Assessment of Comorbidity Burden and Treatment Response: Reanalysis of the SCD-HEFT Trial
ConclusionsIncreasing comorbidity burden was associated with HTE when evaluating amiodarone and ICD compared with placebo in the SCD-HeFT trial. Our results highlight the importance of enrolling diverse patient populations in clinical trials and considering the possibility of HTE when translating results to clinical practice. (Source: Drugs and Aging)
Source: Drugs and Aging - February 1, 2022 Category: Geriatrics Source Type: research
Onychomycosis in Older Adults: Prevalence, Diagnosis, and Management
AbstractThe risk of having onychomycosis increases with age. Data suggest that the prevalence of onychomycosis may be ≥ 20% in subjects aged ≥ 60 years and ≥ 50% in those aged ≥ 70 years. Older males are 2.1 times more prone to onychomycosis than are females. Although most nail dystrophies (approximately 50%) are caused by onychomycosis, proper clinical assessment followed by mycological examination is recommended to exclude other conditions such as nail trauma, lichen planus, and psoriasis. The US FDA-approved onychomycosis treatments are systemic antifungals (terbinafine and itraconazole) for severe onychomyc...
Source: Drugs and Aging - February 1, 2022 Category: Geriatrics Source Type: research
Complement Mediators in Development to Treat Age-Related Macular Degeneration
AbstractOver recent years, great attention has been paid to the role of the complement system in the pathogenesis of age-related macular degeneration (AMD). In particular, several studies have highlighted a link between AMD development and complement dysregulation, which can probably be explained as a complement cascade hyperactivation resulting from the presence of a series of risk factors such as aging; smoking; obesity; alcohol consumption; exposure to pesticides, industrial chemicals, or pollution; and other causes of oxidative stress. This hypothesis has been mainly supported by the presence of complement mediators as...
Source: Drugs and Aging - January 20, 2022 Category: Geriatrics Source Type: research
Pharmacological Treatment in the Management of Glenohumeral Osteoarthritis
AbstractGlenohumeral osteoarthritis (GH-OA) is a common cause of shoulder pain and is characterized by articular cartilage thinning, glenoid bone loss and deformity, osteophytosis, and other associated changes. The prevalence is estimated to be between 85 and 94% in men and women over the age of 80 years. A diagnosis of GH-OA is established based on clinical history, physical examination, and radiographic assessments. Non-pharmacological treatment options may serve as adjuvants to other therapies and should be incorporated for a more holistic approach to management. Pharmacological treatment s include oral agents such as...
Source: Drugs and Aging - January 19, 2022 Category: Geriatrics Source Type: research
Medical Cannabis Use Among Older Adults in Canada: Self-Reported Data on Types and Amount Used, and Perceived Effects
This study describes the patterns of use of medical cannabis by older adults and highlights the need for research to determine appropriate indications, precise doses of active ingredients, and short- and long-term outcomes among older adults. (Source: Drugs and Aging)
Source: Drugs and Aging - December 23, 2021 Category: Geriatrics Source Type: research
Management of Hyperglycemia in Older Adults with Type 2 Diabetes
AbstractThe increasing incidence of type 2 diabetes in the general population as well as enhanced life expectancy has resulted in a rapid rise in the prevalence of diabetes in the older population. Diabetes causes significant morbidity and impairs quality of life. Managing diabetes in older adults is a daunting task due to unique health and psychosocial challenges. Medical management is complicated by polypharmacy, cognitive impairment, urinary incontinence, injurious falls, and persistent pain. Health care providers now have several traditional and contemporary pharmacologic agents to manage diabetes. Avoidance of hypogly...
Source: Drugs and Aging - December 18, 2021 Category: Geriatrics Source Type: research
Highly Variable Paracetamol Pharmacokinetics After Multiple Oral Dosing in Frail Older People: A Population Pharmacokinetic Analysis
ConclusionA population of average geriatric inpatients achieved target Css-mean with paracetamol 1000 mg q6h, while q8h resulted in underexposure for the majority of them. Due to high unexplained variability, a relevant proportion remained either above or below the target concentration of 10 mg/L. Research focusing on PK, efficacy and safety is needed to recommend dosing regimens. (Source: Drugs and Aging)
Source: Drugs and Aging - December 17, 2021 Category: Geriatrics Source Type: research
Neuropsychiatric Systemic Lupus Erythematosus in Older Adults: Diagnosis and Management
AbstractSystemic lupus erythematosus (SLE) is a multisystem chronic autoimmune disease with variable clinical manifestations. Neuropsychiatric systemic lupus erythematosus (NPSLE) includes the neurologic syndromes of the central, peripheral and autonomic nervous system and the psychiatric syndromes observed in patients with SLE. Neuropsychiatric systemic lupus erythematosus events may present as an initial manifestation of SLE or may be diagnosed later in the course of the disease. Older adults with NPLSE include those who are ageing with known SLE and those with late-onset SLE. The diagnosis of NPSLE across the lifespan c...
Source: Drugs and Aging - December 16, 2021 Category: Geriatrics Source Type: research
Non-Steroidal Anti-Inflammatory Drugs and Risk of Acute Kidney Injury and Hyperkalemia in Older Adults: A Retrospective Cohort Study and External Validation of a Clinical Risk Model
ConclusionsLonger NSAID duration and systemic compared with topical route were associated with incremental odds for acute renal events. Further studies are required to improve the available risk model to guide NSAID prescriptions in older adults. (Source: Drugs and Aging)
Source: Drugs and Aging - December 10, 2021 Category: Geriatrics Source Type: research
Prevention of Chemotherapy-Induced Nausea and Vomiting in the Older Patient: Optimizing Outcomes
AbstractChemotherapy-induced nausea and vomiting (CINV) are still two of the most feared side effects of cancer therapy. Although major progress in the prophylaxis of CINV has been made during the past 40 years, nausea in particular remains a significant problem. Older patients have a lower risk of CINV than younger patients, but are at a higher risk of severe consequences of dehydration and electrolyte disturbances following emesis. Age-related organ deficiencies, comorbidities, polypharmacy, risk of drug–drug interactions, and lack of compliance all need to be addressed in the older patient with cancer at risk of CIN...
Source: Drugs and Aging - December 9, 2021 Category: Geriatrics Source Type: research
Frequency and Acceptance of Clinical Decision Support System-Generated STOPP/START Signals for Hospitalised Older Patients with Polypharmacy and Multimorbidity
ConclusionThe involvement of an expert team in translating population-based CDSS signals to individual patients is essential, as more than half of the signals for potential overuse, underuse, and misuse were not deemed clinically appropriate in a hospital setting. Patient-related potential determinants were poor predictors of acceptance. Future research investigating factors that affect patients ’ and physicians’ agreement with medication changes recommended by expert teams may provide further insight for implementation in clinical practice.RegistrationClinicalTrials.gov Identifier: NCT02986425. (Source: Drugs and Aging)
Source: Drugs and Aging - December 8, 2021 Category: Geriatrics Source Type: research
The Effect of Aspirin on the Primary Prevention of Major Adverse Cardiac and Cerebrovascular Events in Chinese Older Adults: A Registration Study
ConclusionsThere were no significant benefits from using aspirin as primary prevention for MACCE in older Chinese adults. (Source: Drugs and Aging)
Source: Drugs and Aging - December 6, 2021 Category: Geriatrics Source Type: research
Renal Function, Cardiovascular Diseases, Appropriateness of Drug Prescription and Outcomes in Hospitalized Older Patients
ConclusionsIn older hospitalized patients, impaired eCrCl is prevalent and associated with several factors, polypharmacy in particular. Patients with reduced eCrCl have a higher risk of major clinical outcomes, and> 10% of them are prescribed an inappropriate drug, with a higher risk for major clinical outcomes. (Source: Drugs and Aging)
Source: Drugs and Aging - December 3, 2021 Category: Geriatrics Source Type: research
Safety of Remdesivir for Patients 80 Years of Age or Older with Coronavirus Disease 2019 (COVID-19)
ConclusionsThe safety of remdesivir was suggested to be comparable between patients older than 80 years of age and patients younger than 80 years of age. The results of this study may encourage the administration of remdesivir to this older patient group. (Source: Drugs and Aging)
Source: Drugs and Aging - December 2, 2021 Category: Geriatrics Source Type: research
Anticholinergic and Sedative Medications and Dynamic Gait Parameters in Older Patients
ConclusionsThese findings show that in older patients with comorbidities, cumulative anticholinergic and sedative exposure is associated with poorer function on multiple gait dimensions. (Source: Drugs and Aging)
Source: Drugs and Aging - December 2, 2021 Category: Geriatrics Source Type: research
