Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia: Research on Asian Psychotropic Prescription Pattern

2019 ◽  
Vol 32 (6) ◽  
pp. 304-311 ◽  
Author(s):  
Min Dong ◽  
Liang-Nan Zeng ◽  
Qinge Zhang ◽  
Shu-Yu Yang ◽  
Lian-Yu Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Multiple Logistic Regression Analysis ◽  
Mainland China ◽  
Careful Consideration ◽  
Drug Induced ◽  
Prescription Pattern ◽  
Asian Patients ◽  
Increased Risk ◽  
Collection Form

Background and Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors. Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics. Fifteen Asian countries/territories participated in this survey, including Bangladesh, Mainland China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Basic demographic and clinical characteristics were collected using a standardized data collection form. Results: Among the 879 older adults with schizophrenia included in the survey, the rate of APP was 40.5%. Multiple logistic regression analysis revealed that higher antipsychotic doses ( P < .001, odds ratio [OR] = 1.003, 95% confidence interval [CI]: 1.002-1.003), longer duration of illness ( P = .02, OR = 1.845, 95% CI: 1.087-3.132), and the prescription of anticholinergics ( P < .001, OR = 1.871, 95% CI: 1.329-2.635), second-generation antipsychotics ( P = .001, OR = 2.264, 95% CI: 1.453-3.529), and first-generation antipsychotics ( P < .001, OR = 3.344, 95% CI: 2.307-4.847) were significantly associated with APP. Conclusion: Antipsychotic polypharmacy was common in older adult Asian patients with schizophrenia. Compared to the results of previous surveys, the use of APP showed a declining trend over time. Considering the general poor health status of older patients with schizophrenia and their increased risk of drug-induced adverse events, the use of APP in this population needs careful consideration.

scholarly journals A Systematic Review Examining the Efficacy of Epidural Analgesia on Mortality in Older Adult Patients with Rib Fractures

2019 ◽  
Author(s):  
Erin Casimiro
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Epidural Analgesia ◽  
Older Adult ◽  
Patient Population ◽  
Effective Means ◽  
Pulmonary Complications ◽  
Rib Fractures ◽  
Definitive Treatment ◽  
Increased Risk

Rib fractures are a common consequence of blunt force trauma, producing pain and potentially leading to complications such as pneumonia, atelectasis, respiratory failure, and death. Due to physiological changes related to aging, older adults aged 65 and over are at increased risk for developing such complications. Aggressive treatment of pain has been recognized as paramount in preventing such consequences. While there are multiple modalities to treat pain related to rib fractures, epidural analgesia has frequently been recognized as an effective means of preventing pulmonary complications and decreasing mortality in an opioid sparing technique. However, it remains unclear if this therapy would serve as a definitive treatment in the population of older adults. The purpose of this systematic review was to determine the effect of epidural analgesia on decreasing mortality in the older adult patient population. Literature and pertinent randomized controlled trials were searched for inclusion within this review. Six trials were included within this review utilizing the PRISMA checklist and CASP tool to extract and critically appraise data. Cross study analysis was then utilized to determine overarching themes within the data. This systematic review did not find any statistically significant data to suggest that mortality is decreased in older adults by utilizing epidural analgesia after thoracic trauma. Further research is necessary utilizing prospective data focusing on this particular patient population in order to better determine the effectiveness of this treatment.

An age-friendly city? LGBTQ and frail older adults

2021 ◽  
pp. 89-108
Author(s):  
Lindsay Herman ◽  
Ryan Walker ◽  
Mark W. Rosenberg
Keyword(s):  
Older Adults ◽  
Lived Experience ◽  
Older Adult ◽  
Adult Population ◽  
Careful Consideration ◽  
World Health ◽  
Daily Experience ◽  
Health And Wellbeing ◽  
Aging Infrastructure ◽  
Older Adult Population

This chapter discusses the aging demographic in Saskatoon, Saskatchewan, and across Canada that is changing the way communities function. It examines the intersection of age and diversity that compound the daily experience of aging, which subject older adults to a 'double jeopardy' in accessing important spaces, services, and opportunities for health and wellbeing. It also mentions age-friendly community development, popularized by the World Health Organization's Age-Friendly Cities Guide, which encompasses an approach to the physical, social, and political fabric of cities and includes a careful consideration of older-adult lived experience. The chapter highlights the age-friendly development theory, which considers the social capital as a foundational component to healthy and sustainable aging infrastructure. It analyzes the experiences of two of the most at-risk or isolated communities among the overall older adult population in Saskatoon: the members of the LGBTQ community, and those experiencing physical or cognitive frailty.

scholarly journals The Correlation of Food and Physical Activity with Diabetes Incidence Among Older-Adult

2020 ◽  
Vol 5 (2) ◽  
pp. 166
Author(s):  
Maria Getrida Simon ◽  
Sakti Oktaria Batubara
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Older Adults ◽  
Older Adult ◽  
Diabetes Incidence ◽  
Public Health Community ◽  
Type 2 Dm ◽  
Health Community ◽  
Increased Risk

Introduction: Diabetes in older adults is associated with higher mortality, reduced functional status, and increased risk of institutionalization. Older adult with Diabetes type 2 additionally have high risk for both intense and constant microvascular and cardiovascular disease. The purpose of this study is to analyze the correlation of food and physical activity with diabetes incidence among older adults in Pasir Panjang public health community, Kupang. Methods: The research used observational analytic design with cross-sectional approach. The sampling technique taken was convenience sampling. The samples were 120 respondents. To analyze food and physical activity with DM incidence, the researchers used a statistical chi square. To measure activity, the instrument used was the Global Physical Activity Questionnaire (GPAQ) from the WHO and to measure food it used the Indonesian Family Life Survey (IFLS) from Indonesia’s health ministry. Results: This study showed that there was a correlation between food and type 2 DM incidence for the older adults in Pasir Panjang public health community Kupang (p = 0.008 <0.05), but there was no correlation between activity with the incidence of type 2 DM (p = 0.138> 0.05). Conclusion: Nurses need to create suitable health education regarding food consumed for older adult with type 2 diabetes, and involve their family to support patients to consume the diet.

scholarly journals Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians: a cohort analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jakob Lederman ◽  
Veronica Lindström ◽  
Carina Elmqvist ◽  
Caroline Löfvenmark ◽  
Gunnar Ljunggren ◽  
...  
Keyword(s):  
Older Adults ◽  
Patient Safety ◽  
Adverse Events ◽  
Older Adult ◽  
Emergency Department Visits ◽  
Adult Patients ◽  
Ambulance Service ◽  
Oxygen Saturation Level ◽  
Presenting Symptoms ◽  
Increased Risk

Abstract Background Older adults (age ≥ 65 years) represent a significant proportion of all patients who are not transported to hospital after assessment by ambulance clinicians (non-conveyed patients). This study aimed to fill the knowledge gap in the understanding of the prevalence of older adult non-conveyed patients and investigate their characteristics and risk factors for subsequent and adverse events with those of younger non-conveyed patients comparatively. Methods This population-based retrospective cohort study included all adult non-conveyed patients who availed the ambulance service of Region Stockholm, Sweden in 2015; they were age-stratified into two groups: 18–64 and ≥ 65 years. Inter-group differences in short-term outcomes (i.e. emergency department visits, hospitalisations, and mortality within 7 days following non-conveyance) were assessed using multivariate regression analyses. Results Older adult patients comprised 48% of the 17,809 non-conveyed patients. Dispatch priority levels were generally lower among older non-conveyed patients than among younger patients. Non-conveyance among older patients occurred more often during daytime, and they were more frequently assessed by ambulance clinicians with nonspecific presenting symptoms. Approximately one in five older adults was hospitalised within 7 days following non-conveyance. Patients presenting with infectious symptoms had the highest mortality risk following non-conveyance. Oxygen saturation level < 95% or systolic blood pressure > 160 mmHg had significantly higher associations with hospitalisation within 7 days following non-conveyance in older adult patients. Conclusions Older adult patients have an increased risk for adverse events following non-conveyance. In combination with a complex and variating presentation of symptoms and vital signs proved difficult for dispatch operators and ambulance clinicians to identify and assess, the identified risks raise questions on the patient safety of older adult non-conveyed patients. The results indicate a system failure that need to be managed within the ambulance service organisation to achieve higher levels of patient safety for older non-conveyed patients.

scholarly journals The motor repertoire of older adult fallers may constrain their response to balance perturbations

2018 ◽  
Vol 120 (5) ◽  
pp. 2368-2378 ◽  
Author(s):  
Jessica L. Allen ◽  
Jason R. Franz
Keyword(s):  
Older Adults ◽  
Visual Perception ◽  
Older Adult ◽  
Balance Control ◽  
Lateral Instability ◽  
Increased Risk ◽  
Motor Module ◽  
Risk Of Falls ◽  
History Of ◽  
Walking Balance

Older adults are at a high risk of falls, and most falls occur during locomotor activities like walking. This study aimed to improve our understanding of changes in neuromuscular control associated with increased risk of falls in older adults in the presence of dynamic balance challenges during walking. Motor module (also known as muscle synergy) analyses identified changes in the neuromuscular recruitment of leg muscles during walking with and without perturbations designed to elicit the visual perception of lateral instability. During normal walking we found that a history of falls (but not age) was associated with reduced motor module complexity and that age (but not a history of falls) was associated with increased step-to-step variability of module recruitment timing. Furthermore, motor module complexity was unaltered in the presence of optical flow perturbations. The specific effects of a history of falls on leg muscle recruitment included an absence and/or inability to independently recruit motor modules normally recruited to perform biomechanical functions important for walking balance control. These results suggest that fallers do not recruit the appropriate motor modules necessary for well-coordinated walking balance control even in the presence of perturbations. The identified changes in the modular control of walking balance in older fallers may either represent a neural deficit that leads to poor balance control or a prior history of falls that results in a compensatory motor adaptation. In either case, our study provides initial evidence that a reduced motor repertoire in older adult fallers may be a constraint on their ability to appropriately respond to balance challenges during walking. NEW & NOTEWORTHY This is the first study to demonstrate a reduced motor repertoire during walking in older adults with a history of falls but without any overt neurological deficits. Furthermore, using virtual reality during walking to elicit the visual perception of lateral instability, we provide initial evidence that a reduced motor repertoire in older adult fallers may be a constraint on their ability to appropriately respond to balance challenges during walking.

scholarly journals Exploring the beliefs and experiences of older Irish adults and family carers during the novel coronavirus (COVID-19) pandemic: A qualitative study protocol

2020 ◽  
Vol 3 ◽  
pp. 16 ◽  
Author(s):  
Katie Robinson ◽  
Aoife O'Neill ◽  
Mairead Conneely ◽  
AnnMarie Morrissey ◽  
Siobhan Leahy ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Older Adult ◽  
Well Being ◽  
World Health Organisation ◽  
Open Access Journal ◽  
World Health ◽  
Research Centre ◽  
Services Research ◽  
Increased Risk

Background: In December 2019 a novel human coronavirus (COVID-19) was identified in Wuhan, China (Wu et al, 2020). The virus subsequently spread to most countries worldwide and the World Health Organisation characterised the outbreak a pandemic on March 11th 2020 (WHO, 2020a). Older age is associated with an increased risk of mortality in patients with COVID-19 (Chen et al., 2020). In March 2020, the Irish Government introduced 'cocooning' as a measure for those over 70 years of age to minimise interactions with others by not leaving their homes (Dept. of Health, 2020). The COVID-19 pandemic presents unique threats to the health and well-being of older adults. This study aims to explore the longitudinal experiences and beliefs of older adults during the COVID-19 pandemic. Findings will be important for tailoring supports, interventions and public health information for this population. Methods: A longitudinal exploratory qualitative study will be conducted using repeated semi-structured telephone interviews with a convenient sample of older adults recruited from participants of an older adult and family carer stakeholder panel for health services research established by the Ageing Research Centre (ARC) at the University of Limerick and through known older adult contacts of ARC academic members. Interviews will be audio recorded, transcribed and analysed using a reflexive approach to thematic analysis. Participants will have the opportunity to review and discuss preliminary analysis of the interview data and to co-write / design dissemination materials. Ethics and Dissemination: Ethical approval has been granted by the Faculty of Education and Health Sciences University of Limerick, Research Ethics Committee (2020_03_51_EHS (ER)). Findings will be disseminated through open access journal publications and distribution of lay summaries, a press release and an infographic to organisations of and for older people in Ireland, broadcast and print media.

scholarly journals Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians: A cohort analysis

2020 ◽  
Author(s):  
Jakob Lederman ◽  
Veronica Lindström ◽  
Carina Elmqvist ◽  
Caroline Löfvenmark ◽  
Gunnar Ljunggren ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Events ◽  
Older Adult ◽  
Cohort Analysis ◽  
Significant Proportion ◽  
Emergency Department Visits ◽  
Adult Patients ◽  
Oxygen Saturation Level ◽  
Presenting Symptoms ◽  
Increased Risk

Abstract Background: Older adults (age ≥65 years) represent a significant proportion of all patients who are not transported to hospital after assessment by ambulance clinicians (non-conveyed patients). This study aimed to fill the knowledge gap in the understanding of the prevalence of older adult non-conveyed patients and investigate their characteristics and risk factors for subsequent and adverse events with those of younger non-conveyed patients comparatively.Methods: This population-based retrospective cohort study included all adult non-conveyed patients who availed the ambulance service of Region Stockholm, Sweden in 2015; they were age-stratified into two groups: 18–64 and ≥65 years. Inter-group differences in short-term outcomes (i.e. emergency department visits, hospitalisations, and mortality within 7 days following non-conveyance) were assessed using multivariate regression analyses.Results: Older adult patients comprised 48% of the 17,809 non-conveyed patients. Dispatch priority levels were generally lower among older non-conveyed patients than among younger patients. Non-conveyance among older patients occurred more often during daytime, and they were more frequently assessed by ambulance clinicians with nonspecific presenting symptoms. Approximately one in five older adults was hospitalised within 7 days following non-conveyance. Patients presenting with infectious symptoms had the highest mortality risk following non-conveyance. Oxygen saturation level <95% or systolic blood pressure >160 mmHg had significantly higher associations with hospitalisation within 7 days following non-conveyance in older adult patients.Conclusions: Older adult patients have an increased risk for adverse events following non-conveyance. In combination with a complex symptom presentation which proves difficult for dispatch operators and ambulance clinicians to identify, this risk raises questions on the patient safety of older adult non-conveyed patients.

scholarly journals Villanova ReachOut Forming Connections with Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 746-746
Author(s):  
Christina Whitehouse ◽  
Catherine Curley ◽  
Caitlin Gomes ◽  
Michelle McKay ◽  
Christine Brewer ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Older Adult ◽  
Cardiovascular Health ◽  
Positive Impact ◽  
Training Satisfaction ◽  
Increased Risk ◽  
Rich Data ◽  
The Impact ◽  
Question Survey

Abstract Older adults are at increased risk for loneliness and social isolation. Research on loneliness identifies increased rates of depression, increased cognitive decline, and poor cardiovascular health outcomes. The COVID-19 pandemic forced many older adults into social isolation for protection against this insidious virus. Mandated lockdowns and personal decisions to shelter-in-place produced a tremendous increase in rates of loneliness, especially among older adults. Identifying a need for communication and relationships, we created Villanova ReachOut, a program that partners interprofessional students (N= 66) with older adults (N=53) through weekly telephone or video calls. To assess the impact of our program we developed a five question survey administered via phone to older adults and a 13-item survey for volunteers to assess training, satisfaction, needs and impact of the program. Of the older adults (n=16) who completed the survey, 78.6% believe the program helped them feel less isolated throughout the pandemic and 93.8% indicated they looked forward to weekly calls with their partner . Volunteers who completed the survey (N=25), overwhelmingly stated they enjoy and look forward to their calls (100%) and their communication skills have improved (92%). Volunteers reported being paired up with an older adult for weekly conversation had a positive impact on their personal and professional development. Findings from our program evaluation provide rich data in descriptions of positive impact for both the older adult and volunteer. These findings also support the need for programs that engage in intergenerational dialogue, specifically targeting older adults and the potential older adult workforce.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

2017 ◽  
Vol 2 (5) ◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Prescription

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

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