Correlation to antipsychotics medications and dementia

OBJECTIVE: This meta-analysis aimed to comprehensively explore the risk factors for inadequate bowel preparation (IBP). METHODS: We searched the Embase, PubMed, Web of Science, and The Cochrane Library databases up to August 24, 2023, to identify observational studies and randomized controlled trials (RCTs) that examined risk factors for IBP. A random effects model was used to pool the adjusted odds ratios and 95% confidence intervals. RESULTS: A total of 125 studies (91 observational studies, 34 RCTs) were included...

Dimenhydrinate is an over-the-counter antihistaminergic medication with anticholinergic properties used to treat nausea or motion sickness worldwide. There is a well-established correlation between the use of anticholinergic medications and dementia, however, it is unclear if a causal role exists. We report a case of minor neurocognitive disorder in a woman in her 40s with several years of high-dose daily dimenhydrinate abuse who subsequently developed significant delusional beliefs. Her clinical presentation was confounded by numerous other factors that could have impacted her cognition, such as a longstanding presumed learning disability, ankylosing spondylitis with adalimumab treatment, extensive cannabis use or potential development of a primary psychotic disorder...

OBJECTIVES: Nursing home (NH) Minimum Data Set (MDS) have frequently been used to measure medication use in epidemiologic studies, but there is little evidence on the accuracy of MDS-based medication records. We compared antipsychotic use estimated using 2 data sources-MDS and NH electronic medication administration records (eMAR). DESIGN: Cross-sectional comparison. SETTING AND PARTICIPANTS: This analysis was based on MDS and linked eMAR data of 604 NH residents with dementia at 54 NHs in 10 states, participating in a cluster-randomized pragmatic trial (METRIcAL), from June 2019 to February 2020...

OBJECTIVES: Falls are common among older people in nursing homes, and the assessment of fall risk factors is critical for the success of fall prevention interventions. This study aimed to systematically assess the incidence and risk factors of falls in older people living in nursing homes. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Older people living in nursing homes. METHODS: Literature searches were conducted independently by 2 researchers in 8 databases...

BACKGROUND: The term sundowning is used to describe the emergence or worsening of neuropsychiatric symptoms in late afternoon or early evening in people with dementia. OBJECTIVE: Our aim was to evaluate sundowning's prevalence and clinical manifestations among patients attending a tertiary memory clinic and to investigate its clinical and neuropsychological correlates. METHODS: Patients with dementia attending our memory clinic were enrolled in the study...

Patients with schizophrenia have substantial comorbidity contributing to reduced life expectancy of 10-20 years. Identifying which comorbidities might be modifiable could improve rates of premature mortality in this population. We hypothesize that conditions that frequently co-occur but lack shared genetic risk with schizophrenia are more likely to be products of treatment, behavior, or environmental factors and therefore potentially modifiable. To test this hypothesis, we calculated phenome-wide comorbidity from electronic health records (EHR) in 250,000 patients in each of two independent health care institutions (Vanderbilt University Medical Center and Mass General Brigham) and association with schizophrenia polygenic risk scores (PRS) across the same phenotypes (phecodes) in linked biobanks...

BACKGROUND: Improving or maintaining quality of life (QoL) is an important aim for caring for people with dementia living in residential aged care facilities (RACFs). OBJECTIVES: This study aimed to investigate the effect of a specific intervention, the Medication Management Consultancy (MMC), on the QoL of residents of RACFs in Western Australia, and to examine the association between psychotropic medications and QoL. METHODS: A before-after study was conducted...

BACKGROUND: Chemical and physical restraints are associated with harm in older adults, but our understanding of their use during acute care hospitalizations is limited. OBJECTIVES: To (1) describe restraint use during acute care hospitalizations of older adults at the onset of the COVID-19 pandemic compared to pre-pandemic levels and (2) describe between-hospital variability in restraint use. DESIGN: Retrospective cohort study with a time series analysis...

BACKGROUND: Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer's disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia. Available medications provide symptomatic benefits and provide relief from BPSD and associated health issues. However, it is unclear how specific dementia, antidepressant, antipsychotic, antianxiety, and mood stabiliser drugs, used in the treatment of depression and dementia subtypes are prescribed in hospital admission, during hospital stay, and at the time of discharge...

BACKGROUND: Anticholinergic medications are drugs that block cholinergic transmission, either as their primary therapeutic action or as a secondary effect. Patients with dementia may be particularly sensitive to the central effects of anticholinergic drugs. Anticholinergics also antagonise the effects of the main dementia treatment, cholinesterase inhibitors. Our study aimed to investigate anticholinergic prescribing for dementia patients in UK acute hospitals before and after admission...

BACKGROUND: cognitively impaired hospital patients often experience agitation and aggression due to pain. Agitation complicates care, increasing the risk of adverse outcomes and patient-to-nurse violence. Managing agitation is challenging for nurses. Literature suggests they may rely on antipsychotics while missing other more appropriately targeted treatments. However, nurses' management of agitation remains unclear and under-researched. OBJECTIVE: the aim of this study was to investigate hospital nurses' management of agitation in older cognitively impaired patients with pain...

Up to 80% of Alzheimer's disease (AD) patients in nursing homes experiences chronic pain and 97% develops fluctuant neuropsychiatric symptoms (NPS). Agitation, associated with unrelieved pain, is managed through antipsychotics and may increase the risk of death. Evidence is accumulating in favor of analgesia for a safer, effective therapy of agitation. The Italian version of Mobilization-Observation-Behavior-Intensity-Dementia, I-MOBID2, recently validated in the Italian setting, shows: good scale content validity index (0...

BACKGROUND: Pain-related agitation in hospital patients with dementia presents a diagnostic challenge as patients often cannot explain their agitation. Generally, a deductive process is required of staff, culminating in an analgesic trial. However, evidence suggests the deductions of hospital nurses may be flawed because they may not associate agitation in dementia with painful conditions, thereby missing key clinical cues. While analytical rule-based deduction applies explicit formal knowledge, cognitive scientists argue that tacit experiential knowledge, i...

BACKGROUND: Individuals with Parkinson's disease (PD) may be especially vulnerable to future cognitive decline from anticholinergic medications. OBJECTIVE: To characterize anticholinergic medication burden, determine the co-occurrence of anticholinergic and cholinesterase inhibitors, and to assess the correlations among anticholinergic burden scales in PD outpatients. METHODS: We studied 670 PD outpatients enrolled in a clinic registry between 2012 and 2020...

Dopamine and noradrenaline are functionally connected to delirium and have been targets for pharmacological interventions but the biochemical evidence to support this notion is limited. To study the CSF levels of dopamine, noradrenaline and the third catecholamine adrenaline in delirium and dementia, these were quantified in three patient cohorts: (i) cognitively normal elderly patients ( n  = 122); (ii) hip fracture patients with or without delirium and dementia ( n  = 118); and (iii) patients with delirium precipitated by another medical condition (medical delirium, n  = 26)...

BACKGROUND: The off-label use of antipsychotic medications is common in many countries, and the extent of such use in psychiatric inpatients in China has not been sufficiently studied. The purpose of this study was to survey the incidence and examine the correlates of off-label antipsychotic use in a large, nationally-representative sample in China. METHODS: This study included discharged psychiatric patients between March 19 and 31, 2019 from 41 tertiary psychiatric hospitals across 29 provinces in China...

INTRODUCTION: We sought to assess longitudinal electronic health records (EHRs) using machine learning (ML) methods to computationally derive probable Alzheimer's Disease (AD) and related dementia subphenotypes. METHODS: A retrospective analysis of EHR data from a cohort of 7587 patients seen at a large, multi-specialty urban academic medical center in New York was conducted. Subphenotypes were derived using hierarchical clustering from 792 probable AD patients (cases) who had received at least one diagnosis of AD using their clinical data...

People with coronavirus disease (COVID-19) might have several risk factors for delirium, which could in turn notably worsen the prognosis. Although pharmacological approaches for delirium are debated, haloperidol and other first-generation antipsychotics are frequently employed, particularly for hyperactive presentations. However, the use of these conventional treatments could be limited in people with COVID-19, due to the underlying medical condition and the risk of drug-drug interactions with anti-COVID treatments...

BACKGROUND: Parkinsonism is common in people with dementia, and is associated with neurodegenerative and vascular changes in the brain, or with exposure to antipsychotic or other dopamine antagonist medications. The detection of parkinsonian changes to gait may provide an opportunity to intervene and address reversible causes. In this study, we investigate the use of a vision-based system as an unobtrusive means to assess severity of parkinsonism in gait. METHODS: Videos of walking bouts of natural gait were collected in a specialized dementia unit using a Microsoft Kinect sensor and onboard color camera, and were processed to extract sixteen 3D and eight 2D gait features...

Background: Frequently used nonmotor scales do not cover all aspects of dysautonomia in Parkinson's disease (PD). This study explores the association between autonomic symptoms and sicca symptoms with other nonmotor symptoms and health-related quality of life (QoL) in PD. Methods: Autonomic symptoms (Survey of Autonomic Symptoms, SASs), motor function (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale III, MDS-UPDRS III), nonmotor symptoms (nonmotor symptoms questionnaire, NMS-Quest), and QoL (PD Questionnaire-39, PDQ-39) were analysed in 93 PD patients without dementia...