New Antidepressants for Older People: A Critical Review of the Evidence Base

L Encéphale ◽  
2008 ◽  
Vol 34 ◽  
pp. S71-S76 ◽  
Author(s):  
C. Katona
Keyword(s):  
Older People ◽  
Critical Review ◽  
Evidence Base

Not that old person: Older people’s responses to ageism revealed through digital storytelling

2021 ◽  
pp. 144078332110401
Author(s):  
Diana Bossio ◽  
Anthony McCosker ◽  
Max Schleser ◽  
Hilary Davis ◽  
Ivana Randjelovic
Keyword(s):  
Older People ◽  
Digital Storytelling ◽  
Social Acceptance ◽  
Elder Abuse ◽  
Evidence Base ◽  
Social Constructionist ◽  
Physical Decline ◽  
Actual Experience ◽  
Social Discourses ◽  
Positive Ageing

One of the issues limiting prevention of elder abuse in Australia is lack of a strong evidence base to target social drivers of abuse, particularly ageism. This evidence gap is exacerbated by social discourses that perpetuate negative representations of older age as a time of vulnerability and physical decline, often in opposition to people’s actual experience of ageing. This article presents findings of the ‘OPERA Project’, which used co-designed digital storytelling to explore how ageing and ageism are perceived by older people. The project findings indicated that preventing elder abuse requires discursive intervention to combat negative social discourses representing older people, and to frame social acceptance of the inherent complexity of experiences of ageing. Using a social constructionist approach, this article puts forward a ‘middle path’ through traditional theories of ageing and associated ‘positive ageing’ discourses, which often problematise ageing itself.

Interpersonal psychotherapy

2020 ◽  
pp. 261-264
Author(s):  
Philip Wilkinson ◽  
Ken Laidlaw
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Psychological Treatment ◽  
Interpersonal Psychotherapy ◽  
Evidence Base ◽  
Theory And Practice ◽  
Role Transitions ◽  
Treatment Of Depression

This chapter on interpersonal psychotherapy (IPT) describes the theory and practice of this structured psychological treatment. It discusses the implementation of IPT with older people. Next it reviews the applications of IPT with a main focus on the treatment of depression in older adults and distinguishes between the treatment of depression with and without cognitive impairment. It summarizes the structure of IPT and the use of specific techniques, and it then addresses the main therapeutic foci encountered in treatment (grief, interpersonal role disputes, role transitions, and interpersonal deficits). Finally, it briefly reviews the evidence base for IPT with older people.

Corrigendum to “Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base” [Nutrition 31 (2015) 1-13]

Nutrition ◽  
2019 ◽  
Vol 62 ◽  
pp. 213 ◽  
Author(s):  
Richard D. Feinman ◽  
Wendy K. Pogozelski ◽  
Arne Astrup ◽  
Richard K. Bernstein ◽  
Eugene J. Fine ◽  
...  
Keyword(s):  
Critical Review ◽  
Diabetes Management ◽  
Evidence Base ◽  
Carbohydrate Restriction ◽  
Dietary Carbohydrate

scholarly journals New horizons in deprescribing for older people

2019 ◽  
Vol 48 (6) ◽  
pp. 768-775 ◽  
Author(s):  
Henry J Woodford ◽  
James Fisher
Keyword(s):  
Medication Adherence ◽  
Older People ◽  
Evidence Base ◽  
Ageing Population ◽  
Improve Medication Adherence ◽  
Long Term Conditions ◽  
Team Working ◽  
Drug Adverse Effects ◽  
Potential Benefits ◽  
Few Data

Abstract Deprescribing has gained interest recently, driven by an ageing population seeing an increasing number living with multiple long-term conditions. This, coupled with disease-specific guidelines derived from clinical trials in younger people, has led to an increase in exposure to polypharmacy and the associated therapeutic burden. Older people, especially those living with frailty, tend to experience lower efficacy of these medications along with a higher risk of drug adverse effects. Explanations for these differences include the physiological effects of frailty, drug–drug interactions, drug–disease interactions and reduced medication adherence. Adverse drug reactions often go unnoticed and can trigger further prescribing. Certain medications have been recognised as potentially inappropriate for people with frailty, yet their use remains common. Evidence suggests that many older people are open to the concept of reducing medications. Deprescribing should be based around a shared decision-making approach. Trials to date have suggested that it can often be achieved without harm. To date, there are few data to support improvements in hospitalisation or mortality rates. However, there is some evidence that it may reduce polypharmacy, improve medication adherence, reduce financial costs and improve quality of life. In the future, it will be necessary to grow the evidence base and improve public and clinician awareness of the potential benefits of deprescribing. It will require excellent team working and communication between all of those involved in the prescribing and administration of medications, also supported by improved healthcare informatics. Non-pharmacological approaches will need to be promoted. Fewer drugs is not less care.

scholarly journals Exploring the role of volunteers in social care for older adults

2020 ◽  
Vol 21 (2) ◽  
pp. 129-139 ◽  
Author(s):  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Paul B. Willis ◽  
Liz Lloyd ◽  
Randall Smith
Keyword(s):  
Older Adults ◽  
Older People ◽  
Social Care ◽  
Evidence Base ◽  
Care Staff ◽  
Small Scale ◽  
The South ◽  
Content Type ◽  
South West

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided.

scholarly journals Comparative effectiveness of sitagliptin vs sulphonylureas in older people

2019 ◽  
Vol 48 (5) ◽  
pp. 725-732
Author(s):  
Manuj Sharma ◽  
Irwin Nazareth ◽  
Irene Petersen
Keyword(s):  
Older People ◽  
Comparative Effectiveness ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Age Groups ◽  
Evidence Base ◽  
Lower Proportion ◽  
Multivariate Adjustment ◽  
Younger Age ◽  
Multivariable Regression

Abstract Background two common anti-diabetic treatments used are sitagliptin and sulphonylureas however evidence examining their comparative effectiveness in older people is limited. Objective to evaluate effectiveness of sitagliptin vs sulphonylureas when added to metformin in older (aged ≥75) vs younger people (18–75). Design retrospective cohort study. Setting UK Primary Care. Subjects 2,904 individuals prescribed sitagliptin (223 aged≥75) and 13,683 prescribed sulphonylureas (1,725 aged ≥75). Methods multivariable regression to analyse difference in HbA1c and weight, 12 months after add-on initiation and proportion achieving different glycaemic targets. Results after multivariate adjustment to remove baseline differences, the HbA1c after 12 months of treatment was on average 1 mmol/mol (95%CI −0.7 to 2.8) higher with sitagliptin vs sulphonylureas in older people though this was not statistically significant. The weight however, was significantly lower −1.4 kg (95%CI −2.1 to −0.7) with sitagliptin vs sulphonylureas. A lower proportion prescribed sitagliptin vs sulphonylureas recorded HbA1c < 48 mmol/mol by study end: Odds Ratio 0.63 (95%CI 0.42–0.95). In younger people, similar HbA1c reductions were also observed with both treatments, however weight after 12 months was even lower with sitagliptin vs sulphonylureas: −2.3 kg (95%CI −2.5 to −2.0). Conclusions similar HbA1c reduction was observed when sitagliptin or sulphonylureas were added to metformin in older and younger age-groups. Sitagliptin use led to modest comparative weight loss. There may be greater risk of over-treatment with sulphonylureas evidenced by greater proportion recording HbA1c < 48 mmol/mol by study end. This evidence supporting use of sitagliptin when add-on therapy is selected in older adults should be considered alongside the wider evidence-base and patient-preference.

A Critical Review of the Evidence Base of Imagery Rehearsal for Posttraumatic Nightmares: Pointing the Way for Future Research

2013 ◽  
Vol 26 (5) ◽  
pp. 570-579 ◽  
Author(s):  
Gerlinde C. Harb ◽  
Andrea J. Phelps ◽  
David Forbes ◽  
Richard J. Ross ◽  
Philip R. Gehrman ◽  
...  
Keyword(s):  
Critical Review ◽  
Evidence Base ◽  
Future Research ◽  
Posttraumatic Nightmares ◽  
Imagery Rehearsal ◽  
The Way

scholarly journals Modernising social care services for older people: scoping the United Kingdom evidence base

2009 ◽  
Vol 29 (4) ◽  
pp. 497-538 ◽  
Author(s):  
SALLY JACOBS ◽  
CHENGQIU XIE ◽  
SIOBHAN REILLY ◽  
JANE HUGHES ◽  
DAVID CHALLIS
Keyword(s):  
United Kingdom ◽  
Older People ◽  
Social Care ◽  
Developed Countries ◽  
Evidence Base ◽  
Research Literature ◽  
Care Services ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Care For Older People

ABSTRACTIn common with other developed countries at the end of the 20th century, modernising public services was a priority of the United Kingdom (UK) Labour administration after its election in 1997. The modernisation reforms in health and social care exemplified their approach to public policy. The authors were commissioned to examine the evidence base for the modernisation of social care services for older people, and for this purpose conducted a systematic review of the relevant peer-reviewed UK research literature published from 1990 to 2001. Publications that reported descriptive, analytical, evaluative, quantitative and qualitative studies were identified and critically appraised under six key themes of modernisation: integration, independence, consistency, support for carers, meeting individuals' needs, and the workforce. This paper lists the principal features of each study, provides an overview of the literature, and presents substantive findings relating to three of the modernisation themes (integration, independence and individuals' needs). The account provides a systematic portrayal both of the state of social care for older people prior to the modernisation process and of the relative strengths and weaknesses of the evidence base. It suggests that, for evidence-based practice and policy to become a reality in social care for older people, there is a general need for higher quality studies in this area.

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