion of tuberculosis (TB) patients who are older adults is increasing worldwide. Nearly 60% of TB patients in Japan are 70 years or older, and the TB incidence rate in Japan is one of the highest among high-income countries. The previous TB treatment guidelines prior to 2018 in Japan recommended excluding pyrazinamide (PZA) from the initial regimen for patients aged over 80 years.ObjectivesWe aimed to examine differences in TB treatment outcomes among different age groups, and between those who received PZA and those who did not.MethodsWe performed a retrospective cohort study of patients with p...
Source: Drugs and Aging - July 5, 2021 Category: Geriatrics Source Type: research

Diagnosis and Management of Pain in Parkinson's Disease: A New Approach
AbstractPain is a frequent and disabling non-motor feature of Parkinson ’s disease (PD). The recently proposed PD Pain Classification System (PD-PCS) allows for an association of pain with PD to be determined before being allocated to the main pain mechanism (i.e. nociceptive, neuropathic, and nociplastic). In this article, previous studies on treatments for pain in P D are summarized according to the pain mechanisms. A mechanistic approach to treatment is discussed. We suggest that the first step should be optimizing dopaminergic therapy before other therapy is started. When these treatments remain unsuccessful, fur...
Source: Drugs and Aging - July 5, 2021 Category: Geriatrics Source Type: research

Attitudes to Drug Use in Residential Aged Care Facilities: A Cross-Sectional Survey of Nurses and Care Staff
ConclusionsTo successfully and sustainably optimise medication use in RACF residents, it is important to consider the variation in views of nurses and care staff. (Source: Drugs and Aging)
Source: Drugs and Aging - June 25, 2021 Category: Geriatrics Source Type: research

Current Insights into Treating Vertigo in Older Adults
AbstractThe number of older people has been increasing over recent decades in Western populations. Dizziness, imbalance, and vertigo constitute some of the most common complaints in older patients, and risk of falling is the most frequent and worrying consequence. It has been reported that 15 –20% of the adult population experiences these debilitating symptoms. Among the diseases that may be associated with vertigo, the three classes of otological, central, and functional (psychological) dizziness may be distinguished. Overall, vestibular disorders account for 48% of vertiginous compla ints in the older population. T...
Source: Drugs and Aging - June 23, 2021 Category: Geriatrics Source Type: research

Risk of Fractures in Older Adults with Chronic Non-cancer Pain Receiving Concurrent Benzodiazepines and Opioids: A Nested Case –Control Study
ConclusionThe concurrent use of benzodiazepines and opioids was associated with an increased risk of fractures in older patients with chronic non-cancer pain. Therefore, patients continuously receiving benzodiazepines in whom opioids are newly initiated need careful monitoring, and such combined therapy should be limited to the shortest duration possible. (Source: Drugs and Aging)
Source: Drugs and Aging - June 23, 2021 Category: Geriatrics Source Type: research

Systemic Treatment for Older Patients with Unresectable Hepatocellular Carcinoma
AbstractThe incidence rate of hepatocellular carcinoma is growing and age at diagnosis is increasing; however, despite the unprecedented wealth of therapeutic options for advanced HCC, its optimal management in some categories, such as older adults, is yet to be defined. Even though age is not an exclusion criterion per se, most of the landmark trials enrolled a limited number of senior patients, raising some concerns on the potential benefit of active treatments in this group. The identification of more vulnerable patients remains a crucial issue in clinical practice. In fact, the suitability assessment for systemic thera...
Source: Drugs and Aging - June 21, 2021 Category: Geriatrics Source Type: research

Management of Metastatic Colorectal Carcinoma in Older Adults: Balancing Risks and Benefits of Novel Therapies
AbstractThe prevalence of older patients with metastatic colorectal cancer (mCRC) will continue to increase with our aging population. Treatment of mCRC has changed significantly in the last few decades as we have learned how to personalize the treatment of mCRC to the biology of the tumor, utilizing new treatment approaches. With an ever-changing treatment paradigm, managing the population of older adults becomes paramount. This review highlights the pivotal clinical trials that defined the use of systemic therapy, immunotherapy and targeted therapies for mCRC, and how those are applied to the older patient population. In...
Source: Drugs and Aging - June 18, 2021 Category: Geriatrics Source Type: research

Vaccination in Older Adults: An Underutilized Opportunity to Promote Healthy Aging in India
AbstractOver the last 50 years, the Indian population aged 50 years and above (older adults) has quadrupled and is expected to comprise 404 million people in 2036, representing 27% of the country ’s projected population. Consequently, the contribution of chronic disease to older adults’ total burden of diseases in India is likely to escalate. Disease burden is notably amplified by immunosenescence, a deterioration of the immune system that develops with age, leading to increasing suscept ibility to infectious diseases and other comorbidities. Older adults with infectious diseases have a higher incidence and lik...
Source: Drugs and Aging - June 14, 2021 Category: Geriatrics Source Type: research

Correction to: A Structured Literature Review and International Consensus Validation of FORTA Labels of Oral Anticoagulants for Long-Term Treatment of Atrial Fibrillation in Older Patients (OAC-FORTA 2019)
A correction to this paper has been published: https://doi.org/10.1007/s40266-021-00873-3 (Source: Drugs and Aging)
Source: Drugs and Aging - June 14, 2021 Category: Geriatrics Source Type: research

Gout Flare Burden, Diagnosis, and Management: Navigating Care in Older Patients with Comorbidity
AbstractGout is the most common form of inflammatory arthritis, and its incidence is highest in middle-aged and older patients. Adding to the diagnostic complexity, up to 50% of patients aged>  65 years present atypically, with subacute oligo- or polyarticular flares. Comorbidity and polypharmacy, common in older populations, affect real-world treatment decisions in gout management, and no specific guidelines are available to address these issues in these at-risk groups. Despite the gro wing public health burden posed by gout, suboptimal management has led to increased morbidity and substantial healthcare utiliza...
Source: Drugs and Aging - June 9, 2021 Category: Geriatrics Source Type: research

Differences in Health-Related Quality of Life Among Adults with a Potential Dihydropyridine Calcium Channel Blocker –Loop Diuretic Prescribing Cascade
ConclusionsNew loop diuretic use was associated with lower physical functioning among DH CCB users. These findings suggest that this potential prescribing cascade may result in both significant and clinically meaningful decreases in health-related quality of life. It is important for clinicians to avoid or intervene on this inappropriate prescribing cascade when possible. (Source: Drugs and Aging)
Source: Drugs and Aging - June 7, 2021 Category: Geriatrics Source Type: research

Adjunctive Perampanel in Older Patients With Epilepsy: A Multicenter Study of Clinical Practice
ConclusionsAdjunctive perampanel was associated with improvement in seizure control and good tolerability in a real-life setting and can represent a viable therapeutic option in older patients with epilepsy. (Source: Drugs and Aging)
Source: Drugs and Aging - June 2, 2021 Category: Geriatrics Source Type: research

Ghent Older People ’s Prescriptions Community Pharmacy Screening (GheOP3S)-Tool Version 2: Update of a Tool to Detect Drug-Related Problems in Older People in Primary Care
ConclusionGheOP3S-criteria were revised and updated according to experts ’ agreement on their clinical relevance and recent scientific evidence. Future studies should investigate the impact of pharmacist-led medication reviews with GheOP3S-tool version 2 on clinical, humanistic and economic outcomes in primary care. (Source: Drugs and Aging)
Source: Drugs and Aging - June 1, 2021 Category: Geriatrics Source Type: research

Antimuscarinic Cascade Across Individual Cholinesterase Inhibitors in Older Adults with Dementia
ConclusionThis study found that donepezil use is more likely to lead to antimuscarinic cascade than rivastigmine. Future studies are needed to determine the potential consequences of this cascade in dementia. (Source: Drugs and Aging)
Source: Drugs and Aging - May 24, 2021 Category: Geriatrics Source Type: research

Ghent Older People ’s Prescriptions Community Pharmacy Screening (GheOP 3 S)-Tool Version 2: Update of a Tool to Detect Drug-Related Problems in Older People in Primary Care
ConclusionGheOP3S-criteria were revised and updated according to experts ’ agreement on their clinical relevance and recent scientific evidence. Future studies should investigate the impact of pharmacist-led medication reviews with GheOP3S-tool version 2 on clinical, humanistic and economic outcomes in primary care. (Source: Drugs and Aging)
Source: Drugs and Aging - May 3, 2021 Category: Geriatrics Source Type: research

Major Depressive Disorder in Older Patients as an Inflammatory Disorder: Implications for the Pharmacological Management of Geriatric Depression
AbstractDepression is a common and highly disabling condition in older adults. It is a heterogenous disorder and there is emerging evidence of a link between inflammation and depression in older patients, with a possible inflammatory subtype of depression. Persistent low-level inflammation, from several sources including psychological distress and chronic disease, can disrupt monoaminergic and glutaminergic systems to create dysfunctional brain networks. Despite the evidence for the role of inflammation in depression, there is insufficient evidence to recommend use of any putative anti-inflammatory agent in the treatment o...
Source: Drugs and Aging - April 29, 2021 Category: Geriatrics Source Type: research

Correction to: The Influence of Age on Central Effects of Methylnaltrexone in Patients with Opioid-Induced Constipation
A correction to this paper has been published: https://doi.org/10.1007/s40266-021-00860-8 (Source: Drugs and Aging)
Source: Drugs and Aging - April 23, 2021 Category: Geriatrics Source Type: research

Trends in Anticoagulant Use at Nursing Home Admission and Variation by Frailty and Chronic Kidney Disease Among Older Adults with Atrial Fibrillation
AbstractBackgroundAtrial fibrillation (AF) is relatively common among nursing home residents, and decisions regarding anticoagulant therapy in this setting may be complicated by resident frailty and other factors.ObjectivesThe aim of this study was to examine trends and correlates of oral anticoagulant use among newly admitted nursing home residents with AF following the approval of direct-acting oral anticoagulants (DOACs).MethodsWe conducted a retrospective cohort study of all adults aged>  65 years with AF who were newly admitted to nursing homes in Ontario, Canada, between 2011 and 2018 (N  =  36,46...
Source: Drugs and Aging - April 21, 2021 Category: Geriatrics Source Type: research

Comment on “Safety of Janus Kinase Inhibitors in Older Patients: A Focus on the Thromboembolic Risk”
(Source: Drugs and Aging)
Source: Drugs and Aging - April 19, 2021 Category: Geriatrics Source Type: research

Authors ’ Reply to Moura et al.: “Safety of Janus Kinase Inhibitors in Older Patients: A Focus on the Thromboembolic Risk”
(Source: Drugs and Aging)
Source: Drugs and Aging - April 19, 2021 Category: Geriatrics Source Type: research

Efficacy and Safety of the Association of Nimodipine and Choline Alphoscerate in the Treatment of Cognitive Impairment in Patients with Cerebral Small Vessel Disease. The CONIVaD Trial
ConclusionPatients ’ adherence to treatment was low. With this limitation, the combined choline alphoscerate–nimodipine treatment showed no significant effect in our cohort of VCI patients with SVD. The safety profile was good overall.Trial RegistrationClinical Trial NCT03228498. Registered 25 July 2017. (Source: Drugs and Aging)
Source: Drugs and Aging - April 15, 2021 Category: Geriatrics Source Type: research

International Validation of the Turkish Inappropriate Medication Use in the Elderly (TIME) Criteria Set: A Delphi Panel Study
ConclusionWe developed the internationally validated TIME criteria set based on a Delphi process involving international experts. The validation study suggests that the TIME criteria set can be applied in both central and Eastern European settings. Further studies are needed to assess the utility and benefit of the TIME criteria in reducing inappropriate drug use and improving clinical outcomes. (Source: Drugs and Aging)
Source: Drugs and Aging - April 13, 2021 Category: Geriatrics Source Type: research

The Influence of Age on Central Effects of Methylnaltrexone in Patients with Opioid-Induced Constipation
AbstractBackgroundMethylnaltrexone, a peripherally acting µ-opioid receptor antagonist approved for the treatment of opioid-induced constipation (OIC), has restricted diffusion across the blood–brain barrier (BBB) and has not been demonstrated to impact opioid-induced central analgesia. Age-related changes in BBB permeability may compromise methylnaltre xone’s restricted diffusion and alter opioid-induced central analgesic effects.ObjectiveThis analysis evaluated whether opioid analgesia is compromised in older adults receiving methylnaltrexone for OIC.MethodsThe analysis included adults diagnosed with OI...
Source: Drugs and Aging - March 31, 2021 Category: Geriatrics Source Type: research

Drug –Drug Interactions in Patients with COVID-19 in Nursing Homes
(Source: Drugs and Aging)
Source: Drugs and Aging - March 31, 2021 Category: Geriatrics Source Type: research

Antipsychotic Initiation Among Older Dementia Patients Using Cholinesterase Inhibitors: A National Retrospective Cohort Study
ConclusionThe study found a 27% increased risk of antipsychotic initiation among users of rivastigmine compared with donepezil users. There was no difference between galantamine and donepezil for antipsychotic initiation. Although the limitations of the study should be considered, the results suggest that donepezil or galantamine may be more appropriate treatments for older patients with dementia, to minimize antipsychotic use. (Source: Drugs and Aging)
Source: Drugs and Aging - March 25, 2021 Category: Geriatrics Source Type: research

Clinical Experience with Extended-Release Tacrolimus in Older Adult Kidney Transplant Recipients: A Retrospective Cohort Study
ConclusionsOlder adult recipients required significantly lower LCP-Tac doses compared with younger recipients and with the FDA-labeled starting dose. There were no differences in graft outcomes or adverse effects in older adult patients who received LCP-Tac versus IR-Tac. (Source: Drugs and Aging)
Source: Drugs and Aging - March 23, 2021 Category: Geriatrics Source Type: research