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Source: Drugs and Aging

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Total 41 results found since Jan 2013.

Anticholinergic Burden and Cognitive Impairment in Nursing Homes: A Comparison of Four Anticholinergic Scales
ConclusionsThe cumulative effect of medications with modest antimuscarinic activity may influence the cognitive performance of NH residents. The anticholinergic burden measured with the ACB scale should help identify NH residents who may benefit from reducing the anticholinergic burden.A clear direct relationship between anticholinergic burden and cognitive impairment was found only for the ACB Scale.
Source: Drugs and Aging - August 24, 2023 Category: Geriatrics Source Type: research

Inappropriate Combined Antiplatelet and Anticoagulant Therapy in Older Patients with Atrial Fibrillation: Trend over Time (2009 –18)
ConclusionsWhile inappropriate combined antiplatelet and anticoagulant therapy has declined over the last decade, there is still room for improvement. Antiplatelet deprescribing should be considered in all patients with inappropriate combined antiplatelet and anticoagulant therapy, including those with vascular disease and no recent cardiovascular event.
Source: Drugs and Aging - February 23, 2023 Category: Geriatrics Source Type: research

Implications of Under-Reporting Medication Side Effects: Beta-Blockers in Heart Failure as a Case Example
ConclusionWe conclude that under-reporting perceived side effects of beta-blockers among adults with heart failure is common, is associated with Black race and low education, and may contribute to patient willingness to take additional medication to prevent future medical encounters.
Source: Drugs and Aging - February 17, 2023 Category: Geriatrics Source Type: research

Management of Hypertension in the Elderly and Frail Patient
AbstractHypertension is a frequent finding in elderly patients. Hypertension in older age can be both associated with frailty and represent a risk factor for frailty. Hypertension is recognized as a main risk factor for cardiovascular diseases such as heart failure, atrial fibrillation, and stroke and the occurrence of these diseases may provoke a decline in health status and/or worsen the degree of frailty. Blood pressure targets in hypertensive older and frail patients are not completely defined. However, specific evaluations of individual patients and their co-morbidities and assessment of domains and components of frai...
Source: Drugs and Aging - July 29, 2022 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 - December 6, 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 - September 6, 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 - July 8, 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 likelihood ...
Source: Drugs and Aging - June 14, 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
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 - April 21, 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 - April 15, 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 - March 31, 2021 Category: Geriatrics Source Type: research

The Risk of Falling and Consequences of Falling in Patients with Atrial Fibrillation Receiving Different Types of Anticoagulant
ConclusionOlder patients who had comorbidities and were taking amiodarone, diuretics, or short- or medium-acting benzodiazepines had the highest risk of falls. The type and quality of anticoagulation did not seem to affect the risk of falling but did significantly affect survival after the first fall.
Source: Drugs and Aging - March 2, 2021 Category: Geriatrics Source Type: research

Seizures and Epilepsy After Stroke: Epidemiology, Biomarkers and Management
AbstractStroke is the leading cause of seizures and epilepsy in older adults. Patients who have larger and more severe strokes involving the cortex, are younger, and have acute symptomatic seizures and intracerebral haemorrhage are at highest risk of developing post-stroke epilepsy. Prognostic models, including the SeLECT and CAVE scores, help gauge the risk of epileptogenesis. Early electroencephalogram and blood-based biomarkers can provide information additional to the clinical risk factors of post-stroke epilepsy. The management of acute versus remote symptomatic seizures after stroke is markedly different. The choice ...
Source: Drugs and Aging - February 23, 2021 Category: Geriatrics Source Type: research

Recent Advances in the Management of Migraine in Older Patients
AbstractAlthough the prevalence of migraine tends to decrease in the fifth to sixth decades of life, there are still a significant number of patients  >  65 years of age who experience migraine or have new-onset migraine. Because these older patients are often excluded from clinical trials, there are fewer evidence-based treatment guidelines for them. Migraine treatment in the older population requires careful consideration of changes in medicati on metabolism and increased medical comorbidities. Furthermore, older patients can present with an atypical migraine phenotype and have a higher rate of secondary headache...
Source: Drugs and Aging - June 22, 2020 Category: Geriatrics Source Type: research

Comparison of Healthcare Resource Utilization and Costs between Rivaroxaban and Warfarin for Nonvalvular Atrial Fibrillation in a Skilled Nursing Facility Setting
ConclusionIn this SNF setting, HCRU and costs were lower among patients with NVAF who were experienced users of rivaroxaban compared with those who were experienced users of warfarin. These findings may help inform clinical decision making to reduce the economic burden of NVAF among older adults in SNFs.
Source: Drugs and Aging - March 8, 2020 Category: Geriatrics Source Type: research