scholarly journals An Update on Medication Use in Older Adults: a Narrative Review

2021 ◽  
Author(s):  
Heather E. Barry ◽  
Carmel M. Hughes
Keyword(s):  
Older Adults ◽  
Population Aging ◽  
Inappropriate Prescribing ◽  
Medication Use ◽  
Complex Interventions ◽  
Medical Intervention ◽  
Narrative Review ◽  
Care Needs ◽  
Related Factors ◽  
Age Related

Abstract Purpose of Review The global phenomenon of population aging is impacting the health and care needs of society. The use of medications by older adults is acknowledged to be the most common form of medical intervention for many acute and chronic conditions and prescribing in this population continues to increase. In this narrative review, we summarise the age-related factors that should be considered when prescribing for older adults, address some of the perennial challenges related to medicine use in older people, and highlight important emerging research in this area. Recent Findings A range of age-related factors should be considered when prescribing for older adults. However, the evidence base still lacks data pertaining to older adults due to their continued under-representation in clinical trials. Multimorbidity, polypharmacy, and inappropriate prescribing continue to remain prevalent among older adults, although recent research has been focused on the development and evaluation of complex interventions to address these challenges. Summary Further high-quality studies of interventions to improve and support medication use in older adults are needed, ensuring that older adults are well represented in such trials and consideration is given to the measurement of patient- and provider-focused outcomes.

scholarly journals What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK

2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Older People ◽  
Social Engagement ◽  
Community Dwelling ◽  
Related Factors ◽  
Age Related ◽  
Hertfordshire Cohort Study ◽  
The Uk ◽  
Community Dwelling Older Adults

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

scholarly journals Predictors of Blood Pressure in Iranian Women- A Narrative Review

2020 ◽  
Author(s):  
Maryam Etaat ◽  
Zohre Tabatabaye ◽  
Samaneh Motamed Jahromi ◽  
Poneh Yosefi ◽  
Sadegh Sedigh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Stress ◽  
Narrative Review ◽  
Iranian Women ◽  
Related Factors ◽  
Factors Affecting ◽  
Waist Size ◽  
Age Related ◽  
Diet And Exercise ◽  
Important Health

Introduction: hypertension is one of the most important health problems in the world and in developing countries, including Iran. The prevalence of hypertension among Iranian women is higher than men. This study aimed to investigate the predictive causes of hypertension among Iranian women. This study was a narrative review that was conducted by searching related studies and resources in databases of Google Scholar, SID, Pubmed, Magiran, Web of Science, and Scopus. Finally, 49 qualified articles were analyzed and the texts were reviewed. Based on the obtained data, the predictors of hypertension among Iranian women included the underlying factors of obesity (diet and exercise), psychosocial factors (stress, occupation and addiction) and age-related factors. Conclusion:  Obesity and increased waist size had a greater role in high blood pressure in Iranian women. After obesity, age and factors affecting them, lack of exercise, high stress, occupational factors, education, and addiction can also influence high blood pressure.As a result, it can be predicted that by identifying the risk factors, hypertension can be reduced among Iranian women; by teaching the causes and methods of preventing hypertension to the Iranian women as well as screening for timely diagnose and treatment, hypertension could be decreased among Iranian women.

scholarly journals Aging, Resistance Training, and Diabetes Prevention

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Kyle D. Flack ◽  
Kevin P. Davy ◽  
Matthew W. Hulver ◽  
Richard A. Winett ◽  
Madlyn I. Frisard ◽  
...  
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Glucose Tolerance ◽  
Diabetes Prevention ◽  
Baby Boom ◽  
Related Factors ◽  
Age Related ◽  
Increased Risk ◽  
Factor Α ◽  
Necrosis Factor

With the aging of the baby-boom generation and increases in life expectancy, the American population is growing older. Aging is associated with adverse changes in glucose tolerance and increased risk of diabetes; the increasing prevalence of diabetes among older adults suggests a clear need for effective diabetes prevention approaches for this population. The purpose of paper is to review what is known about changes in glucose tolerance with advancing age and the potential utility of resistance training (RT) as an intervention to prevent diabetes among middle-aged and older adults. Age-related factors contributing to glucose intolerance, which may be improved with RT, include improvements in insulin signaling defects, reductions in tumor necrosis factor-α, increases in adiponectin and insulin-like growth factor-1 concentrations, and reductions in total and abdominal visceral fat. Current RT recommendations and future areas for investigation are presented.

scholarly journals Barriers to effective prescribing in older adults: applying the theoretical domains framework in the ambulatory setting – a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sabrina Lau ◽  
Penny Lun ◽  
Wendy Ang ◽  
Keng Teng Tan ◽  
Yew Yoong Ding
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Grey Literature ◽  
Inappropriate Prescribing ◽  
Theoretical Domains Framework ◽  
Ambulatory Setting ◽  
Eligibility Criteria ◽  
Related Factors ◽  
Prescribing Behaviour ◽  
The Impact

Abstract Background As the population ages, potentially inappropriate prescribing (PIP) in the older adults may become increasingly prevalent. This undermines patient safety and creates a potential source of major morbidity and mortality. Understanding the factors that influence prescribing behaviour may allow development of interventions to reduce PIP. The aim of this study is to apply the Theoretical Domains Framework (TDF) to explore barriers to effective prescribing for older adults in the ambulatory setting. Methods A scoping review was performed based on the five-stage methodological framework developed by Arksey and O’Malley. From 30 Aug 2018 to 5 Sep 2018, we conducted our search on PubMed, CINAHL, EMBASE, the Cochrane Database of Systematic Reviews, and Web of Science. We also searched five electronic journals, Google and Google Scholar to identify additional sources and grey literature. Two reviewers applied eligibility criteria to the title and abstract screening, followed by full text screening, before systematically charting the data. Results A total of 5731 articles were screened. Twenty-nine studies met the selection criteria for qualitative analysis. We mapped our results using the 14-domain TDF, eventually identifying 10 domains of interest for barriers to effective prescribing. Of these, significant domains include physician-related factors such as “Knowledge”, “Skills”, and “Social/Professional Role and Identity”; issues with “Environmental Context and Resources”; and the impact of “Social Influences” and “Emotion” on prescribing behaviour. Conclusion The TDF elicited multiple domains which both independently and collectively lead to barriers to effective prescribing for older adults in the ambulatory setting. Changing the prescribing climate will thus require interventions targeting multiple stakeholders, including physicians, patients and hospital/clinic systems. Further work is needed to explore individual domains and guide development of frameworks to aid guide prescribing for older adults in the ambulatory setting.

scholarly journals Approach to the Older Adult With Multiple Myeloma

2019 ◽  
pp. 500-518 ◽  
Author(s):  
Roberto Mina ◽  
Sara Bringhen ◽  
Tanya M. Wildes ◽  
Sonja Zweegman ◽  
Ashley E. Rosko
Keyword(s):  
Older Adults ◽  
Multiple Myeloma ◽  
High Risk ◽  
Chromosomal Abnormalities ◽  
Performance Status ◽  
Therapeutic Options ◽  
Post Transplantation ◽  
Related Factors ◽  
Sequential Approach ◽  
Age Related

Multiple myeloma (MM) is a disease of aging adults, and numerous therapeutic options are available for this growing demographic. MM treatment of older adults continues to evolve and includes novel combinations, new generations of targeted agents, immunotherapy, and increasing use of autologous stem cell transplantation (ASCT). Understanding age-related factors, independent of chronologic age itself, is an increasingly recognized factor in MM survivorship, especially in understudied populations, such as octogenarians. Octogenarians have inferior survival that cannot be explained by cytogenetic profiles alone. Incorporating assessments of geriatric factors can provide guidance on how to intensify or de-escalate therapeutic options. Functional status, using objective testing, is superior to traditional metrics of performance status and should be implemented to optimize the risk-benefit ratio of ASCT. ASCT is feasible and cost-effective, and chronologic age should not exclude ASCT eligibility. Upfront ASCT remains the standard of care, in the context of a sequential approach that includes pre-transplantation induction and post-transplantation maintenance. High-risk MM is classically defined by disease characteristics, yet shifting frameworks suggest that the high-risk designation could refer to any patient subgroup who is at risk for poorer outcomes—beyond disease-focused outcomes to patient-focused outcomes. Defining the optimal treatment of subgroups of older patients with high-risk disease on the basis of chromosomal abnormalities is unexplored. Here, we review tools to assess individual health status, explore vulnerability in octogenarians with MM, address ASCT decision-making, and examine high-risk MM to understand factors that contribute to survival disparities for older adults with MM.

scholarly journals PREPARATION FOR FUTURE IN OLD AGE: WHY AND WHY NOT?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S749-S749
Author(s):  
Helene H Fung
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Old Age ◽  
Population Aging ◽  
Well Being ◽  
Future Research ◽  
Age Related ◽  
The Usa ◽  
Older Chinese ◽  
Using Data

Abstract With population aging, many people can expect to spend 30 or more years in old age. The five papers included in this symposium aim at shedding light on whether and how to make plans for old age, using data from the “Aging as Future” Project. First, Park and Hess used data spanning across adulthood from Germany, Hong Kong and the USA to examine how changes experienced in domains of functioning and the importance attached to these domains influenced preparations for old age. Next, de Paula Couto and Rothermund, examining Germans aged 40-90 years, pointed out that prescriptive age stereotypes might be the main drive for why people make preparations for age-related changes. The remaining three papers use qualitative data to qualify the above quantitative findings. Adamson and Ekerdt interviewed older Midwest US residents. They observed that SES greatly impacted how older adults perceived and made plans for their future. The final two papers examined how rural vs. urban contexts might affect preparations for future. Liou interviewed older adults in rural Tainan and found that their ideal old age was one about no future preparation, at least not about making plans for themselves (called “tranquil life”). Ho and colleagues, in contrast, found that for older Chinese residing in urban Hong Kong, not preparing for the future (called “time freeze”) was negatively related to physical and psychological well-being. The symposium will end with an overall discussion on future research directions on whether and how to make plans for old age.

Frailty, sarcopenia, and falls in cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 2950-2954
Author(s):  
Antonio Cherubini ◽  
Massimiliano Fedecostante
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Clinical Manifestations ◽  
Drug Effects ◽  
Adverse Outcomes ◽  
Assessment Tools ◽  
Management Approach ◽  
Older Individuals ◽  
Related Factors ◽  
Age Related

Frailty reflects a state of high vulnerability to stressors, even at low intensity, putting frail older adults at high risk of adverse outcomes. Sarcopenia (i.e. skeletal muscle decline) explains many of the clinical manifestations of the frailty syndrome and is the key component of physical frailty. Many frailty assessment tools are built around the concept of sarcopenia. Frailty is not only a consequence of the ageing process, but cardiovascular disease can contribute to its genesis, also sharing common pathogenetic pathways. Falls are very common in older individuals and are the best example of the interplay between age-related conditions and diseases. Falls, as well as frailty and sarcopenia, are most often multifactorial in nature. Cardiovascular disorders are among the risk factors that have been identified to cause falls in older adults; in particular, unexplained and recurrent falls. Orthostatic hypotension, carotid sinus syndrome, and adverse drug effects are the most important cardiovascular disease-related factors that have been found to be associated with falls in older people. Implementing the comprehensive geriatric assessment, a multidomain and multidisciplinary evaluation and management approach, represents the best strategy to properly manage older patients with cardiovascular disease.

scholarly journals Interprofessional Healthcare Education on Aging Increases Students' Confidence in Medication Management Skills

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-14
Author(s):  
Laura Finn ◽  
Deborah Summers
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Physician Assistant ◽  
Medication Use ◽  
Care Plan ◽  
Safe Medication ◽  
Physician Assistant Students ◽  
Age Related ◽  
Survey Results ◽  
The Impact

Abstract Students studying for health care professions have limited opportunities to learn about medication use and aging in an interprofessional experience. Health Care students who interact in a simulation of age-related sensory changes can identify adaptations for safe medication use and counseling necessary to promote healthy aging. This research assessed the impact of a simulated team experience on pharmacy and physician assistant students’ confidence in understanding age related changes and in learning adaptations to promote safe medication use for older adults who may experience those changes. 63 pharmacy and 113 Physician Assistant students participated in 2-hour Interprofessional Education (IPE) sessions. The teams of pharmacy/physician assistant students utilized glasses to simulate changes in vision and gloves to simulate conditions of arthritis and neuropathy which increase in prevalence with age. Teams practiced skills of medication counseling and empathy towards their peers experiencing the simulations and learned medication administration adaptations for aging well. Pre survey results show a deficit of Pharmacist-Physician Assistant IPE with less than 20% of students reporting a strong understanding of the other profession’s role in developing an older adult’s care plan. Post survey results demonstrate an increase in students’ confidence in both understanding how sensory impairments may affect a patient’s ability to properly administer medication and confidence in counseling older adults on safe medication use. Descriptive data on learning in Interprofessional teams, Pre/Post comparison data and application to students studying other majors will be presented.

scholarly journals ETHNIC DISPARITY IN NUTRITIONAL STATUS: EVIDENCE FROM ECUADOR’S NATIONAL SURVEY OF HEALTH, WELFARE AND AGING (SABE)

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S247-S247
Author(s):  
Takashi Amano ◽  
Carlos Andres Gallegos
Keyword(s):  
Older Adults ◽  
Ethnic Identity ◽  
Nutritional Status ◽  
Indigenous People ◽  
Nutritional Assessment ◽  
Population Aging ◽  
Economic Status ◽  
Public Investment ◽  
Mini Nutritional Assessment ◽  
Related Factors

Abstract Providing effective public services to improve the nutritional status among older adults is pivotal in countries experiencing population aging. Public investment and social policy in Ecuador have focused mainly on standard food-based interventions and cash transference programs. These efforts, however, may be not effective enough to reach those populations that need the most. This study aims to identify those populations that should be targeted by specific interventions. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE) – 2009, a probability sample of households with at least one person who were 60 years or older in Ecuador. The final sample consisted of 5,235 people who were 60 years or older. Ethnic identity was categorized into four categories: Indigenous People, Mestizo (Mixed of Spanish and Indigenous People), Afro-Ecuadorian/Mulato, and Other. Nutritional status was measured using Mini Nutritional Assessment (MNA). Ordered logistic regression analysis was utilized to assess the association between ethnic identity and nutritional status. Results revealed that the Indigenous ethnicity was significantly associated with worse nutritional status compared to Mestizo and Other even after controlling for a range of covariates including socio-economic status, health related factors, and social support. These findings suggest the existence of underlaying factors hindering the nutritional status of among indigenous older adults in Ecuador. Considering the information revealed by SABE, interventions and other strategies should be targeted and designed specifically accounting for the needs, preferences, and culture of the most vulnerable population.

Sign in / Sign up

Export Citation Format

Share Document