scholarly journals Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults

2020 ◽  
Vol 23 (4) ◽  
pp. 286-296 ◽  
Author(s):  
Shirley Musich ◽  
Shaohung S. Wang ◽  
Luke B. Slindee ◽  
Joann Ruiz ◽  
Charlotte S. Yeh
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Concurrent Use

scholarly journals Sleep-Disordered Breathing Is Associated With Impaired Odor Identification in Older U.S. Adults

2020 ◽  
Author(s):  
Jesse K Siegel ◽  
Xiandao Yuan ◽  
Kristen E Wroblewski ◽  
Martha K McClintock ◽  
Jayant M Pinto
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Sleep Disordered Breathing ◽  
Odor Identification ◽  
Odor Sensitivity ◽  
Disordered Breathing

Abstract Background Sleep-disordered breathing (SDB) is a common, underdiagnosed condition in older adults with major health consequences, including disrupted central nervous system functioning. Whether SDB may affect sensory function is unclear. We sought to address this question by comparing 2 forms of olfactory testing which measure peripheral and central olfactory processing. Methods We assessed SDB (survey-reported snoring frequency, nighttime apneic events, or diagnosis of sleep apnea) in the National Social Life, Health, and Aging Project, a nationally representative sample of older U.S. adults. Odor sensitivity (peripheral) and odor identification (central) were assessed with validated instruments. Logistic regression was used to test the relationship between SDB and olfaction, accounting for relevant covariates, including demographics, cognition, and comorbidity. Results Twenty-nine percent of older U.S. adults reported symptoms of SDB (apneic events or nightly snoring). Of these, only 32% had been diagnosed with sleep apnea. Older adults with SDB (those who reported symptoms or have been diagnosed with sleep apnea) were significantly more likely to have impaired odor identification (odds ratio 2.13, 95% confidence interval 1.19–3.83, p = .012) in analyses that accounted for age, gender, race/ethnicity, education, cognition, comorbidities (including depression), and body mass index. Presence of SDB was not associated with impaired odor sensitivity (odds ratio 1.03, 95% confidence interval 0.75–1.43, p = .84). Conclusion SDB is highly prevalent but underdiagnosed in older U.S. adults and is associated with impaired odor identification but not odor sensitivity. These data support the concept that SDB affects pathways in the central nervous system which involve chemosensory processing.

EVALUATING THE ASSOCIATION BETWEEN CENTRAL NERVOUS SYSTEM (CNS)-ACTIVE MEDICATION USE AND FALL-RELATED INJURIES IN OLDER ADULTS WITH DEMENTIA

2017 ◽  
Vol 13 (7) ◽  
pp. P1564-P1565
Author(s):  
Laura A. Hart ◽  
Zachary Marcum ◽  
Shelly L. Gray ◽  
Rod L. Walker ◽  
Paul K. Crane ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Medication Use ◽  
Active Medication

scholarly journals Association Between Medications Acting on the Central Nervous System and Fall-Related Injuries in Community-Dwelling Older Adults: A New User Cohort Study

2019 ◽  
Vol 75 (5) ◽  
pp. 1003-1009 ◽  
Author(s):  
Shelly L Gray ◽  
Zachary A Marcum ◽  
Sascha Dublin ◽  
Rod Walker ◽  
Negar Golchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Injury Risk ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Active Medication ◽  
Increased Risk ◽  
The Central Nervous System ◽  
Community Dwelling Older Adults

Abstract Background It is well established that individual medications that affect the central nervous system (CNS) increase falls risk in older adults. However, less is known about risks associated with taking multiple CNS-active medications. Methods Employing a new user design, we used data from the Adult Changes in Thought study, a prospective cohort of community-dwelling people aged 65 and older without dementia. We created a time-varying composite measure of CNS-active medication exposure from electronic pharmacy fill data and categorized into mutually exclusive categories: current (within prior 30 days), recent (31–90 days), past (91–365 days), or nonuse (no exposure in prior year). We calculated standardized daily dose and identified new initiation. Cox proportional hazards models examined the associations between exposures and the outcome of fall-related injury identified from health plan electronic databases. Results Two thousand five hundred ninety-five people had 624 fall-related injuries over 15,531 person-years of follow-up. Relative to nonuse, fall-related injury risk was significantly greater for current use of CNS-active medication (hazard ratio [HR] = 1.95; 95% CI = 1.57–2.42), but not for recent or past use. Among current users, increased risk was noted with all doses. Risk was increased for new initiation compared with no current use (HR = 2.81; 95% CI = 2.09–3.78). Post hoc analyses revealed that risk was especially elevated with new initiation of opioids. Conclusions We found that current use, especially new initiation, of CNS-active medications was associated with fall-related injury in community-dwelling older adults. Increased risk was noted with all dose categories. Risk was particularly increased with new initiation of opioids.

scholarly journals Aging, the Central Nervous System, and Mobility in Older Adults: Neural Mechanisms of Mobility Impairment

2015 ◽  
Vol 70 (12) ◽  
pp. 1526-1532 ◽  
Author(s):  
Farzaneh A. Sorond ◽  
Yenisel Cruz-Almeida ◽  
David J. Clark ◽  
Anand Viswanathan ◽  
Clemens R. Scherzer ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Neural Mechanisms ◽  
Mobility Impairment ◽  
The Central Nervous System

scholarly journals Prevalence of Central Nervous System–Active Polypharmacy Among Older Adults With Dementia in the US

JAMA ◽  
2021 ◽  
Vol 325 (10) ◽  
pp. 952
Author(s):  
Donovan T. Maust ◽  
Julie Strominger ◽  
H. Myra Kim ◽  
Kenneth M. Langa ◽  
Julie P. W. Bynum ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
The Us

scholarly journals Potentially inappropriate medication use in older adults: prevalence and physician knowledge

2021 ◽  
Vol 15 ◽  
Author(s):  
Gabriela Santos Pessoa Isidoro ◽  
Mariana Axer Vieira Pinto ◽  
Natália Caetano Alves Melo ◽  
Paula Alves Melo de Souza ◽  
Luanna Gabriella Resende da Silva ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Inappropriate Medication ◽  
Primary Data ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Physician Knowledge ◽  
Central Nervous System Disorders ◽  
Validated Questionnaire

OBJECTIVE: To analyze the frequency, profile, and additional variables associated with the prescription of potentially inappropriate medications (PIM) to older adults in primary care, and evaluate physicians’ knowledge about these medications. METHODS: A cross-sectional study was conducted based on data from patient records for the period of January 2014 to December 2017 in a city located in the state of Minas Gerais. The frequency of PIM use was evaluated based on the 2019 Beers-Fick criteria. Physician knowledge was evaluated using a validated questionnaire as a primary data source. RESULTS: In a sample of 423 older adults, 75.89% (n = 321) used at least one PIM, the most common of which were medications used to treat central nervous system disorders (48.00%; n = 203). Most participants were female (62.41%; n = 264) and 70 years or older (69.50%; n = 294). When presented with clinical cases illustrating common situations in the management of older patients, 53.33% of physicians (n = 8) answered four or five questions correctly out of a possible seven; 13.33% (n = 2) answered six questions correctly; and 33.33% (n = 5) obtained three correct answers or fewer. CONCLUSIONS: These findings showed a high frequency of PIM use among older adults treated in Primary Health Care settings, with medications used in the treatment of central nervous system disorders. Our results highlight the importance of continuing education for health professionals and improved assessments of the medication available in the Unified Health System (Sistema Único de Saúde; SUS) for use in older adults, especially those taking multiple medications

scholarly journals COVID-19’s Pathways to Human Central Nervous System and Relevant Drug Treatment

2020 ◽  
Vol 218 ◽  
pp. 03009
Author(s):  
Zhaolun Liang
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory System ◽  
Severe Disease ◽  
Shortness Of Breath ◽  
Human Central Nervous System ◽  
The Earth ◽  
Different Types

COVID-19, also known as Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV2), is a severe disease. It can cause different types of symptoms including shortness of breath, fever, cough, fatigue and sore throat. Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk to develop more complex complications due to the infection. Until August 6th, 2020, COVID-19 has caused 700, 000 deaths across the Earth; however, the actual death number could be higher than 700,000. COVID-19’s origin is still remained unknown, but the speculation is targeted to bats or pangolins. Although COVID-19 is a disease target human’s respiratory system, based on the research and clinical cases of COVID-19, evidence shows that COVID-19 can also invade human’s central nervous system (CNS).

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