Trends in Anticoagulant Use at Nursing Home Admission and Variation by Frailty and Chronic Kidney Disease Among Older Adults with Atrial Fibrillation
ConclusionsWhile the proportion of residents with AF receiving oral anticoagulants at admission increased following the approval of DOACs, over 40% remained untreated. Among those treated, use of a DOAC increased, while warfarin use declined. The impact of these recent treatment patterns on the balance between benefit and harm among residents warrant further investigation. (Source: Drugs and Aging)
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
ConclusionsMethylnaltrexone use did not adversely affect pain control, opioid withdrawal effects, or AEs while providing effective RFL, regardless of age. These results suggest that age does not appear to influence the safety and efficacy of methylnaltrexone for OIC. Further research is needed to assess the impact of other factors that alter BBB permeability, such as dementia, stroke, or drug interactions, on the safety and efficacy of methylnaltrexone.Clinical Trial Registration NumbersStudy 302, NCT00402038; study 3200K1-4000, NCT00672477; study 3200K1-3356, NCT00529087; study 3201, NCT01186770. (Source: Drugs and Aging)
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
The Future of Incretin-Based Approaches for Neurodegenerative Diseases in Older Adults: Which to Choose? A Review of their Potential Efficacy and Suitability
AbstractThe current treatment options for neurodegenerative diseases in older adults rely mainly on providing symptomatic relief. Yet, it remains imperative to identify agents that slow or halt disease progression to avoid the most disabling features often associated with advanced disease stages. A potential overlap between the pathological processes involved in diabetes and neurodegeneration has been established, raising the question of whether incretin-based therapies for diabetes may also be useful in treating neurodegenerative diseases in older adults. Here, we review the different agents that belong to this class of d...
Source: Drugs and Aging - March 19, 2021 Category: Geriatrics Source Type: research
Feasibility of Intranasal Dexmedetomidine in Treatment of Postoperative Restlessness, Agitation, and Pain in Geriatric Orthopedic Patients
ConclusionsThese preliminary findings suggest that intranasal dexmedetomidine reduces opioid consumption without causing respiratory depression and may be used to treat postoperative restlessness, agitation, and pain in geriatric patients. However, hemodynamic effects of dexmedetomidine may require close observation for 3 hours following administration in older adult patients. (Source: Drugs and Aging)
Source: Drugs and Aging - March 16, 2021 Category: Geriatrics Source Type: research
Preoperative Comparison of Three Anticholinergic Drug Scales in Older Adult Patients and Development of Postoperative Delirium: A Prospective Observational Study
ConclusionThis study found no association between the anticholinergic load of drugs used preoperatively and the development of POD in older adult patients without severe preexisting cognitive impairment. Future analyses should examine the influence of intra- and postoperative administration of anticholinergic drugs as well as dosages of and interactions between medications. (Source: Drugs and Aging)
Source: Drugs and Aging - March 15, 2021 Category: Geriatrics Source Type: research
A Phase II, Single-Center, Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Therapeutic Efficacy of Intranasal Glulisine in Amnestic Mild Cognitive Impairment and Probable Mild Alzheimer ’s Disease
ConclusionsIntranasal glulisine was relatively safe and well-tolerated and did not consistently impact peripheral glucose or insulin levels. There were no enhancing effects of intranasal glulisine on cognition, function, or mood, but the ability to detect significance was limited by the number of subjects successfully enrolled and the study duration.ClinicalTrials.gov RegistrationNCT02503501. (Source: Drugs and Aging)
Source: Drugs and Aging - March 15, 2021 Category: Geriatrics Source Type: research
National Trends in Statin Use among the United States Nursing Home Population (2011 –2016)
ConclusionOverall, statin use in US nursing homes increased from 2011 to 2016. Guidelines and statin-related events appeared to impact use in the nursing home setting. As such, statin guidelines and messaging should provide special consideration for nursing home populations, who may have more risk than benefit from statin pharmacotherapy. (Source: Drugs and Aging)
Source: Drugs and Aging - March 11, 2021 Category: Geriatrics Source Type: research
Prevalence and Factors Associated with Cumulative Anticholinergic Burden Among Older Long-Stay Nursing Home Residents with Overactive Bladder
ConclusionsThis study revealed a high level of anticholinergic burden among LSNH residents. Multiple factors were associated with a high level of burden. There is a need to optimize the use of anticholinergics due to their significant safety concerns in the LSNH setting. (Source: Drugs and Aging)
Source: Drugs and Aging - March 8, 2021 Category: Geriatrics Source Type: research
