scholarly journals Study of adverse drug reactions and clinical profile of elderly in relation to polypharmacy

2019 ◽  
Vol 10 (6) ◽  
pp. 80-84
Author(s):  
Nagaraja BS ◽  
Keerthana Sharma

Background: Polypharmacy is a becoming more prevalent in older adults and adverse risk increases with age-related change. Adverse drug reactions (ADRs) are common in older adults and worrisome aspect of treatment in elderly. Aims and Objective: The study aimed to identify the common clinical conditions leading to polypharmacy and to compare the adverse drug profiles of the 2 groups. Materials and Methods: This case-control study was conducted in Hospitals attached to BMCRI, where 200 patients aged 65 or more were interviewed. 100 elderly patients using 5 or more drugs were identified as cases and assessed against a control group of 100 patients. Results: Our study found that ADRs were found to be three times higher in individuals on polypharmacy compared to the control group (OR 3.4675 95% CI 1.6241 to 7.4035). The most commonly occurring ADRs were dyspepsia (OR 1.9259), drowsiness (OR 3.5926) and fatigue (OR 1.5319) with increased incidence in the case group. The most common conditions associated with polypharmacy were found to be hypertension (53%), diabetes mellitus(46%), COPD(14%) and IHD(14%). 66% of the study group had two or more of the above diseases, whereas in the control group only 32% had multiple illnesses. The most commonly prescribed medications were antihypertensives (61%), hypolipidemics (44%), antiplatelets (41%) and antibiotics(40%). Conclusion: Polypharmacy in the elderly comes with a significant increase in adverse effects. The reduced pill burden will not only decrease ADRs and improve compliance, but will also result in greater patient satisfaction and mental health, thereby improving the quality of geriatric care.

2021 ◽  
Vol 36 (4) ◽  
pp. e288-e288
Author(s):  
Niusha Barzideh ◽  
Arezoo Alaee ◽  
Arash Azizi

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.


Author(s):  
GAYATRI SUJIVE ◽  
BENSAM T MATHEW ◽  
MAMATHA K ◽  
ANURADHA HV

Objective: The process of aging involves an individual’s structural and functional depravity of their organ systems often results in compromised pharmacological principles of the prescribed drugs. Multimorbidity and polypharmacy along with change in pharmacokinetic and pharmacodynamic responses of drugs predispose the elderly to adverse drug reactions (ADRs). The present study was aimed to identify and report the characteristics and incidence of ADRs among geriatrics in an outpatient clinic. Methods: This was a 6-month prospective hospital-based observational study among patients of either sex aged 60 years and above visiting an outpatient clinic at the study site. The suspected ADRs were categorized according to the Will’s and Brown classification system. Causality of these ADRs was verified by applying the WHO-UMC criteria and the Naranjo’s scale. Severity and preventability of the ADRs were classified using the modified Hartwig and Siegel scale and modified Schumock and Thornton scale, respectively. Multivariate logistic regression was used to determine the risk factors for developing ADRs. Results: Among the 365 patients monitored, 57 (15%) patients experienced 60 ADRs. Therapeutic classes of drugs frequently associated with ADRs were the drugs used in hypertension (27 [45%]). Patients presenting with amlodipine (9 [15%]) induced pedal edema were observed with the highest frequency of ADRs. Polypharmacy (OR: 1.619, 95% confidence interval: 0.957−2.741, p=0.021) was observed as the influential risk factor for ADRs. Conclusion: Pharmacist’s services and involvement in geriatric patient’s centered care can be associated with their improved health, quality of life and economic outcomes, a reduction in medicine-related adverse events, and limiting the morbidity and mortality in this age band.


2014 ◽  
Vol 26 (5) ◽  
pp. 759-767 ◽  
Author(s):  
Agnieszka Niedźwieńska ◽  
Peter G. Rendell ◽  
Krystian Barzykowski ◽  
Alicja Leszczyńska

ABSTRACTBackground:Prospective memory, or remembering to do things in the future, is crucial for independent living in old age. Although there is evidence of substantial age-related deficits in memory for intentions, older adults have demonstrated the ability to compensate for their deficits in everyday life. The present study investigated feedback as a strategy for facilitating prospective memory in the elderly.Method:Young and older adults played a computer-based task, Virtual Week, in which they had to remember to carry out life-like intentions. After each virtual day, specific feedback on prospective memory performance was automatically provided on the computer screen that participants either proceeded through by themselves (non-social feedback) or were taken through by an experimenter (social feedback). The control group received no feedback.Results:We found that, compared with no-feedback group, only social feedback substantially reduced the age-related deficit in prospective memory. Older adults significantly benefited from feedback provided by the experimenter on the tasks of intermediate difficulty. Unexpectedly, prospective memory with non-social feedback was not only worse than with social feedback, but it was not any better than without any feedback at all.Conclusions:The results extended previous findings on the effectiveness of feedback in improving the memory performance of older adults to include memory for intentions. Despite the feedback meeting the critical recommendations of being specific, objective, and well-targeted, it was ineffective when the feedback displayed on the computer was not introduced by the experimenter. This has implications for computerized training tasks where automated feedback is considered crucial.


Author(s):  
Krishna Ketan Patel ◽  
Mayura Deshmukh ◽  
Tushar Palekar

Background : The geriatric population is defined as population aged 60 years and above. (1)During this age many of the systems undergo deterioration. Balance problems in elderly are most commonly due to multi factorial condition which may include age related or disease-related declines in the balance system. Research shows that altered balance is the greatest collaborator towards falls in the elderly with a high correlation between balance deficit and the incidence of falls. Iyengar yoga, one of the active, or Hatha, yoga techniques, is a system for developing physical and mental well-being through stretching of all muscle groups for strength, flexibility, and physical balance. Yoga as a complementary therapy is thought to be more therapeutic than traditional exercise because it involves active engagement between mind and body. Its practice has been associated with increased muscle strength, endurance, flexibility, range of motion and cardiopulmonary endurance. It mainly works on increasing body awareness and proprioception, which will lead to improvement of balance in older adults. Objectives: To compare pre and post score of Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). To compare pre and post score of Time up and go test. Materials and Methodology: This was an experimental study that included 40 participants, healthy older adults between the age group 60-75 years, both male and female. The subjects were randomly divided in to 2 groups; Group A was the experimental group whereas group B was the control group. The experimental group was made to perform yogasanas for the duration of four weeks for 5 times a week whereas the control group was not given any intervention. Result and Conclusion: The study conducted concludes that yogasanas are effective in improving balance in elderly individuals at the end of four weeks compared to control group. Thus, it can be used clinically to improve balance in geriatric population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pei Ern Mary Ng ◽  
Sean Olivia Nicholas ◽  
Shiou Liang Wee ◽  
Teng Yan Yau ◽  
Alvin Chan ◽  
...  

AbstractTo address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.


Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 517
Author(s):  
Ilia Adami ◽  
Michalis Foukarakis ◽  
Stavroula Ntoa ◽  
Nikolaos Partarakis ◽  
Nikolaos Stefanakis ◽  
...  

Improving the well-being and quality of life of the elderly population is closely related to assisting them to effectively manage age-related conditions such as chronic illnesses and anxiety, and to maintain their independence and self-sufficiency as much as possible. This paper presents the design, architecture and implementation structure of an adaptive system for monitoring the health and well-being of the elderly. The system was designed following best practices of the Human-Centred Design approach involving representative end-users from the early stages.


Gerontology ◽  
2017 ◽  
Vol 63 (5) ◽  
pp. 488-494 ◽  
Author(s):  
Hirofumi Tanaka

Demographics of human aging are rapidly changing. As illustrated in the biomedicalization of aging, an ever increasing number of older adults is affected by a variety of clinical conditions and diseases, including vascular stiffening, sarcopenia, physical disability, and poor quality of life. One population that is situated in the opposite end of the health and functional spectrum to the sedentary frail elderly is Masters athletes. These older competitive athletes are endowed with substantial functional capacity, overall long-term health, high motivation, and psychosocial outlook. Masters athletes are combating the dogma and negative stereotypes of older adults and aging. From the scientific standpoint, examining Masters athletes can provide insight into preventive gerontology, primary prevention of age-related diseases and dysfunctions, and exercise-based medical practices. Moreover, the study on Masters athletes is simply joyous and entertaining as they often remind us what can be possible in aging.


2015 ◽  
Vol 55 (5) ◽  
pp. 243
Author(s):  
Hilda Hilda ◽  
Bidasari Lubis ◽  
Hakimi Hakimi ◽  
Olga Rasiyanti Siregar

Background Cancer treatment in children influences the quality of life of patients and their families. The Pediatric Quality of Life (PedsQL) inventory is a questionnaire to assess quality of life of the healthy and ill children. Objective To compare quality of life in children with cancer and their normal siblings, and to compare quality of life in those with hematologic malignancies to those with solid tumors. Methods A cross-sectional study was conducted among 5-to-18- year-olds at the Hematology-Oncology Division at Haji Adam Malik Hospital, Medan, North Sumatera, from May to July 2012. The case group (subjects with cancer) filled the PedsQL 3.0 and 4.0 questionnaires, while the control group (normal siblings) filled only the PedsQL 4.0 questionnaire. Independent T-test was used to compare the quality of life between children with cancer and their normal siblings. Results There were 46 children in each group. The PedsQL 4.0 results in children with cancer and their normal siblings, and PedsQL 3.0 between hematology malignant and solid cancer were as follows: physical function 36.9 vs. 80.7, respectively (95%CI of differences -52.639 to -34.990; P= 0.0001), emotional function 40.4 vs. 69.3, respectively (95%CI of differences -35.912 to -21.914; P=0.0001), social function 71.5 vs. 93.9, respectively (95%CI of differences - 29.238 to -15.587; P=0.0001), school function 20.7 vs. 74.2, respectively (95%CI of differences - 62.124 to -44.832; P=0.0001), and total score 42.1 vs. 79.3, respectively (95%CI of differences - 43.066 to -31.344; P=0.0001). School function was the most affected parameter in children with cancer compared to their normal siblings. Conclusion There is a significant difference in quality of life between children with cancer and their normal siblings, for all four parameters examined by the PedsQL inventory. However, there are no significant differences in quality of life between children with hematologic malignancy and those with solid cancer.


2019 ◽  
Vol 5 (s2) ◽  
Author(s):  
Daniel Müller-Feldmeth ◽  
Katharina Ahnefeld ◽  
Adriana Hanulíková

AbstractWe used self-paced reading to examine whether stereotypical associations of verbs with women or men as prototypical agents (e.g. the craftsman knits a sweater) are activated during sentence processing in dementia patients and healthy older adults. Effects of stereotypical knowledge on language processing have frequently been observed in young adults, but little is known about age-related changes in the activation and integration of stereotypical information. While syntactic processing may remain intact, semantic capacities are often affected in dementia. Since inferences based on gender stereotypes draw on social and world knowledge, access to stereotype information may also be affected in dementia patients. Results from dementia patients (n = 9, average age 86.6) and healthy older adults (n = 14, average age 79.5) showed slower reading times and less accuracy in comprehension scores for dementia patients compared to the control group. While activation of stereotypical associations of verbs was visible in both groups, they differed with respect to the time-course of processing. The effect of stereotypes on comprehension accuracy was visible for healthy adults only. The evidence from reading times suggests that older adults with and without dementia engage stereotypical inferences during reading, which is in line with research on young adults.


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