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Elderly fall medication

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https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#1
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27913598/describing-visible-acute-injuries-development-of-a-comprehensive-taxonomy-for-research-and-practice
#2
Tony Rosen, Christopher Reisig, Veronica M LoFaso, Elizabeth M Bloemen, Sunday Clark, Thomas J McCarthy, Estomih P Mtui, Neal E Flomenbaum, Mark S Lachs
BACKGROUND: Little literature exists classifying and comprehensively describing intentional and unintentional acute injuries, which would be valuable for research and practice. In preparation for a study of injury patterns in elder abuse, our goal was to develop a comprehensive taxonomy of relevant types and characteristics of visible acute injuries and evaluate it in geriatric patients. METHODS: We conducted an exhaustive review of the medical and forensic literature focusing on injury types, descriptions, patterns and analyses...
December 2, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/27909987/orexin-ox2-receptor-antagonists-as-sleep-aids
#3
Laura H Jacobson, Sui Chen, Sanjida Mir, Daniel Hoyer
The discovery of the orexin system represents the single major progress in the sleep field of the last three to four decades. The two orexin peptides and their two receptors play a major role in arousal and sleep/wake cycles. Defects in the orexin system lead to narcolepsy with cataplexy in humans and dogs and can be experimentally reproduced in rodents. At least six orexin receptor antagonists have reached Phase II or Phase III clinical trials in insomnia, five of which are dual orexin receptor antagonists (DORAs) that target both OX1 and OX2 receptors (OX2Rs)...
December 2, 2016: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#4
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27891571/high-risk-medications-in-hospitalized-elderly-adults-are-we-making-it-easy-to-do-the-wrong-thing
#5
Nina L Blachman, Rosanne M Leipzig, Madhu Mazumdar, Jashvant Poeran
OBJECTIVES: To examine dosages of high-risk medications administered to elderly adults who fall in the hospital and to determine whether electronic default doses are appropriate for elderly adults. DESIGN: Retrospective. SETTING: Large urban academic hospital. PARTICIPANTS: Individuals aged 65 and older experiencing a fall. MEASUREMENTS: Prescribed daily dosages and use of high-risk medications (opiates, benzodiazepines, benzodiazepine-receptor agonists (BRAs), sleep medications, muscle relaxants, antipsychotics) administered within 24 hours before a fall were ascertained and compared with published recommended dosages for older adults and the hospital's electronic medical record (EMR) default doses for these drugs...
November 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27882314/the-role-of-pharmacists-in-preventing-falls-among-america-s-older-adults
#6
Mamta V Karani, Yara Haddad, Robin Lee
Falls are the leading cause of both fatal and non-fatal injuries in people aged 65 years and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient-centered team-based approach, pharmacists can collaborate with the primary care providers to reduce fall risk...
2016: Frontiers in Public Health
https://www.readbyqxmd.com/read/27881180/polypharmacy-and-adverse-outcomes-after-hip-fracture-surgery
#7
Maria Härstedt, Cecilia Rogmark, Richard Sutton, Olle Melander, Artur Fedorowski
BACKGROUND: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. METHODS: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82 ± 9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register...
November 24, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27868320/predictors-of-rehospitalization-among-older-adults-results-of-the-crime-study
#8
Federica Sganga, Francesco Landi, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Andrea Corsonello, Paolo Fabbietti, Fabrizia Lattanzio, Ester Manes Gravina, Roberto Bernabei, Graziano Onder
AIM: To assess the predictors of readmission among older adults hospitalized in acute care wards. METHODS: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics...
November 21, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27857999/do-age-and-anticoagulants-affect-the-natural-history-of-acute-subdural-hematomas
#9
Brandon P Lucke-Wold, Ryan C Turner, Darnell Josiah, Chelsea Knotts, Sanjay Bhatia
Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy...
2016: Arch Emerg Med Crit Care
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#10
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27823737/a-one-year-proprioceptive-exercise-programme-reduces-the-incidence-of-falls-in-community-dwelling-elderly-people-a-before-after-non-randomised-intervention-study
#11
Pilar Pérez-Ros, Francisco M Martinez-Arnau, Vincenzo Malafarina, Francisco J Tarazona-Santabalbina
BACKGROUND: The risk of falls increases with age. Balance alteration and polypharmacy are independent contributors to an increased risk of falls. OBJECTIVE: The primary aim was to assess whether a proprioceptive exercise programme reduces the incidence of falls. A secondary aim was to assess the association between drugs and falls. DESIGN: This was a before-after non-randomised intervention study. PARTICIPANTS: The study recruited independent and cognitively intact community-dwelling people aged over 69 years, from December 2012 to May 2014...
December 2016: Maturitas
https://www.readbyqxmd.com/read/27818970/factors-associated-with-mortality-among-elderly-people-hospitalized-due-to-femoral-fractures
#12
Léo Graciolli Franco, Amanda Loffi Kindermann, Lucas Tramujas, Kelser de Souza Kock
OBJECTIVE: To analyze factors associated with mortality among elderly people hospitalized in a single-center regional hospital due to femoral fractures. METHODS: This was a retrospective cohort study. Patients aged 60 years or over who were hospitalized with a diagnosis of femoral fracture (ICD S72) between 2008 and 2013 were selected through the electronic medical records. RESULTS: The study evaluated 195 individuals of mean age 78.5 ± 9...
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27801714/temporal-patterns-of-in-hospital-falls-of-elderly-patients
#13
Pablo J López-Soto, Michael H Smolensky, Linda L Sackett-Lundeen, Alfredo De Giorgi, María A Rodríguez-Borrego, Roberto Manfredini, Cristiano Pelati, Fabio Fabbian
BACKGROUND: A potentially important factor yet to receive adequate study is the time when hospital falls occur. A prior study conducted before the system-wide introduction of preventive measures revealed a biphasic 24-hour pattern of hospital falls with major peak in the morning. OBJECTIVES: The purpose was to identify the temporal patterning of falls among elderly patients in hospitals with comprehensive fall prevention programs in place. METHODS: A 4-year observational study was conducted by the local health authority in the five nonteaching public hospitals located in the province of Ferrara, Italy...
November 2016: Nursing Research
https://www.readbyqxmd.com/read/27773377/outcomes-in-elderly-fall-victims-what-happens-after-hospital-discharge
#14
Lance M Larson, Robert Sliter, Stephen D Helmer, Jared Reyes, Greg Crawford, James M Haan
BACKGROUND: Falls are the leading cause of trauma-related death in the elderly, but postdischarge outcomes' data are lacking. The purpose of this study was to evaluate 12-month postdischarge mortality and causes of death. METHODS: A retrospective review was conducted of patients 65 years and older admitted for a fall and discharged alive. Data collection included demographics, injury characteristics, hospitalization details, and outcomes. A state death database and hospital records were queried to identify patients who died within 12 months of hospital discharge...
September 29, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27770207/gait-disorders-in-adults-and-the-elderly-a%C3%A2-clinical-guide
#15
Walter Pirker, Regina Katzenschlager
Human gait depends on a complex interplay of major parts of the nervous, musculoskeletal and cardiorespiratory systems. The individual gait pattern is influenced by age, personality, mood and sociocultural factors. The preferred walking speed in older adults is a sensitive marker of general health and survival. Safe walking requires intact cognition and executive control. Gait disorders lead to a loss of personal freedom, falls and injuries and result in a marked reduction in the quality of life. Acute onset of a gait disorder may indicate a cerebrovascular or other acute lesion in the nervous system but also systemic diseases or adverse effects of medication, in particular polypharmacy including sedatives...
October 21, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#16
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27747833/potentially-inappropriate-medications-in-elderly-haemodialysis-patients-using-the-stopp-criteria
#17
Krystina Parker, Willy Aasebø, Knut Stavem
BACKGROUND: Polypharmacy is commonly applied to elderly haemodialysis patients for treating terminal renal failure and multiple co-morbidities. Potentially inappropriate medications (PIMs) in multidrug regimens in geriatric populations can be identified using specially designed screening tools. OBJECTIVE: The aims of this study were to estimate the prevalence of PIMs by applying the Screening Tool of Older Persons' Prescriptions (STOPP) criteria and the Beers criteria to elderly haemodialysis patients and to assess the association of some risk factors with the presence of PIMs...
September 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27747735/epidemiologic-patterns-of-injuries-treated-at-the-emergency-department-of-a-swedish-medical-center
#18
Fredrik Röding, Marie Lindkvist, Ulrica Bergström, Jack Lysholm
BACKGROUND: The injury spectrum published in the literature has mainly been presented for a certain age group, as elderly or for a certain type of injury, as fracture and often restricted to in-hospital care cases. Our objective was to give an overview of the major types of injuries for all age groups and trends in the adult population. METHODS: We analyzed 68,159 adult injury events, which occurred between 1999 and 2008 and was treated at the Emergency Department of Umea University Hospital...
December 2015: Injury Epidemiology
https://www.readbyqxmd.com/read/27726521/use-of-methadone-as-an-adjuvant-medication-to-low-dose-opioids-for-neuropathic-pain-in-the-frail-elderly-a-case-series
#19
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
December 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27702858/reduction-of-falls-and-fractures-after-permanent-pacemaker-implantation-in-elderly-patients-with-sinus-node-dysfunction
#20
Roman Brenner, Peter Ammann, See-Il Yoon, Stefan Christen, Jens Hellermann, Grégoire Girod, Urs Knaus, Firat Duru, Nazmi Krasniqi, David Ramsay, Christian Sticherling, Kurt Lippuner, Michael Kühne
AIMS: Elderly patients with sinus node dysfunction (SND) are at increased risk of falls with possible injuries. However, the incidence of these adverse events and its reduction after permanent pacemaker (PPM) implantation are not known. METHODS AND RESULTS: Eighty-seven patients (mean [SD] age 75.4 [8.3] years, 51% women) with SND and an indication for cardiac pacing were included and were examined by a standardized interview targeting fall history. The incidence and total number of falls, falls with injury, falls requiring treatment, and falls resulting in a fracture were assessed for the time period of 12 months before (retrospectively) and after PPM implantation (prospectively)...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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