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Drugs & Aging

Kirsten K Viktil, Ina Lehre, Anette H Ranhoff, Espen Molden
BACKGROUND: Use of direct-acting oral anticoagulants (DOACs) is increasing, but knowledge about pharmacokinetics and safety in frail patients is lacking. OBJECTIVE: The aim was to determine serum concentrations and elimination rates of DOACs in older hip fracture patients hospitalized for surgery. METHODS: The study included patients ≥ 65 years of age hospitalized for acute hip fracture surgery over a period of 6 months. Use of antithrombotic drugs was registered and serum samples collected for analysis of DOACs (apixaban, dabigatran and rivaroxaban) at admission and surgery...
November 9, 2018: Drugs & Aging
Melissa K Andrew, Susan K Bowles, Graham Pawelec, Laura Haynes, George A Kuchel, Shelly A McNeil, Janet E McElhaney
Influenza can lead to serious illness, particularly for older adults. In addition to short-term morbidity and mortality during the acute infection, recovery can be prolonged and often incomplete. This may lead to persistent declines in health and function, including catastrophic disability, which has dramatic implications for the well-being and support needs of older adults and their caregivers. All of this means that prevention of infection and effective treatment when illness has occurred are of paramount importance...
November 9, 2018: Drugs & Aging
Raquel Costa, Bernhard Steinhoff, Helena Gama, Fábio Ikedo, José-Francisco Rocha, Patrício Soares-da-Silva
BACKGROUND: The incidence of epilepsy is high within the first few years of life, stabilizes over the second through fifth decades, and then rises again. Treatment of elderly patients with antiepileptic drugs (AEDs) is complicated by increased sensitivity to drug effects, altered pharmacokinetics and an increased risk for drug interactions due to polytherapy. On the other hand, the safety and efficacy data of AEDs attained during clinical development programmes are relatively limited for this age group...
November 1, 2018: Drugs & Aging
Edeltraut Kröger, Marilyn Simard, Marie-Josée Sirois, Marianne Giroux, Caroline Sirois, Lisa Kouladjian-O'Donnell, Emily Reeve, Sarah Hilmer, Pierre-Hugues Carmichael, Marcel Émond
BACKGROUND: The Canadian Emergency Team Initiative (CETI) cohort showed that minor injuries like sprained ankles or small fractures trigger a downward spiral of functional decline in 16% of independent seniors up to 6 months post-injury. Such seniors frequently receive medications with sedative or anticholinergic properties. The Drug Burden Index (DBI), which summarises the drug burden of these specific medications, has been associated with decreased physical and cognitive functioning in previous research...
October 31, 2018: Drugs & Aging
Yahiya Y Syed
Shingrix® is a recombinant zoster vaccine (RZV) that contains a varicella zoster virus glycoprotein E antigen and the AS01B adjuvant system. The subunit vaccine is approved for the prevention of herpes zoster (HZ) [EU, USA, Japan, Canada and Australia] and postherpetic neuralgia (PHN) [EU and Australia] in adults aged ≥ 50 years. In the pivotal trials in adults aged ≥ 50 years (ZOE-50) and ≥ 70 years (ZOE-70), RZV significantly reduced the risk of HZ and PHN. Its protective efficacy waned minimally over 4 years and was well preserved in adults aged ≥ 70 years...
October 29, 2018: Drugs & Aging
Federico Rea, Giulia Calusi, Matteo Franchi, Davide Liborio Vetrano, Giuseppe Roberto, Stefano Bonassi, Ursula Kirchmayer, Alessandro Chinellato, Alessandra Bettiol, Janet Sultana, Alessandro Mugelli, Giovanni Corrao
OBJECTIVE: The objective of this study was to investigate the relationship between adherence to statin therapy and the risk of exacerbation among elderly individuals affected by chronic obstructive pulmonary disease and cardiovascular disease. METHODS: Using the healthcare utilisation databases of five Italian territorial units accounting for nearly 35% of the Italian population, we recruited a cohort of 6263 elderly persons (i.e. aged 65 years or older) with co-existing chronic obstructive pulmonary disease and cardiovascular disease who initiated statin therapy...
October 26, 2018: Drugs & Aging
Marlous Toren-Wielema, Ruth Veenhuizen, Jan Willem Kappelle, Nic Veeger, Eric van Roon
BACKGROUND: The prevalence of vitamin D deficiency in nursing home residents ranges from 79% to 98%. OBJECTIVES: The aim of this cross-sectional observational study in somatic and psychogeriatric nursing home residents was to determine the efficacy of a standardized oral vitamin D dosing regimen (VDDR) consisting of a loading dose (LD) of cholecalciferol 200,000 IU followed by a maintenance dose (MD) of 100,000 IU every 13 weeks in obtaining and maintaining an adequate and safe vitamin D trough level (VDTL), defined as 75-220 nmol/L (reference range)...
October 22, 2018: Drugs & Aging
Margherita Fabbri, Mario M Rosa, Joaquim J Ferreira
End-of-dose motor fluctuations are regarded as one of the core troublesome symptoms by patients with Parkinson's disease (PD). Treatment of levodopa (L-dopa)-induced motor fluctuations is still an unmet medical need. L-dopa is the gold standard in the treatment of motor PD symptoms; notwithstanding, a wide range of adjunct therapies are currently available for the treatment of end-of-dose motor fluctuations. Additionally, device-aided therapies, such as deep brain stimulation, L-dopa-carbidopa intestinal gel infusion, and on-demand injection or continuous apomorphine infusion, may be considered when oral treatments are not sufficient to control motor fluctuations...
October 15, 2018: Drugs & Aging
Arshag D Mooradian
The number of older adults with diabetes is rapidly increasing worldwide. A variety of factors contribute to the age-related increase in the incidence of diabetes. The lack of empiric evidence in the field has limited the management guidelines to mostly expert opinion. Given uncertainty over the rate at which to lower blood glucose levels and the optimal method of doing so, the goals of diabetes control in older people must be individualized. If the patient requires insulin therapy, the newer insulins, with their improved pharmacodynamic consistency and reduced risk of hypoglycemia, should be preferred...
October 10, 2018: Drugs & Aging
Zeina Al-Mansour, Muthalagu Ramanathan, Jan Cerny
The incidence of most hematological malignancies increases with age. Despite the higher incidence of hematological malignancies in the elderly, the geriatric population is poorly represented in the early oncology clinical trials that established the current standards of care. Hematopoietic cell transplant (HCT), either upfront or at relapse, provides a potentially life-prolonging, often curative option for many patients with hematological malignancies and is considered the standard of care, at least for younger patients...
October 9, 2018: Drugs & Aging
Carlos Estevez-Fraga, Paul Zeun, Jose Luis López-Sendón Moreno
Drug-induced parkinsonism (DIP) and tardive dyskinesia (TD) are iatrogenic consequences of antidopaminergic drugs. Both are particularly prevalent among the elderly and those with dementia. However, despite their prevalence, these disorders are often overlooked. Both entities share risk factors, physiopathological mechanisms and, to some degree, therapeutic approaches. Withdrawing the causal agent, reducing the dose or switching to a less potent antidopaminergic drug should be the first therapeutic options...
November 2018: Drugs & Aging
Anna-Maija Tolppanen, Miia Tiihonen, Heidi Taipale, Marjaana Koponen, Antti Tanskanen, Piia Lavikainen, Jari Tiihonen, Sirpa Hartikainen
BACKGROUND: It is unknown whether cognitive status or diagnosed cognitive decline affects estrogen use. OBJECTIVES: We assessed how common systemic estrogen use was among community-dwellers with Alzheimer's disease (AD) and a matched comparison cohort without AD. METHODS: This study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005-2011 (N = 46,116; index cases) and an equally sized matched comparison cohort without AD...
November 2018: Drugs & Aging
Niko M Perttila, Hanna Öhman, Timo E Strandberg, Hannu Kautiainen, Minna Raivio, Marja-Liisa Laakkonen, Niina Savikko, Reijo S Tilvis, Kaisu H Pitkälä
INTRODUCTION: No study has investigated how exercise modifies the effect of fall-related drugs (FRDs) on falls among people with Alzheimer's disease (AD). OBJECTIVE: The aim of this study was to investigate how exercise intervention and FRDs interact with fall risk among patients with AD. METHODS: In the FINALEX trial, community-dwelling persons with AD received either home-based or group-based exercise twice weekly for 1 year (n =129); the control group received normal care (n =65)...
November 2018: Drugs & Aging
Laura K Triantafylidis, Chelsea E Hawley, Laura P Perry, Julie M Paik
Older adults with chronic kidney disease (CKD) often experience polypharmacy, a recognized predictor of prescribing problems including inappropriately dosed medications, drug-drug and drug-disease interactions, morbidity and mortality. Polypharmacy is also associated with nonadherence, which leads to recurrent hospitalizations and poorer hemodialysis outcomes in CKD patients. Further complicating medication management in this vulnerable population are the physiologic changes that occur with both age and CKD...
November 2018: Drugs & Aging
Wade Thompson, Anton Pottegård, Jesper Bo Nielsen, Peter Haastrup, Dorte Ejg Jarbøl
In Section 4.3 "Factors Associated with Statin Use in the Oldest Old".
November 2018: Drugs & Aging
Sashika Samaranayaka, Robert J Walker, Ari Samaranayaka, Sarah Derrett, John W B Schollum
BACKGROUND: The impact of multiple medication exposure on health outcomes among older patients with end-stage kidney disease (ESKD) is unknown. OBJECTIVE: The objective of this study was to identify the impact of medicine exposure on hospitalisation rates and mortality in a prospective longitudinal observational study of older dialysis patients. METHODS: Patient demographics, medication use, hospitalisation, mortality and co-morbidity data were collected through the prospective longitudinal cohort study DOS65 + (Dialysis Outcomes in those aged ≥ 65 years Study) (n = 225)...
November 2018: Drugs & Aging
Maximilian König, Maik Gollasch, Adrian Rosada, Ilja Demuth, Dominik Spira, Elisabeth Steinhagen-Thiessen
BACKGROUND: Hypertension is highly prevalent in older adults and represents a major public health issue since recognition, awareness, treatment and control are insufficient. Analyses of prescription patterns in conjunction with clinical parameters can provide novel insights into the current practice of hypertension management and help to identify barriers to sufficient hypertension control. METHODS: A cross-sectional analysis was conducted. Prevalence of hypertension, patterns of antihypertensive therapy, and determinants of blood pressure (BP) control were examined in the Berlin Aging Study II cohort, including 1654 community-dwelling older adults (60-85 years of age)...
November 2018: Drugs & Aging
Veronica Bonderski, Daniel G Morrow, Jessie Chin, Michael D Murray
Heart failure is a chronic disease requiring careful attention to self-care. Patients must follow instructions for diet and medication use to prevent or delay a decline in functional status, quality of life, and expensive care. However, there is considerable heterogeneity in heart failure patients' knowledge of important care routines, their cognition, and their health literacy, which predict the ability to implement self-care. Our interdisciplinary team of cognitive scientists with health literacy expertise, pharmacists, and physicians spent 18 years designing and testing protocols and materials to assist ambulatory heart failure patients with their care...
November 2018: Drugs & Aging
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