Psychopharmacology in older people

2013 ◽  
Author(s):  
Craig W. Ritchie
Keyword(s):  
Older People ◽  
Psychotropic Medication ◽  
Later Life ◽  
The Elderly ◽  
Pharmacological Interventions ◽  
Pharmacodynamic Effects ◽  
Adherence To Medication ◽  
Prescribing Practice ◽  
Altered Pharmacokinetic ◽  
Pharmacokinetic Drug

It is well recognised that older people are particularly sensitive to psychotropic medication. In general, pharmacological interventions in the elderly pose specific problems due to the patient exhibiting both altered pharmacokinetic drug profiles due to gerontological effects on absorption, distribution, metabolism and elimination of drug and pharmacodynamic effects related to aging and polypharmacy. Adherence to medication in later life also mediates sub-optimal pharmacological care. Finally, the effects of comorbidities which accumulate with advancing years should also influence prescribing practice in the elderly. The general principles underlying these changes and observations are discussed with specific examples listed to illustrate these points.

scholarly journals What happens to anxiety disorders in later life?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 74-80 ◽  
Author(s):  
Gerard JA Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Older Patients ◽  
Depressive Disorders ◽  
Late Onset ◽  
Reliability And Validity ◽  
Later Life ◽  
Pharmacological Interventions ◽  
Measuring Change ◽  
Pathological Anxiety

Anxiety disorders decline in prevalence with advancing age but remain more common than depressive disorders. They are often of late-onset and there is frequent comorbidity with depressive disorders and physical illness. While anxiety disorders in older people are likely to respond to the same non-pharmacological interventions that have been shown to work in younger people, there is currently little formal evidence of this. Although there is some evidence that the non-benzodiazepine anxiolytic medication, buspirone, is effective against late life anxiety symptoms, clinical trials in older people with rigorously diagnosed anxiety disorders are needed. An anxiety scale with demonstrated reliability and validity in older people is needed for screening for pathological anxiety and for measuring change in older patients undergoing treatment for anxiety disorders.

scholarly journals The impact of traditional filial piety between older people and their children in Taiwan

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Older People ◽  
Family Member ◽  
Filial Piety ◽  
Structural Changes ◽  
Later Life ◽  
The Elderly ◽  
Chinese People ◽  
Traditional Belief ◽  
Social Structural ◽  
The Impact

Filial piety is a significant traditional belief among Chinese people. However, social structural changes have created a limited number of people available to take care of the elderly. Elderly infirm parents may be sent to nursing homes when no family member is available to take care of them, which may effectively reduce older people’s satisfaction in their later life. It also increases the caring stress from children because of this traditional belief.

Driving and Incidence of Functional Limitation in Older People: A Prospective Population-Based Study

Gerontology ◽  
2016 ◽  
Vol 62 (6) ◽  
pp. 636-643 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Hyuma Makizako ◽  
Kota Tsutsumimoto ◽  
Ryo Hotta ◽  
Sho Nakakubo ◽  
...  
Keyword(s):  
Older People ◽  
Functional Limitation ◽  
Later Life ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Strong Impact ◽  
Driving Cessation ◽  
Safe Driving ◽  
Elderly Cohort

Background: Many studies have examined the negative social and health consequences of driving cessation in later life. However, whether the transition to driving cessation results in the incidence of functional limitation in older people remains unclear. Objective: The aim of this study was to examine whether driving cessation was associated with the incidence of functional limitation in older Japanese individuals. Methods: The study included 3,556 participants (mean age: 71.5 ± 5.3 years, 50.2% women) enrolled in the ‘Obu Study of Health Promotion for the Elderly' cohort study between August 2011 and February 2012. The participants were classified into three groups according to their driving status: driving, driving cessation, and nondriving. We assessed new incidence of functional limitation over a 24- month period and examined several confounding factors. Results: The incidence rates for functional limitation in the driving, driving cessation, and nondriving groups were 0.9, 10.8, and 5.6%, respectively (p < 0.001). The fully adjusted Cox proportional hazard model showed that hazard ratios (HRs) for functional limitation in nondrivers [HR: 2.37, 95% confidence interval (CI): 1.27-4.44] and those who had ceased driving (HR: 7.80, 95% CI: 2.61-23.36) were significantly higher relative to those observed in current drivers. Conclusion: Driving cessation exerted a strong impact on the risk of functional limitation. Further study is required to determine appropriate intervention strategies to help older people to maintain the abilities required for safe driving and delay the functional limitation associated with driving cessation.

APPROPRIATE PRESCRIBING FOR OLDER PEOPLE: A NEW TOOL FOR THE GENERAL PRACTITIONER

2013 ◽  
pp. 1-7
Author(s):  
E. LENAERTS ◽  
F. DE KNIJF ◽  
B. SCHOENMAKERS
Keyword(s):  
Nursing Home ◽  
Older People ◽  
Short Form ◽  
Nursing Home Residents ◽  
Well Being ◽  
The Elderly ◽  
Future Research ◽  
Slight Reduction ◽  
Appropriate Prescribing ◽  
Prescribing Practice

Background:Appropriate prescribing for older people is a challenge. General practitioners (GPs) areaware of their key position in relation to prescribing practice in the elderly. However, they often feel powerlessand report a need for simple GP friendly tools to assess and support their prescribing practice. Objectives: In thisstudy such a tool is developed: the Appropriate Medication for Older people-tool (AMO-tool). The purpose of thestudy is to investigate whether GPs consider the use of the AMO-tool to be practically feasible and resulting inmore appropriate prescribing. Design:This pilot study with an interventional design was conducted over a periodof six months. Setting:The study was conducted in nursing homes visited by GPs. Participants:The studiedpopulation consisted of nine GPs and 67 nursing home residents. Intervention:The intervention consisted of theuse of the AMO-tool. Measurements:The Short Form (SF)-12 questionnaire was administered to the patients.Patients' medication lists were recorded. The GPs completed a semi-quantitative questionnaire on theirexperiences with the AMO-tool. A descriptive qualitative and semi-quantitative analysis was carried out on theGP questionnaire. The results of the SF-12 questionnaires and medication lists were analysed quantitatively. Amultivariate analysis was carried out. Results: In the perception of GPs, applying the AMO-tool to medicationlists of nursing home residents was feasible and resulted in more appropriate prescribing. A slight reduction wasrecorded in the number of medications prescribed. Self-reported well-being improved and rose in parallel withthe number of medication changes. Conclusion:According to GPs, the AMO-tool offers GPs the support in theirprescribing practice. Changes are made to medication lists and improvements occur in patients' self-reportedwell-being. Future research should objectify the appropriateness of prescriptions before and after using the tool.Furthermore, it should investigate the possible causal relationship between the use of the AMO-tool, an increasein appropriateness of medication lists and an improvement of general well-being.

scholarly journals Lifecourse transitions, gender and drinking in later life

2015 ◽  
Vol 37 (3) ◽  
pp. 462-494 ◽  
Author(s):  
CLARE HOLDSWORTH ◽  
MARTIN FRISHER ◽  
MARINA MENDONÇA ◽  
CESAR DE OLIVEIRIA ◽  
HYNEK PIKHART ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Older People ◽  
Age Groups ◽  
Later Life ◽  
The Elderly ◽  
Adult Age ◽  
The United Kingdom ◽  
Younger Age ◽  
Frequent Consumption ◽  
Over Time

ABSTRACTOlder people consume less alcohol than any other adult age group. However, in recent years survey data on alcohol consumption in the United Kingdom have shown that while younger age groups have experienced a decline in alcohol consumption, drinking behaviours among the elderly have not reduced in the same way. This paper uses data from the English Longitudinal Study of Ageing to analyse both the frequency and quantity of older adult's alcohol consumption using a lifecourse approach over a ten-year period. Overall drinking declined over time and the analysis examined how socio-economic characteristics, partnership, employment and health statuses were associated with differences in drinking behaviours and how these changed over time. Higher wealth and level of education were associated with drinking more and drinking more frequently for men and women. Poorer self-rated health was associated with less frequent consumption and older people with poor and deteriorating health reported a steeper decline in the frequency of alcohol consumption over time. Men who were not in a partnership drank more than other men. For women, loss of a partner was associated with a steeper decline in drinking behaviours. These findings have implications for programmes to promote responsible drinking among older adults as they suggest that, for the most part, characteristics associated with sustaining wellbeing in later life are also linked to consuming more alcohol.

scholarly journals Older People’s Preferences for Housing and Environment Characteristics

2020 ◽  
Vol 12 (14) ◽  
pp. 5723
Author(s):  
Emma Mulliner ◽  
Mike Riley ◽  
Vida Maliene
Keyword(s):  
Older People ◽  
Independent Living ◽  
Academic Research ◽  
Later Life ◽  
The Elderly ◽  
Ageing In Place ◽  
Health And Wellbeing ◽  
Age In Place ◽  
Key Drivers

Population ageing presents significant challenges for many countries, one of which is the provision of adequate housing. Developing understanding of the needs and preferences of ageing societies will be crucial in order to assist in the provision of suitable housing and communities that are sustainable in the long term. While a preference to ‘age in place’ is clear in the literature, comparatively less academic research is available on older people’s preferences for more specific housing and environment attributes. The aim of this study is to identify the main housing and environment characteristics that are linked to the health and wellbeing of the elderly and determine the preferences for such characteristics via a survey with UK residents aged 55+. The results indicate a strong preference for independent living and an increasing desire for bungalows in later life. Housing conditions, energy efficiency, thermal comfort, and home adaptions to facilitate ageing in place are particularly important housing characteristics to older people. The location and environment are also key drivers of housing preferences; a safe neighbourhood, accessibility to amenities, public transport, and a clean and walkable environment are particularly important. Preferences varied with age, but gender has a less significant impact on the preferences expressed. The findings of this study will be valuable for stakeholders engaged in housing policy and provision for older people.

Can a Theory of Suicide Predict All “Suicides” in the Elderly?

Crisis ◽  
2003 ◽  
Vol 24 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Antoon A. Leenaars
Keyword(s):  
Sigmund Freud ◽  
Terminally Ill ◽  
Later Life ◽  
Psychological Theory ◽  
The Elderly ◽  
Theory Building ◽  
Personality Factors ◽  
Comprehensive Model ◽  
Suicide Notes ◽  
Psychiatric Study

Summary: Older adults consistently have the highest rates of suicide in most societies. Despite the paucity of studies until recently, research has shown that suicides in later life are best understood as a multidimensional event. An especially neglected area of research is the psychological/psychiatric study of personality factors in the event. This paper outlines one comprehensive model of suicide and then raises the question: Is such a psychiatric/psychological theory applicable to all suicides in the elderly? To address the question, I discuss the case of Sigmund Freud; raise the topic of suicide and/or dignified death in the terminally ill; and examine suicide notes of the both terminally ill and nonterminally ill elderly. I conclude that, indeed, greater study and theory building are needed into the “suicides” of the elderly, including those who are terminally ill.

scholarly journals Population aging and the historical development of intergenerational transfer systems

Genus ◽  
2020 ◽  
Vol 76 (1) ◽  
Author(s):  
Ronald Lee
Keyword(s):  
Older People ◽  
Population Aging ◽  
Intergenerational Transfers ◽  
The Elderly ◽  
Intergenerational Transfer ◽  
Agricultural Revolution ◽  
Public Transfers ◽  
Working Age ◽  
Social Sharing ◽  
Private Transfers

Abstract From our evolutionary past, humans inherited a long period of child dependency, extensive intergenerational transfers to children, cooperative breeding, and social sharing of food. Older people continued to transfer a surplus to the young. After the agricultural revolution, population densities grew making land and residences valuable assets controlled by older people, leading to their reduced labor supply which made them net consumers. In some East Asian societies today, elders are supported by adult children but in most societies the elderly continue to make private net transfers to their children out of asset income or public pensions. Growing public intergenerational transfers have crowded out private transfers. In some high-income countries, the direction of intergenerational flows has reversed from downward to upwards, from young to old. Nonetheless, net private transfers remain strongly downward, from older to younger, everywhere in the world. For many but not all countries, projected population aging will bring fiscal instability unless there are major program reforms. However, in many countries population aging will reduce the net cost to adults of private transfers to children, partially offsetting the increased net costs to working age adults for public transfers to the elderly.

scholarly journals Rational Use of Protein Supplements in the Elderly—Relevance of Gastrointestinal Mechanisms

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1227
Author(s):  
Ian Chapman ◽  
Avneet Oberoi ◽  
Caroline Giezenaar ◽  
Stijn Soenen
Keyword(s):  
Blood Glucose ◽  
Older People ◽  
The Elderly ◽  
Time Intervals ◽  
Lower Blood Glucose ◽  
Protein Supplements ◽  
Protein Requirements ◽  
Lower Blood ◽  
Older Subjects

Protein supplements are increasingly used by older people to maintain nutrition and prevent or treat loss of muscle function. Daily protein requirements in older people are in the range of 1.2 gm/kg/day or higher. Many older adults do not consume this much protein and are likely to benefit from higher consumption. Protein supplements are probably best taken twice daily, if possible soon after exercise, in doses that achieve protein intakes of 30 gm or more per episode. It is probably not important to give these supplements between meals, as we have shown no suppressive effects of 30 gm whey drinks, and little if any suppression of 70 gm given to older subjects at varying time intervals from meals. Many gastrointestinal mechanisms controlling food intake change with age, but their contributions to changes in responses to protein are not yet well understood. There may be benefits in giving the supplement with rather than between meals, to achieve protein intakes above the effective anabolic threshold with lower supplement doses, and have favourable effects on food-induced blood glucose increases in older people with, or at risk of developing, type 2 diabetes mellitus; combined protein and glucose drinks lower blood glucose compared with glucose alone in older people.

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