Substance Abuse among the Elderly Population: Overview and Management

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.

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The Impact of an Aging Rural Population on Local Tax Structures

Agricultural and Resource Economics Review ◽

10.1017/s1068280500008819 ◽

1995 ◽

Vol 24 (2) ◽

pp. 174-184

Author(s):

Timothy W. Kelsey ◽

Stephen M. Smith ◽

A.E. Luloff

Keyword(s):

Economic Development ◽

Elderly Population ◽

Telephone Survey ◽

The Elderly ◽

Direct Role ◽

Local Taxes ◽

Critical Effect ◽

The Impact ◽

The Relationship ◽

Tax Structures

The growing American retired population increasingly is viewed for its economic development potential. The relationship between the elderly and local taxes may have a critical effect on this potential, however. This paper examines the local tax implications of an increasing elderly population in communities prohibiting tax referenda. In such communities, citizens have no direct role in tax decisions. The elderly's attitudes towards different local taxes are examined using telephone survey data, before using aggregate data to investigate the relationship between the elderly and the specific taxes used in communities. The results suggest that a high proportion of elderly do not affect the mix of local taxes, but that an increasing proportion does have an influence.

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Pharmacologic Considerations in the Elderly Surgical Patient

DeckerMed Surgery ◽

10.2310/surg.2193 ◽

2016 ◽

Author(s):

Linda Sohn ◽

Joe C. Hong ◽

Michael W. Yeh ◽

Tara A. Russell ◽

Marcia M. Russell

Keyword(s):

Older Adults ◽

Surgical Procedures ◽

Postoperative Delirium ◽

Medication Management ◽

The Elderly ◽

The United States ◽

Surgical Patient ◽

Age Related ◽

The Impact ◽

Preoperative Medication

The most rapidly growing segment of the elderly population corresponds to persons age 85 and over. As of 2006, elderly patients accounted for 35.3% of the inpatient and 32.1% of the outpatient surgical procedures occurring in the United States. Because age-related changes occur in each organ system in all elderly individuals, this population merits special consideration when undergoing surgical procedures. Furthermore, there is a high probability that older adults will have multiple chronic medical problems, which may present a complex medication management challenge. This review covers the pharmacologic impact of physiologic changes associated with aging, preoperative assessment, preoperative medication management, delirium and the impact of perioperative medications in the elderly, anesthesia and related medications, and specific drug classes and their use in the elderly surgical patient. Figures show an overview of the management of the elderly surgical patient, and preoperative medication management. Tables list medications that should be avoided in older patients with reduced renal function, drugs that exhibit additive adverse effects, medications with high anticholinergic activity, medications that inhibit and induce the CYP450 system, herbal supplements, 2015 Beers Criteria summary of potentially inappropriate medication use in older adults, drugs associated with postoperative delirium, risk factors for postoperative delirium, and clinical pharmacology of commonly used anesthetic agents. This review contains 2 highly rendered figures, 9 tables, and 61 references

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Pharmacologic Considerations in the Elderly Surgical Patient

10.2310/vasc.2193 ◽

2017 ◽

Author(s):

Linda Sohn ◽

Joe C. Hong ◽

Michael W. Yeh ◽

Tara A. Russell ◽

Marcia M. Russell

Keyword(s):

Older Adults ◽

Surgical Procedures ◽

Postoperative Delirium ◽

Medication Management ◽

The Elderly ◽

The United States ◽

Surgical Patient ◽

Age Related ◽

The Impact ◽

Preoperative Medication

The most rapidly growing segment of the elderly population corresponds to persons age 85 and over. As of 2006, elderly patients accounted for 35.3% of the inpatient and 32.1% of the outpatient surgical procedures occurring in the United States. Because age-related changes occur in each organ system in all elderly individuals, this population merits special consideration when undergoing surgical procedures. Furthermore, there is a high probability that older adults will have multiple chronic medical problems, which may present a complex medication management challenge. This review covers the pharmacologic impact of physiologic changes associated with aging, preoperative assessment, preoperative medication management, delirium and the impact of perioperative medications in the elderly, anesthesia and related medications, and specific drug classes and their use in the elderly surgical patient. Figures show an overview of the management of the elderly surgical patient, and preoperative medication management. Tables list medications that should be avoided in older patients with reduced renal function, drugs that exhibit additive adverse effects, medications with high anticholinergic activity, medications that inhibit and induce the CYP450 system, herbal supplements, 2015 Beers Criteria summary of potentially inappropriate medication use in older adults, drugs associated with postoperative delirium, risk factors for postoperative delirium, and clinical pharmacology of commonly used anesthetic agents. This review contains 2 highly rendered figures, 9 tables, and 61 references

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When Grandparents Move In

Social Psychology ◽

10.1027/1864-9335/a000415 ◽

2020 ◽

Vol 51 (5) ◽

pp. 299-308 ◽

Cited By ~ 1

Author(s):

Brian T. Smith ◽

Kelly Charlton

Keyword(s):

Older Adults ◽

Older Adult ◽

Aging Process ◽

Negative Impact ◽

The Elderly ◽

Growing Up ◽

Attitudes Toward Older Adults ◽

The Impact ◽

The Relationship

Abstract. This paper explores the impact of growing up with an older adult in the home on one’s attitudes toward older adults. We surveyed 309 participants for their opinions on older adults, whether they grew up living with an older adult, and whether the older adult they lived with was ill. Those who grew up with an older adult had significantly lower opinions of the elderly but had less anxiety around their own aging process. This negative impact of contact seemed especially pronounced if the older adult was ill. Results indicate that although contact in and of itself can have a positive benefit on opinions toward the elderly, the nature of the relationship impacts the effectiveness of the contact.

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The Impact of Epidemic Outbreak

Crisis ◽

10.1027/0227-5910/a000015 ◽

2010 ◽

Vol 31 (2) ◽

pp. 86-92 ◽

Cited By ~ 80

Author(s):

Paul S.F. Yip ◽

Y.T. Cheung ◽

P.H. Chau ◽

Y.W. Law

Keyword(s):

Older Adults ◽

Older Adult ◽

Negative Impact ◽

Well Being ◽

The Elderly ◽

Control Measures ◽

High Rate ◽

Completed Suicide ◽

The Impact ◽

The Relationship

Background: Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003. Aims: In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong. Methods: We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly. Results: SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths. Conclusions: We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community. In addition, it is important to alert family members to vulnerable individuals who are at potential risk because of their illnesses or anxieties.

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The pattern of substance abuse in Thai elderly: Ramathibodi Poison Center

SAGE Open Medicine ◽

10.1177/2050312119873513 ◽

2019 ◽

Vol 7 ◽

pp. 205031211987351 ◽

Cited By ~ 1

Author(s):

Sirasa Ruangritchankul ◽

Sahaphume Srisuma

Keyword(s):

Older Adults ◽

Substance Abuse ◽

Health Personnel ◽

Elderly Population ◽

Clinical Manifestations ◽

The Elderly ◽

Poison Center ◽

Medical Outcomes ◽

Severe Metabolic Acidosis ◽

Common Manifestation

Objective: To describe substances, clinical manifestations, treatment, and medical outcomes of substance abuse exposures among older adults in Thailand. Method: This is a retrospective study of individuals aged 60 years or older with intentional abuse exposures reported to the Ramathibodi Poison Center from 1 January 2010 to 31 December 2017. Results: Forty-four cases were reported. The most common manifestation was somnolence (20, 45.5%). The most common substance used was kratom. There were 12 severe and fatal cases. Only one died due to methadone abuse. The most frequent manifestation among severe cases was respiratory failure (8 of 12 cases, 66.7%). Two cases had severe metabolic acidosis and were treated with hemodialysis. Three cases received norepinephrine. Conclusion: Substance abuse in the elderly is a serious problem that is often overlooked. Health personnel should promptly recognize and address this issue in order to reduce morbidity and mortality in the elderly population.

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DISCRIMINATION AND DEPRESSION IN MID- TO LATE LIFE: THE ROLE OF OPTIMISM

Innovation in Aging ◽

10.1093/geroni/igz038.1154 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S315-S316

Author(s):

Elliottnell Perez ◽

Joseph Dzierzewski ◽

Scott Ravyts

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Positive Association ◽

Late Life ◽

The United States ◽

Future Research ◽

Cross Sectional ◽

Life Orientation Test ◽

The Impact ◽

The Relationship

Abstract he positive association between discrimination and depression is well-supported throughout the literature. Previous evidence exploring potential mechanisms suggest discrimination is associated with depression via changes in social cognition. The goal of the current study was to investigate whether optimism explained the relationship between discrimination and depressive symptoms in mid-to-late life. Furthermore, the study assessed whether this mediated relationship was moderated by race or sex. This study included cross-sectional and longitudinal secondary data analysis of 2453 middle-aged and older adults (M age=68.30,SD=8.93) from the Midlife in the United States study. Discrimination was measured using an 11-item count of the number of discriminatory events experienced. Optimism was measured using the 6-item Life Orientation Test. Depressive symptoms were assessed using a 7-item count of the number of symptoms experienced. Optimism mediated the relationship between discrimination and depressive symptoms cross-sectionally, 95% CI:[.012, .034], and longitudinally, 95% CI:[.008, .024]. There was no evidence of moderated mediation; however, sex did moderate the direct relationship between discrimination and depressive symptoms cross-sectionally, b=.10, 95% CI:[.001, .194], and longitudinally, b=.03, 95% CI:[.01, .05]. The current study extends the literature by providing cross-sectional and longitudinal support for optimism as a mechanism through which discrimination leads to depressive symptoms in older adults. Evidence also suggests that women experience greater depressive symptoms than men in response to discrimination. Future research may wish to examine the developmental course of observed relationships and the impact of multiple marginalized identities on these relationships.

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The Geriatric Medication Game to Raise Community Pharmacists’ Awareness on Older Adults’ Day-to-Day Challenges

Saudi Journal of Health Systems Research ◽

10.1159/000516346 ◽

2021 ◽

pp. 1-6

Author(s):

Aisha F. Badr

Keyword(s):

Older Adults ◽

Saudi Arabia ◽

Learning Process ◽

Community Pharmacists ◽

The Elderly ◽

Learning Activity ◽

Simulation Games ◽

Self Reflection ◽

Satisfaction Rate ◽

The Impact

Introduction: In Saudi Arabia; it is estimated that the elderly (aged 60 and above) would reach up to (22.9%) by 2050, compared to (5.6%) in 2017. Simulation games have proven to be a useful and effective method of education in pharmacy schools, as it actively involves participants in the learning process. The objective of this study was to examine the impact of the modified geriatric medication game on community pharmacists’ awareness and attitudes toward older adults with common disabilities. Methods: A modified geriatric medication game was adopted to stimulate both physical and sensory disabilities in older adults. A total of 9 community pharmacists were gathered in 1 room and were asked to play 2 scenarios each. Self-reflection was assessed and ground theories were analyzed. Results: All pharmacists felt frustration and anger playing the game (100%), followed by becoming more aware of the extra time and guidance needed with older adults and realized how disabling chronic diseases could be, and felt they needed to improve common perceived attitude towards the elderly (88.89%). Pharmacists also felt empathy, sympathy, and compassion towards this population, needed improvement of common perceived attitude towards older adults, and felt the need to double check with older adults if they have any disabilities before counseling (77.78%). Finally, over half pharmacists (55.5%) wished they had more training on geriatrics during pharmacy school and the need for further review of Beer’s criteria. All pharmacists were satisfied with the game and recommended it to all community pharmacists. Conclusion: Simulation games are a great way to strengthen awareness and change practice accordingly. Pharmacists improved their awareness and attitude towards the elderly and reported a positive perceived value of this learning activity; with a 100% satisfaction rate. Adding a geriatric course with simulation component is recommended for better geriatric care.

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