Acknowledgement to Referees
(Source: Drugs and Aging)
Source: Drugs and Aging - November 22, 2021 Category: Geriatrics Source Type: research
Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models
ConclusionsVariability and inconsistency exists among scales used to categorize drugs with anticholinergic or sedative burden. In this review, we provide a comprehensive table that proposes a new categorization of these drugs. A longitudinal study will be required to validate the new proposed anticholinergic and sedative burden catalog in an evidence-based manner. (Source: Drugs and Aging)
Source: Drugs and Aging - November 9, 2021 Category: Geriatrics Source Type: research
A 12-Year Retrospective Study of the Prevalence of Anticholinergic Polypharmacy and Associated Outcomes Among Medicare Patients with Overactive Bladder in the USA
ConclusionsAnticholinergic polypharmacy was uncommon among older adults with overactive bladder. Prevalence was higher among women and nursing home residents, and it was associated with negative outcomes, highlighting potential longitudinal implications of anticholinergic burden. (Source: Drugs and Aging)
Source: Drugs and Aging - November 8, 2021 Category: Geriatrics Source Type: research
Safety and Effectiveness of Immune Checkpoint Inhibitors in Older Patients with Cancer: A Systematic Review of 48 Real-World Studies
ConclusionsOur findings suggest that ICIs could be safely administered in older individuals with comparable survival outcomes with respect to younger individuals. Future studies should include some form of geriatric assessment to improve patient stratification. (Source: Drugs and Aging)
Source: Drugs and Aging - October 20, 2021 Category: Geriatrics Source Type: research
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
Conclusion‘Severe’ cardiovascular and CNS DDIs are prevalent in older community-dwellers in Ireland, and those with polypharmacy and depression are at a significantly increased risk. (Source: Drugs and Aging)
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 but are not ne...
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 pharmacokinetic pa...
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, fall...
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
ConclusionMedicines that require renal function monitoring are commonly used in older Australians, and while the majority have claims for tests that include renal function, some are missing out. (Source: Drugs and Aging)
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 from anti-H...
Source: Drugs and Aging - August 23, 2021 Category: Geriatrics Source Type: research
