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https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#1
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29324370/model-based-comparing-efficacy-of-fluoxetine-between-elderly-and-non-elderly-participants-with-major-depressive-disorder
#2
Lidan Dong, Ling Xu, Yanfei Li, Yinghua Lv, Hongxia Liu, Yunfei Li, Fengyan Xu, Junyi Wu, Qingshan Zheng, Lujin Li
BACKGROUND: The high heterogeneity was existed among the studies of the elderly participants with major depressive disorder (MDD), which may lead to incorrect conclusions in the previous meta-analysis. This study used model based meta-analysis to compare the efficacy of fluoxetine between the elderly and non-elderly participants with MDD and to explain the heterogeneity among the studies. METHODS: A comprehensive literature search was conducted in the public databases, involving utilization of fluoxetine for treating MDD in the acute-phase...
January 3, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29317062/could-the-screening-for-correct-oral-health-reduce-the-impact-of-death-due-to-bolus-asphyxia-in-adult-patients-a-forensic-case-report
#3
Isabella Aquila, Santo Gratteri, Matteo A Sacco, Emilio Nuzzolese, Vittorio Fineschi, Paola Frati, Pietrantonio Ricci
INTRODUCTION: "Bolus death" or "Café Coronary syndrome" refers to death due to asphyxia caused by an occlusion of the upper airways due to food. In this kind of asphyxia, the food bolus obstructs the larynx or the bronchial branches. This kind of event often affects subjects with acute intoxication due to alcohol or drugs, or with edentulism and with neurological or psychiatric diseases. CASE REPORT: An elderly woman, suffering from schizophrenia, was found dead in her house due to food bolus asphyxia...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29300436/serum-concentrations-of-25-hydroxyvitamin-d-and-depression-in-a-general-middle-aged-to-elderly-population-in-finland
#4
M Vidgren, J K Virtanen, T Tolmunen, T Nurmi, T-P Tuomainen, S Voutilainen, A Ruusunen
OBJECTIVES: Low concentrations of serum 25-hydroxyvitamin D [25(OH)D] have been postulated to associate with an increased prevalence of depression. As there are a limited number of publications on this issue, we examined the association between serum 25(OH)D and depression in a general middle-aged or older population. DESIGN: A population-based cross-sectional study. SETTING AND PARTICIPANTS: A total of 1602 men and women from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in Eastern Finland, aged 53-73 y in 1998-2001, were analysed...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29244058/antidepressant-use-and-cognitive-outcomes-in-very-old-women
#5
Yue Leng, Susan J Diem, Katie L Stone, Kristine Yaffe
Background: Antidepressant use is very common in the elderly, but the effects of antidepressants on cognition in the elderly are controversial with some studies suggesting harm and others protection. We aimed to investigate the association between different antidepressant use and change in cognition and risk of mild cognitive impairment (MCI) or dementia in very old women. Methods: We examined 1,234 community-dwelling women (mean age 83.2 years) from the Study of Osteoporotic Fractures...
December 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29211139/use-of-psychotropic-medications-in-adults-and-elderly-living-in-campinas-s%C3%A3-o-paulo-brazil-cross-sectional-population-based-study
#6
Maria Aparecida Medeiros Barros do Prado, Priscila Maria S Bergamo Francisco, Marilisa Berti de Azevedo Barros
OBJECTIVE: to estimate the prevalence of use of psychotropic medicines and associated factors in adults and elderly, and to identify the main classes used. METHODS: cross-sectional population-based study, conducted in Campinas-SP, Brazil (January/2008-April/2009); chi-square Rao-Scott test and Poisson multiple regression were applied. RESULTS: the study included 2,472 individuals and the prevalence of use of at least one psychotropic medication in the three previous days was 6...
October 2017: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#7
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29197326/potentially-inappropriate-prescriptions-for-elderly-people-taking-antidepressant-comparative-tools
#8
Izabela Fulone, Luciane Cruz Lopes
BACKGROUND: The use of psychotropic drugs by elderly people is widely spread around the world, given that prevalence of inappropriate medication is frequent. Strictly speaking, in Brazil, the vulnerable population of elderly people is more likely to use Potentially Inappropriate Psychotropic (PIP) due to the impact of social-economic characteristics, to the Brazilian Public Health System, and to the lack of patient monitoring. However, neither the use pattern nor the prevalence rate of PIP have been studied in Brazil so far...
December 2, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29180859/hyponatremia-in-the-elderly-challenges-and-solutions
#9
REVIEW
Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis
Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the "tea and toast" syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29175562/utilisation-and-polypharmacy-aspects-of-antiepileptic-drugs-in-elderly-versus-younger-patients-with-epilepsy-a-pharmacoepidemiological-study-of-cns-active-drugs-in-norway-2004-2015
#10
Arton Baftiu, Silje Andrea Feet, Pål Gunnar Larsson, Margrete Larsen Burns, Oliver Henning, Erik Sætre, Espen Molden, Anne Gerd Granas, Svein I Johannessen, Cecilie Johannessen Landmark
BACKGROUND AND PURPOSE: Many patients with epilepsy use antiepileptic drugs (AEDs) in combination. The elderly is a vulnerable group regarding polypharmacy. The purpose of this study was to investigate changes in utilisation of AEDs, and the extent of polypharmacy with other CNS-active drugs in elderly versus younger patients in Norway. METHODS: This pharmacoepidemiological study included all prescriptions of antiepileptic, antidepressant and antipsychotic drugs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2015)...
November 11, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29138992/use-of-ketamine-in-elderly-patients-with-treatment-resistant-depression
#11
REVIEW
Carolina Medeiros da Frota Ribeiro, Patricio Riva-Posse
PURPOSE OF REVIEW: The purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports...
November 15, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29138901/-which-factors-are-associated-with-the-use-of-potentially-inadequate-medications-pim-in-the-elderly-results-from-the-german-health-interview-and-examination-survey-degs1
#12
Heinz G Endres, Petra Kaufmann-Kolle, Hildtraud Knopf, Petra A Thürmann
BACKGROUND: Recent studies demonstrate a relationship between the prescription of potentially inappropriate medications (PIM) for patients 65 years or older and an increased risk for adverse events, in particular hospitalisations. The RKI conducted DEGS1-Survey ("German health interview and examination survey for adults") provides a representative sample of the target population to identify determinants for PIM use. OBJECTIVE: The aim of this study was to determine characteristics of older persons in Germany, who currently use PIM, and if there are subpopulations among older persons with a particularly high PIM use...
November 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29066874/optimization-of-drug-therapy-in-elderly-individuals-admitted-to-a-geriatric-unit
#13
Antoine Piau, Yoann Huet, Adeline Gallini, Laurine Andre, Bruno Vellas, Fati Nourhashemi
BACKGROUND: A substantial share of adverse drug events involves inappropriate prescribing (IP). Specialized geriatric units are supposed to pay particular attention to prescribing appropriateness and to promoting a higher prescribing quality. OBJECTIVE: The objective of this study was to evaluate the reality of such assessment and optimization in real life (usual care) in a population of elderly individuals admitted to a geriatric unit. METHOD: This is an observational study including all older patients admitted to an acute geriatric unit over a 6-month period...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29066229/depression-and-cardiovascular-disease-in-elderly-current-understanding
#14
REVIEW
Yaxin Zhang, Yujing Chen, Lina Ma
Geriatric depression is a major public health problem and has an especially large effect on health when comorbid with a chronic medical condition. Hypertension, coronary heart disease, and diabetes are accompanied by a high incidence of depression and can affect the treatment and prognosis. Depression is a highly prevalent risk factor for incident of and is associated with morbidity and mortality of cardiovascular disease. In addition to the proactive and effective control of primary diseases, efforts should also be made to improve patients' psychological and social function...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29046942/antidepressants-and-the-risk-of-arrhythmia-in-elderly-affected-by-a-previous-cardiovascular-disease-a-real-life-investigation-from-italy
#15
A Biffi, F Rea, L Scotti, A Mugelli, E Lucenteforte, A Bettiol, A Chinellato, G Onder, C Vitale, N Agabiti, G Trifirò, G Roberto, G Corrao
PURPOSE: The study aimed to fill existing knowledge gaps on the safety of antidepressant drugs (ADs) by estimating the risk of hospitalization for arrhythmia associated with use of selective serotonin reuptake inhibitors (SSRIs) and newer atypical ADs (NAAs) among elderly with previous cardiovascular (CV) events. METHODS: The cohort was composed by 199,569 individuals aged ≥ 65 years from five Italian healthcare territorial units who were discharged for cardiovascular outcomes in the years 2008-2010...
October 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29042180/idiopathic-rem-sleep-behavior-disorder-in-the-elderly-spanish-community-a-primary-care-center-study-with-a-two-stage-design-using-video-polysomnography
#16
Montserrat Pujol, Jesús Pujol, Tomás Alonso, Araceli Fuentes, Mercè Pallerola, Jovita Freixenet, Ferran Barbé, Manel Salamero, Joan Santamaría, Alex Iranzo
OBJECTIVE: To examine the presence and characteristics of idiopathic REM sleep behavior disorder (IRBD) in a representative Caucasian sample from the elderly community of Lleida, Spain, attending primary care centers. METHODS: Participants were individuals aged 60 years or older who underwent routine visits in two primary care centers. They underwent a two-stage study; a validated screening single question for IRBD diagnosis (RBD1Q) followed by, in those who endorsed positive answer, clinical assessment by a neurologist plus video-polysomnography (V-PSG)...
August 24, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28950817/specific-patient-features-affect-antiepileptic-drug-therapy-decisions-focus-on-gender-age-and-psychiatric-comorbidities
#17
Laura Rosa Pisani, Marina Nikanorova, Cecilie Johannessen Landmark, Svein Ivar Johannessen, Francesco Pisani
BACKGROUND: Patient features, apart from the type of seizures/epilepsy, affect markedly antiepileptic drug (AED) choice and dosage. The present review focuses on gender, age and psychiatric comorbidities which play a leading role in influencing antiepileptic treatment. METHODS: Reviews with large population of patients, controlled clinical trials, observational investigations, experimental studies and experimental reviews of experimental data, where appropriated, were analysed and illustrated to produce the most homogeneous indications possible...
September 25, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28950394/what-characterizes-depression-in-old-age-results-from-the-bruneck-study
#18
Michaela Defrancesco, Raimund Pechlaner, Stefan Kiechl, Johann Willeit, Eberhard A Deisenhammer, Hartmann Hinterhuber, Gregor Rungger, Arno Gasperi, Josef Marksteiner
Introduction Depression in old age is associated with functional disabilities, cognitive impairment, lower self-rated quality of life, and increased mortality. The aim of the study was to reveal the prevalence of depression and to investigate the characteristics of patients treated with antidepressants. Methods We analyzed data from the Bruneck Study 2010. All participants completed a clinical examination, cognitive screening, the 30-item Geriatric Depression Scale (GDS) (cutoff score of>8 to define relevant depressive symptoms), and the World Health Organization quality of life questionnaire (WHO-QoL)...
September 26, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28948667/categorical-and-dimensional-perspectives-on-depression-in-elderly-primary-care-patients-results-of-the-agemoode-study
#19
Marie Dorow, Janine Stein, Alexander Pabst, Siegfried Weyerer, Jochen Werle, Wolfgang Maier, Lisa Miebach, Martin Scherer, Anne Stark, Birgitt Wiese, Lilia Moor, Jens-Oliver Bock, Hans-Helmut König, Steffi G Riedel-Heller
An accurate diagnosis is essential for the management of late-life depression in primary care. This study aims to (1) provide information on the agreement on depression diagnoses between general practitioners (GPs), dimensional tools (Geriatric Depression Scale [GDS], Hospital Anxiety and Depression Scale [HADS]) and a categorical tool (Structured Clinical Interview for DSM-IV criteria [SCID]) and (2) identify factors associated with different diagnoses. As part of the multicenter study "Late-life depression in primary care: needs, health care utilization and costs (AgeMooDe)" a sample of 1113 primary care patients aged 75 years and older was assessed...
September 25, 2017: International Journal of Methods in Psychiatric Research
https://www.readbyqxmd.com/read/28948135/pharmacological-management-of-anxiety-disorders-in-the-elderly
#20
Elizabeth A Crocco, Sindy Jaramillo, Caroline Cruz-Ortiz, Katherine Camfield
Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction...
March 2017: Current Treatment Options in Psychiatry
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