keyword
https://read.qxmd.com/read/37977746/geriatric-psychiatric-emergencies
#21
REVIEW
Michelle A Fischer, Monica Corsetti
Geriatric patients, those 65 years of age and older, often experience psychiatric symptoms or changes in mentation as a manifestation of an organic illness. It is crucial to recognize and treat delirium in these patients as it is often under-recognized and associated with significant morbidity. Iatrogenic causes of altered mentation or delirium due to medication adverse reactions are common. Treatment of the underlying cause, creating an environment conducive to orientation, and minimizing agitation and discomfort are first-line interventions...
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37920617/pimavanserin-use-in-lewy-body-dementia-a-case-report-demonstrating-the-medication-s-efficacy
#22
Michelle Baker, Wenxin Song, Adam Fusick
Pimavanserin is an antipsychotic that is approved for use in Parkinson's disease psychosis. Working as a serotonin 2A inverse agonist, pimavanserin allows patients to improve their psychotic symptoms without worsening the motor symptoms of Parkinson's. This mechanism is mediated via serotonin receptors and may allow for pimavanserin to be considered for use in other disease processes that present with psychosis. Here, the authors describe the case of a 75-year-old man with Lewy Body Dementia (LBD) who was started on pimavanserin...
October 2023: Curēus
https://read.qxmd.com/read/37909144/the-impact-of-nursing-home-residency-on-psychotropic-drug-use-in-major-neurocognitive-disorder-a-nationwide-comparison
#23
JOURNAL ARTICLE
Jonas Kindstedt, Eva-Lotta Glader, Hugo Lövheim, Marie Lindkvist, Maria Gustafsson
INTRODUCTION: Psychotropic drugs are utilized against neuropsychiatric symptoms among people with major neurocognitive disorder (NCD) despite well-documented risks, and older people in nursing homes are expected to be more frequently exposed to those medicines. This study compared psychotropic drug use and associated factors between older people with major NCD and matched references. METHODS: This cross-sectional study included individuals from three national registries in Sweden...
November 2023: International Journal of Geriatric Psychiatry
https://read.qxmd.com/read/37892634/the-relationship-between-oral-health-and-schizophrenia-in-advanced-age-a-narrative-review-in-the-context-of-the-current-literature
#24
REVIEW
Sanjana Santhosh Kumar, Raquel Cantillo, Dongxia Ye
Schizophrenia is a psychiatric disorder that makes patients incompetent to perform day-to-day activities due to their progressing mental illness. In addition to disturbances with thoughts, behavioral changes, and impaired cognitive functions, oro-systemic health also becomes compromised. Even though the population with schizophrenia is primarily made up of older people, little is known about this group's oral health treatment. The present review explores the relationship between oral healthcare and elderly patients with schizophrenia...
October 12, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37890520/effects-of-defoliant-exposure-and-medication-use-on-the-development-of-parkinson-s-disease-in-veterans
#25
JOURNAL ARTICLE
Seulki Song, Jun Y Kim, Young Lee, Hyokeun Jeong, Seungyeon Kim, Eunkyung E Lee
BACKGROUND: Vietnam-era veterans were exposed to Agent Orange (AO), which is associated with a high prevalence of Parkinson's disease (PD). However, little is known about the development of PD-like symptoms caused by drug-induced parkinsonism (DIP) in such populations. This study aimed to investigate PD incidence and PD risk following exposure to AO or DIP-risk drugs in veterans. METHODS: A retrospective cohort study was conducted using 12 years (2009-2020) of electronic medical records of the Veterans Health Service Medical Center, the largest Veterans Affairs hospital in South Korea (n = 37,246; 100% male; age, 65...
October 2, 2023: Age and Ageing
https://read.qxmd.com/read/37860872/impact-of-psychotropic-medications-on-cognition-among-older-adults-a-systematic-review
#26
REVIEW
Susmita Chandramouleeshwaran, Waqas U Khan, Fiona Inglis, Tarek K Rajji
OBJECTIVES: The aim of this systematic review is to examine the cognitive impact of psychotropic medications including benzodiazepines, antidepressants, mood stabilizers, antipsychotics, or a combination of these drugs on older adults. DESIGN: Systematic review. SETTING: We searched Medline, PsycINFO, and Embase through the Ovid platform, CINAHL through EBSCO, and Web of Science. PARTICIPANTS AND INTERVENTIONS: Randomized control trials (RCTs) and cohort studies that used a validated scale to measure cognition with a follow-up period of at least six months were included...
October 20, 2023: International Psychogeriatrics
https://read.qxmd.com/read/37854895/compliance-with-national-and-international-guidelines-in-the-treatment-of-nonmotor-symptoms-in-late-stage-parkinson-s-disease
#27
JOURNAL ARTICLE
Kristina Rosqvist, Per Odin
BACKGROUND: National as well as international Parkinson's disease (PD) treatment guidelines are available to guide clinicians. Previous research has shown that nonmotor symptoms (NMS) are pronounced in late-stage PD and has suggested that current treatment is insufficient and could be improved. OBJECTIVES: The aim of this study was to investigate to which degree the national and international treatment guidelines are followed in the treatment of NMS in late-stage PD...
2023: Parkinson's Disease
https://read.qxmd.com/read/37823673/attitudes-towards-deprescribing-in-geriatric-psychiatry-a-survey-among-older-psychiatric-outpatients
#28
JOURNAL ARTICLE
Carina Lundby, Marianne Nielsen, Trine Simonsen, Stine Galsgaard, Maija Bruun Haastrup, Lene Vestergaard Ravn-Nielsen, Anton Pottegård
Understanding the patient perspective is a significant part of the deprescribing process. This study aimed to explore the attitudes of older patients with psychiatric disorders towards deprescribing. A total of 72 of psychiatric outpatients (68% women; median age 76 years) completed the validated Danish version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. Patients used a median of eight medications (interquartile range 6-12), with 88%, 49% and 24% using antidepressants, antipsychotics and anxiolytics, respectively...
October 12, 2023: Basic & Clinical Pharmacology & Toxicology
https://read.qxmd.com/read/37810618/risk-of-hospitalization-in-synucleinopathies-and-impact-of-psychosis
#29
JOURNAL ARTICLE
Capucine Piat, Aidan F Mullan, Cole D Stang, Mania Hajeb, Emanuele Camerucci, Pierpaolo Turcano, Peter R Martin, James H Bower, Rodolfo Savica
BACKGROUND: Few studies have investigated the risk of hospitalization among patients with synucleinopathies (Parkinson disease, Dementia with Lewy Bodies, Parkinson disease dementia, Multiple System Atrophy) with associated psychosis and the impact of antipsychotic treatments on hospital admissions and duration of the stay. OBJECTIVE: To determine the risk of hospitalization among patients with synucleinopathies and in patients with associated psychosis. To evaluate the impact of antipsychotic treatments on hospital admission of patients with synucleinopathies and psychosis in an incident cohort study in Olmsted County, Minnesota (MN)...
2023: Frontiers in Aging Neuroscience
https://read.qxmd.com/read/37804182/effectiveness-and-safety-of-the-co-administration-of-yokukan-san-japanese-herbal-medicine-with-antipsychotics-in-hospitalized-older-patients-with-pneumonia
#30
JOURNAL ARTICLE
Akira Yokoyama, Taisuke Jo, Yukiyo Sakamoto, Hirokazu Urushiyama, Hiroyuki Tamiya, Goh Tanaka, Ryosuke Kumazawa, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Takahide Nagase
AIM: Behavioral and psychological symptoms and delirium frequently occur in hospitalized older patients with pneumonia and are associated with longer hospital stays. Yokukan-San (YKS, traditional Japanese [Kampo] medicine) and antipsychotics are often used to treat delirium and behavioral and psychological symptoms in Japan. Hence, this study aimed to assess the effectiveness and safety of the co-administration of YKS with atypical antipsychotics in older patients with pneumonia. METHODS: We used the Japanese Diagnosis Procedure Combination inpatient database to retrospectively identify older patients (≥65 years) hospitalized for pneumonia who received antipsychotics within 3 days of hospitalization...
October 7, 2023: Geriatrics & Gerontology International
https://read.qxmd.com/read/37755662/the-promising-project-a-pilot-study-to-improve-geriatric-care-through-a-pharmacist-led-psychotropic-stewardship-program
#31
JOURNAL ARTICLE
Marie d'Amours, Farah Ettis, Lauriane Ginefri, Johnny Lim, Angela-Sinlan Lin Poo Yuan, Jennifer Fontaine, Dana Wazzan, David Williamson, Vincent Dagenais-Beaulé
BACKGROUND AND OBJECTIVE: Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a psychotropic medication stewardship program led by pharmacists. METHODS: We conducted a prospective, observational pilot study in patients aged 75 years and older, admitted to a surgical unit with at least one active prescription of a psychotropic medication (antipsychotic, benzodiazepine or non-benzodiazepine receptor agonist)...
November 2023: Drugs & Aging
https://read.qxmd.com/read/37749541/staff-knowledge-attitudes-and-confidence-levels-for-fall-preventions-in-older-person-long-term-care-facilities-a-cross-sectional-study
#32
JOURNAL ARTICLE
Neah Albasha, Ruth McCullagh, Nicola Cornally, Suzanne Timmons
BACKGROUND: Falls are the most common health problem affecting older people in long-term care facilities (LTCFs), with well-recognised adverse psychological and physical resident outcomes, and high staff burden and financial cost. LTCF staff knowledge and skills can play a vital role in providing and promoting fall prevention care. METHODS: A descriptive cross-sectional survey study was conducted across 13 LTCF sites in the Southwest of Ireland; a sampling frame facilitated inclusion of a range of provider types and facility sizes...
September 25, 2023: BMC Geriatrics
https://read.qxmd.com/read/37744391/end-of-life-care-of-hospitalized-patients-with-parkinson-disease-a-retrospective-analysis-and-brief-review
#33
JOURNAL ARTICLE
Sakhi Bhansali, Ekhlas Assaedi, Jeryl Ritzi T Yu, Nymisha Mandava, Claire Sonneborn, Olivia Hogue, Benjamin L Walter, Renato V Samala, Adam Margolius
BACKGROUND: Towards the end of life (EOL), persons with parkinsonism (PwP) have complex needs and can present with unique palliative care (PC) challenges. There are no widely accepted guidelines to aid neurologists, hospitalists, or PC clinicians in managing the symptoms of PwP at EOL. We examined a population of PwP at EOL, aiming to describe trends of in-hospital management and utilization of PC services. METHODS: All PwP admitted to two hospitals during 2018 ( N = 727) were examined retrospectively, assessing those who died in hospital or were discharged with hospice (EOL group, N = 35) and comparing them to the main cohort...
2023: Frontiers in Aging Neuroscience
https://read.qxmd.com/read/37738390/factors-associated-with-malnutrition-risk-in-residents-of-long-term-care-facilities-in-mexico
#34
JOURNAL ARTICLE
Luis E Fernández-Garza, Fernando Coindreau-Frías, Loubette Botello-González, Mauricio Ramos-Bacco, Hugo A Barrera-Saldaña
OBJECTIVE: To investigate factors associated with the nutritional status in institutionalized Mexican older adults. MATERIAL AND METHODS: In this cross-sectional study of residents in three long-term care facilities (LTCFs) in Monterrey, Mexico, a medical history, Mini-Mental State Examination, Barthel index, and geriatric depression scale, and Mini Nutritional Assessment (MNA) were performed. Risk of malnutrition and malnutrition status were defined as MNA 17-23...
2023: Journal of Nutrition in Gerontology and Geriatrics
https://read.qxmd.com/read/37728481/the-use-of-dispensary-obtained-tetrahydrocannabinol-as-a-treatment-for-neuropsychiatric-symptoms-of-dementia
#35
JOURNAL ARTICLE
Samantha M Sawicki, Cristian Hernandez, Neda Laiteerapong, Erin K Zahradnik
Objective: Neuropsychiatric symptoms (NPS) of dementia represent a large driver of health care costs, caregiver burden, and institutionalization of people with dementia. Management options are limited, and antipsychotics are often used, although they carry a significant side effect profile. One novel option is tetrahydrocannabinol (THC); however, in the US, to obtain THC for patients with dementia, caregivers have to go to a commercial dispensary. We evaluated the effectiveness of dispensary-obtained THC for patients with dementia and NPS...
September 18, 2023: Journal of Clinical Psychiatry
https://read.qxmd.com/read/37701890/preventing-and-treating-delirium-in-clinical-settings-for-older-adults
#36
REVIEW
Morgan Faeder, Elizabeth Hale, Daniel Hedayati, Alex Israel, Darcy Moschenross, Melanie Peterson, Ryan Peterson, Mariel Piechowicz, Jonathan Punzi, Priya Gopalan
Delirium is a serious consequence of many acute or worsening chronic medical conditions, a side effect of medications, and a precipitant of worsening functional and cognitive status in older adults. It is a syndrome characterized by fluctuations in cognition and impaired attention that develops over a short period of time in response to an underlying medical condition, a substance (prescribed, over the counter, or recreational), or substance withdrawal and can be multi-factorial. We present a narrative review of the literature on nonpharmacologic and pharmacologic approaches to prevention and treatment of delirium with a focus on older adults as a vulnerable population...
2023: Therapeutic Advances in Psychopharmacology
https://read.qxmd.com/read/37676699/trends-in-use-of-antipsychotics-and-psychoactive-drugs-in-older-patients-after-major-surgery
#37
JOURNAL ARTICLE
Dae Hyun Kim, Hemin Lee, Ajinkya Pawar, Su Been Lee, Chan Mi Park, Raisa Levin, Eran Metzger, Brian T Bateman, E Wesley Ely, Pratik P Pandharipande, Margaret A Pisani, Samuel F Hohmann, Edward R Marcantonio, Sharon K Inouye
BACKGROUND: Professional society guidelines recommend limiting the use of antipsychotics in older patients with postoperative delirium. How these recommendations affected the use of antipsychotics and other psychoactive drugs in the postoperative period has not been studied. METHODS: This retrospective cohort study included patients 65 years or older without psychiatric diagnoses who underwent major surgery in community hospitals (CHs) and academic medical centers (AMCs) in the United States...
September 7, 2023: Journal of the American Geriatrics Society
https://read.qxmd.com/read/37673659/clozapine-for-the-treatment-of-aggressiveness-and-agitation-in-advanced-dementia
#38
JOURNAL ARTICLE
Arwed E Michael, Nikolaus Michael, Andreas Erfurth, Milenko Kujovic
BACKGROUND: Distressing behavioural symptoms, particularly agitation and aggressiveness, remain a difficult problem in everyday clinical practice in the treatment of multimorbid patients with dementia. Clozapine may be an effective therapeutic alternative in this context. METHODS: In a retrospective study, patients who had a diagnosis of dementia and had been treated in a specialized geriatric psychiatry unit with clozapine between August 2018 and February 2022 were included, and medical records were systematically reviewed...
September 6, 2023: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://read.qxmd.com/read/37671461/antipsychotic-use-among-older-patients-with-dementia-receiving-home-health-care-services-prevalence-predictors-and-outcomes
#39
JOURNAL ARTICLE
Jinjiao Wang, Jenny Y Shen, Yeates Conwell, Fang Yu, Kobi Nathan, Kathi L Heffner, Yue Li, Thomas V Caprio
BACKGROUND: Antipsychotic use is a safety concern among older patients in home health care (HHC), particularly for those with Alzheimer's disease and related dementias (ADRD). The objective of this study was to examine the prevalence and predictors of antipsychotic use among older adults with and without ADRD who received HHC, and the association of antipsychotic use with outcomes among patients living with ADRD. METHODS: In this secondary analysis of adults ≥65 years receiving care from an HHC agency in New York in 2019 (N = 6684), we used data from the Outcome and Assessment Information Set, Medicare HHC claims, and home medication review results in the electronic HHC records during a 60-day HHC episode...
September 6, 2023: Journal of the American Geriatrics Society
https://read.qxmd.com/read/37669619/organizational-context-and-quality-indicators-in-nursing-homes-a-microsystem-look
#40
JOURNAL ARTICLE
Yinfei Duan, Matthias Hoben, Yuting Song, Stephanie A Chamberlain, Alba Iaconi, Katharina Choroschun, Shovana Shrestha, Greta G Cummings, Peter G Norton, Carole A Estabrooks
The association of organizational context with quality of care in nursing homes is not well understood at the clinical microsystem (care unit) level. This cross-sectional study examined the associations of unit-level context with 10 unit-level quality indicators derived from the Minimum Data Set 2.0. Study settings comprised 262 care units within 91 Canadian nursing homes. We assessed context using unit-aggregated care-aide-reported scores on the 10 scales of the Alberta Context Tool. Mixed-effects regression analysis showed that structural resources were negatively associated with antipsychotics use (B = -...
September 5, 2023: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
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