Risk Factors for Adverse Drug Events in Older Adults with Mobility Limitations in the Community Setting

AbstractObjective:The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.Design:Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.Setting:Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).Participants:CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.Results:Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.Conclusions:The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.

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Factors Associated With Older Adults’ In-Hospital Mobility: A Comparison Between Israel and Denmark

Innovation in Aging ◽

10.1093/geroni/igab046.093 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 26-26

Author(s):

Mette Merete Pedersen ◽

Janne Petersen ◽

Ove Andersen ◽

Efrat Shadmi ◽

Ksenya Shulyaev ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Length Of Stay ◽

Bed Rest ◽

Analysis Of Covariance ◽

Admission Diagnosis ◽

Mobility Limitations ◽

Post Discharge ◽

Mobility Performance ◽

Similar Risk

Abstract Low levels of in-hospital mobility and excessive bed rest are widely described across the globe as a major risk factor for hospital associated disabilities. Different predictors of in-hospital and post-discharge mobility limitations have been proposed across studies, including age, admission diagnosis, physical performance, cognitive impairment, performance of activities of daily living, and length of stay. However, it is unknown whether similar risk factors across countries are associated with in-hospital mobility given different mobility measurement methods, variations in measurement of predictors and differences in populations studied. In the current study, we investigated the relationship between in-hospital mobility and a set of similar risk factors in functionally independent older adults (65+) hospitalized in acute care settings in Israel (N=206) and Denmark (N=113). In Israel, mobility was measured via ActiGraph and in Denmark by ActivPal for up to seven hospital days. Parallel analysis of covariance (ANCOVA) in each sample showed that community-mobility before hospitalization, mobility performance at admission and length of stay were associated with in-hospital mobility in both countries, whereas age and self-reported health status were associated with mobility only in Denmark. This comparison indicates that despite slightly different measurement approaches, similar risks are attributed to older adults’ low in-hospital mobility and emphasizes the contribution of commonly used pre-hospitalization mobility measures as strong and consistent risk factors. This knowledge can support a better understanding of the need of both standard risk assessments and country-based tailored approaches.

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Risk Factors for Adverse Drug Events Among Older Adults in the Ambulatory Setting

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2004.52367.x ◽

2004 ◽

Vol 52 (8) ◽

pp. 1349-1354 ◽

Cited By ~ 176

Author(s):

Terry S. Field ◽

Jerry H. Gurwitz ◽

Leslie R. Harrold ◽

Jeffrey Rothschild ◽

Kristin R. DeBellis ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Adverse Drug Events ◽

Ambulatory Setting

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Promoting activity, independence and stability in early dementia and mild cognitive impairment (PrAISED): development of an intervention for people with mild cognitive impairment and dementia

Clinical Rehabilitation ◽

10.1177/0269215518758149 ◽

2018 ◽

Vol 32 (7) ◽

pp. 855-864 ◽

Cited By ~ 4

Author(s):

Vicky Booth ◽

Rowan H Harwood ◽

Victoria Hood-Moore ◽

Trevor Bramley ◽

Jennie E Hancox ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Community Setting ◽

Practical Consideration ◽

Cross Sectional Survey ◽

Post Intervention ◽

Cross Sectional ◽

People With Dementia

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless, they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is an understanding of how to develop an intervention for people with mild cognitive impairment and dementia to promote their independence, stability, and physical activity. Introduction: Older adults with dementia are at a high risk of falls. Standard interventions have not been shown to be effective in this patient population potentially due to poor consideration of dementia-specific risk factors. An intervention is required that addresses the particular needs of older people with dementia in a community setting. Methods: We followed guidelines for the development of an intervention, which recommend a structured approach considering theory, evidence and practical issues. The process used 15 information sources. Data from literature reviews, clinician workshops, expert opinion meetings, patient-relative interviews, focus groups with people with dementia and clinicians, a cross-sectional survey of risk factors, a pre-post intervention study and case studies were included. Data were synthesized using triangulation to produce an intervention suitable for feasibility testing. Practical consideration of how an intervention could be delivered and implemented were considered from the outset. Results: Elements of the intervention included individually tailored, dementia-appropriate, balance, strength and dual-task exercises, functional training, and activities aimed at improving environmental access, delivered using a motivational approach to support adherence and long-term continuation of activity. We focussed on promoting safe activity rather than risk or prevention of falls. Conclusion: We used a systematic process to develop a dementia-specific intervention to promote activity and independence while reducing falls risk in older adults with mild dementia.

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Concerns and beliefs about medicines and inappropriate medications: An internet-based survey on risk factors for self-reported adverse drug events among older adults

The American Journal of Geriatric Pharmacotherapy ◽

10.1016/j.amjopharm.2010.06.002 ◽

2010 ◽

Vol 8 (3) ◽

pp. 245-257 ◽

Cited By ~ 15

Author(s):

Olayinka O. Shiyanbola ◽

Karen B. Farris

Keyword(s):

Risk Factors ◽

Older Adults ◽

Adverse Drug Events ◽

Beliefs About Medicines ◽

Inappropriate Medications

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Risk factors associated with adverse drug events among older adults in emergency department

European Journal of Internal Medicine ◽

10.1016/j.ejim.2013.10.006 ◽

2014 ◽

Vol 25 (1) ◽

pp. 49-55 ◽

Cited By ~ 27

Author(s):

Yen-Chia Chen ◽

Ju-Sing Fan ◽

Min-Hui Chen ◽

Teh-Fu Hsu ◽

Hsien-Hao Huang ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Emergency Department ◽

Adverse Drug Events ◽

Factors Associated

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A Qualitative Analysis to Understand Perception about Medication-Related Problems among Older Minority Adults in a Historically Black Community

Pharmacy ◽

10.3390/pharmacy10010014 ◽

2022 ◽

Vol 10 (1) ◽

pp. 14

Author(s):

Ivy O. Poon ◽

Felicia Skelton ◽

Lena R. Bean ◽

Dominique Guinn ◽

Terica Jemerson ◽

...

Keyword(s):

Older Adults ◽

Historically Black ◽

Adverse Drug Events ◽

Ecological Model ◽

Group Discussion ◽

Medication Management ◽

Unmet Need ◽

Community Setting ◽

Patient Centered ◽

Increased Risk

Older adults taking multiple chronic medications experience an increased risk of adverse drug events and other medication-related problems (MRP). Most current literature on medication management involves researcher-driven intervention, yet few studies investigate patients’ understanding of MRP in a diverse community setting. This report investigates patients’ perception of MRP and patient-centered strategies among a cohort of the older adult group in a historically Black urban community. The study design is qualitative using structured open-ended questions in a multidisciplinary patient-centered focus group. Patients (age 65 years or older) taking seven or more medications were recruited. The group comprises patients, caregivers, pharmacists, health educators, a physician, and a nurse. Recordings of the group discussion are transcribed verbatim and analyzed using thematic content analysis and categorized by codes developed from the social-ecological model. The group reports patient-provider relationships, previous experience, fear of side effects played important roles in medication adherence. There is an unmet need for medication management education and tools to organize complex medication lists from multiple providers. This study provides important insights into MRP experienced by minority older adults and provided researchers with potential strategies for future interventions.

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