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Drugs & Aging

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https://www.readbyqxmd.com/read/28718072/diabetes-mellitus-following-renal-transplantation-clinical-and-pharmacological-considerations-for-the-elderly-patient
#1
REVIEW
David Langsford, Adam Steinberg, Karen M Dwyer
Post-transplant diabetes mellitus occurs in 30-50% of cases during the first year post-renal transplantation. It is associated with increased morbidity, mortality and healthcare costs. Risk factors include age and specific immunosuppression regimens. At the same time, renal transplantation is increasingly indicated in elderly (aged >65 years) patients as this proportion of older patients in the prevalent dialysis population has increased. The immune system and β cells undergo senescence and this impacts on the risk for developing post-transplant diabetes and our ability to prevent such development...
July 17, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28710707/prescription-patterns-of-non-vitamin-k-oral-anticoagulants-across-indications-and-factors-associated-with-their-increased-prescribing-in-atrial-fibrillation-between-2012-2015-a-study-from-the-norwegian-prescription-database
#2
Anna Maria Urbaniak, Bjørn Oddvar Strøm, Randi Krontveit, Kristin Helene Svanqvist
OBJECTIVE: We studied prescription patterns for non-vitamin K oral anticoagulants (NOACs) in Norway between 2012 and 2015, and compared NOAC and warfarin patient characteristics such as age, gender and cardiovascular (CV) co-medications across reimbursed indications. Factors associated with NOAC prescribing in atrial fibrillation (AF) were also analysed. METHODS: All Norwegian patients (N = 156,124) who received at least one dispensed NOAC or warfarin prescription within the indications of AF, deep vein thrombosis and pulmonary embolism (DVT_PE) or prevention of venous thromboembolic events after a hip or knee surgery (VTE_surg) between 2012 and 2015 were included in the study...
July 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28707274/cancer-immunotherapies-are-they-as-effective-in-the-elderly
#3
Kate Poropatich, Joel Fontanarosa, Sandeep Samant, Jeffrey A Sosman, Bin Zhang
Almost two-thirds of all new cancer diagnoses are made in persons over the age of 65 years, yet it is unclear if age affects patient responsiveness to immunotherapy, which is increasingly becoming first-line therapy in advanced stages of different tumor types. Preclinical animal studies may be difficult to translate into humans since they frequently use young mice (2-3 months of age) equivalent to adolescent human subjects. Nevertheless, ex vivo studies from humans are concordant with mice tissue findings-older patients have an increased density of circulating regulatory immune cells and a decreased ratio of naïve-to-memory T cells...
July 13, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28702928/underuse-of-oral-anticoagulants-and-inappropriate-prescription-of-antiplatelet-therapy-in-older-inpatients-with-atrial-fibrillation
#4
Lorette Averlant, Grégoire Ficheur, Laurie Ferret, Stéphane Boulé, François Puisieux, Michel Luyckx, Julien Soula, Alexandre Georges, Régis Beuscart, Emmanuel Chazard, Jean-Baptiste Beuscart
BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease. METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data...
July 12, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28656509/older-people-s-preferences-for-side-effects-associated-with-antimuscarinic-treatments-of-overactive-bladder-a-discrete-choice-experiment
#5
Veerle H Decalf, Anja M J Huion, Dries F Benoit, Marie-Astrid Denys, Mirko Petrovic, Karel C M M Everaert
INTRODUCTION: Understanding the importance older people attribute to the different side effects associated with oral antimuscarinic treatments for overactive bladder (OAB) could help inform prescribers, healthcare policy makers and the drug industry. OBJECTIVE: Our objective was to quantify the importance of the most prevalent cognitive and side effects of oral antimuscarinic treatments for OAB in older people. METHODS: We conducted a discrete-choice experiment (DCE) with the assistance of an interviewer with community-dwelling and hospitalized older people aged >65 years...
June 27, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28656508/risk-of-mortality-associated-with-anticholinergic-use-in-elderly-nursing-home-residents-with-depression
#6
Satabdi Chatterjee, Vishal Bali, Ryan M Carnahan, Hua Chen, Michael L Johnson, Rajender R Aparasu
BACKGROUND: Few studies have evaluated the association between anticholinergic use and mortality in elderly nursing home residents. OBJECTIVE: The aim of this study was to examine the risk of mortality associated with anticholinergic use among elderly nursing home residents with depression. METHODS: The study employed a population-based nested case-control design using 2007-2010 Minimum Data Set (MDS)-linked Medicare data from all states. The base cohort included Medicare beneficiaries aged ≥65 years, diagnosed with depression as of 2007, and with any MDS assessment in 2007...
June 27, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28600725/tolerability-safety-and-effectiveness-of-oxycodone-deterx-in-elderly-patients-%C3%A2-65%C3%A2-years-of-age-with-chronic-low-back-pain-a-randomized-controlled-trial
#7
Ernest A Kopecky, Ben Vaughn, Scott Lagasse, Melinda O'Connor
TRIAL DESIGN: This was a phase III, randomized withdrawal, double-blind, placebo-controlled, enriched enrollment, parallel-group, multicenter study intended to demonstrate the safety, tolerability, and analgesic efficacy of oxycodone DETERx(®) (Xtampza™ ER) compared with matching placebo. METHODS: This post hoc analysis was performed using data from a subpopulation of enrolled patients who were ≥65 years of age. The study enrolled male and female patients with a clinical diagnosis of moderate-to-severe chronic low back pain for a minimum of 6 months prior to screening who required around-the-clock opioid therapy...
June 10, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28577045/prevalence-and-risk-factors-of-drug-associated-corrected-qt-prolongation-in-elderly-hospitalized-patients-results-of-a-retrospective-analysis-of-data-obtained-over-6%C3%A2-months
#8
Ophélie Maison, Blandine de la Gastine, Laurent Dayot, Sylvain Goutelle
OBJECTIVES: Little information exists on the frequency and determinants of drug-associated long QT syndrome in older adults. The objectives of this study were to assess the prevalence and identify risk factors of drug-associated long QT syndrome in a population of elderly hospitalized patients. METHODS: This was a retrospective study performed over 6 months in hospital geriatric medicine. Various QT-correction equations were fitted to the individual QT-RR data to evaluate the most appropriate equation...
June 2, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28573553/medication-use-and-fall-related-hospital-admissions-from-long-term-care-facilities-a-hospital-based-case-control-study
#9
Taliesin E Ryan-Atwood, Mieke Hutchinson-Kern, Jenni Ilomäki, Michael J Dooley, Susan G Poole, Carl M Kirkpatrick, Elizabeth Manias, Biswadev Mitra, J Simon Bell
BACKGROUND: Falls are a leading cause of preventable hospitalizations from long-term care facilities (LTCFs). Polypharmacy and falls-risk medications are potentially modifiable risk factors for falling. OBJECTIVE: This study investigated whether polypharmacy and falls-risk medications are associated with fall-related hospital admissions from LTCFs compared with hospital admissions for other causes. METHODS: This was a hospital-based, case-control study of patients aged ≥65 years hospitalized from LTCFs...
June 1, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28540648/impact-of-2015-update-to-the-beers-criteria-on-estimates-of-prevalence-and-costs-associated-with-potentially-inappropriate-use-of-antimuscarinics-for-overactive-bladder
#10
Brandon T Suehs, Cralen Davis, Daniel B Ng, Katherine Gooch
BACKGROUND: Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. OBJECTIVES: The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB)...
May 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28478592/antiepileptic-drug-treatment-in-community-dwelling-older-patients-with-epilepsy-a-retrospective-observational-study-of-old-versus-new-generation-antiepileptic-drugs
#11
Jacques Theitler, Anna Brik, Dotan Shaniv, Matitiahu Berkovitch, Revital Gandelman-Marton
INTRODUCTION: The use of antiepileptic drugs (AEDs) in older patients with epilepsy is challenged by polypharmacy and decreased drug elimination. Newer AEDs have a lower potential for drug interactions and are reported to be better tolerated by the elderly than old-generation AEDs. OBJECTIVE: The objective of this study was to evaluate AED use and the related adverse event rate in an outpatient cohort of older patients with epilepsy. METHODS: We retrospectively reviewed the computerized database and medical records of all the patients aged ≥60 years who visited our epilepsy outpatient clinic (Assaf Harofeh Medical Center, Zerifin, Israel) during a 4-year period from February 2012 to February 2016...
May 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28589466/antibacterial-prophylaxis-for-surgical-site-infection-in-the-elderly-practical-application
#12
Maria Adriana Cataldo, Guido Granata, Nicola Petrosillo
Surgical site infections are among the most common healthcare-associated infections and are linked with increased length of hospitalization, re-admission, mortality and significant financial burden. Risk factors for the occurrence of surgical site infections include variables related to the surgical procedure as well as host factors. Increasing age is associated with the occurrence of surgical site infections. The aim of this review is to give an update on the antibiotic prophylaxis for surgical site infection in elderly people...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28580498/falls-related-drug-use-and-risk-of-falls-among-older-adults-a-study-in-a-us-medicare-population
#13
Shirley Musich, Shaohung S Wang, Joann Ruiz, Kevin Hawkins, Ellen Wicker
BACKGROUND: Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. OBJECTIVE: The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. METHODS: A 10% random sample, insured in AARP(®) Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28536907/drug-use-in-older-adults-with-amyotrophic-lateral-sclerosis-near-the-end-of-life
#14
Giulia Grande, Lucas Morin, Davide Liborio Vetrano, Johan Fastbom, Kristina Johnell
BACKGROUND: Amyotrophic lateral sclerosis (ALS), with its certain prognosis and swift progression, raises concerns regarding the adequacy of pharmacological treatment, including the risk-benefit profiles of prescribed drugs. OBJECTIVE: Our objective was to evaluate the use of prescription drugs over the course of the last year of life in older adults with ALS. METHODS: We conducted a nationwide retrospective cohort study of older adults who died with ALS in Sweden between 2007 and 2013...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28536906/current-status-of-bruton-s-tyrosine-kinase-inhibitor-development-and-use-in-b-cell-malignancies
#15
REVIEW
Andrew Aw, Jennifer R Brown
The B-cell receptor (BCR) pathway plays an important role in the survival, proliferation and trafficking of cancer cells in a variety of B-cell malignancies. Recently, a number of agents have been developed to target various components of the BCR pathway. One such target is Bruton's tyrosine kinase (BTK), a Tec family kinase member found near the cell membrane that is involved in upstream BCR signaling. The biological function of BTK in several B-cell lymphoid malignancies has led to the development of the oral BTK inhibitor ibrutinib...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28493216/appropriateness-of-oral-anticoagulants-for-the-long-term-treatment-of-atrial-fibrillation-in-older-people-results-of-an-evidence-based-review-and-international-consensus-validation-process-oac-forta-2016
#16
REVIEW
Martin Wehling, Ronan Collins, Victor M Gil, Olivier Hanon, Roland Hardt, Martin Hoffmeister, Pedro Monteiro, Terence J Quinn, Dieter Ropers, Giuseppe Sergi, Freek W A Verheugt
BACKGROUND: Age appropriateness of anticoagulants for stroke prevention in atrial fibrillation is uncertain. OBJECTIVE: To review oral anticoagulants for the treatment of atrial fibrillation in older (age >65 years) people and to classify appropriate and inappropriate drugs based on efficacy, safety and tolerability using the Fit-fOR-The-Aged (FORTA) classification. METHODS: We performed a structured comprehensive review of controlled clinical trials and summaries of individual product characteristics to assess study and total patient numbers, quality of major outcome data and data of geriatric relevance...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28478593/weight-loss-in-patients-with-dementia-considering-the-potential-impact-of-pharmacotherapy
#17
REVIEW
Bart A A Franx, Ilse A C Arnoldussen, Amanda J Kiliaan, Deborah R Gustafson
Unintentional body weight loss is common in patients with dementia and is linked to cognitive impairment and poorer disease outcomes. It is proposed that some dementia medications with market approval, while aiming to improve cognitive and functional outcomes of a patient with dementia, are associated with reported body weight or body mass index loss. This review presents evidence in the published literature on body weight loss in dementia, describes selected theories behind body weight loss, evaluates the potential impact of approved dementia pharmacotherapies on body weight, considers the potential role for medical foods, understands the potential influence of treatments for neuropsychiatric symptoms and signs, and finally, summarizes this important area...
June 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28432600/potentially-inappropriate-antihypertensive-prescriptions-to-elderly-patients-results-of-a-prospective-observational-study
#18
Paola H Ponte Márquez, Olga H Torres, Anonio San-José, Xavier Vidal, Antonia Agustí, Francesc Formiga, Alfonso López-Soto, Nieves Ramírez-Duque, Antonio Fernández-Moyano, Juana Garcia-Moreno, Juan A Arroyo, Domingo Ruiz
INTRODUCTION: Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. OBJECTIVES: The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. METHODS: An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person's Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3)...
June 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28405945/the-comparative-risk-of-delirium-with-different-opioids-a-systematic-review
#19
REVIEW
Lieke M Swart, Vera van der Zanden, Petra E Spies, Sophia E de Rooij, Barbara C van Munster
OBJECTIVE: There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS: We performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used...
June 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28405944/clinical-relevance-of-differences-in-glomerular-filtration-rate-estimations-in-frail-older-people-by-creatinine-vs-cystatin-c-based-formulae
#20
Anne Jacobs, Carolien Benraad, Jack Wetzels, Marcel Olde Rikkert, Cornelis Kramers
BACKGROUND: The risk of incorrect medication dosing is high in frail older people. Therefore, accurate assessment of the glomerular filtration rate is important. OBJECTIVE: The objective of this study was to compare the estimated glomerular filtration rate using creatinine- and cystatin C-based formulae, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in frail older people. We hypothesized that frailty determines the difference between the creatinine- and cystatin C-based formulae...
June 2017: Drugs & Aging
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