scholarly journals Medication use in community-dwelling older people: pharmacoepidemiology of psychotropic utilisation

2014 ◽  
Vol 6 (4) ◽  
pp. 269 ◽  
Author(s):  
Anna Schäfers ◽  
Nataly Martini ◽  
Simon Moyes ◽  
Karen Hayman ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
New Zealand ◽  
Older People ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Community Dwelling ◽  
Drug Event ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

INTRODUCTION: Psychotropic medications have a significant adverse drug event profile, particularly in older adults, and appropriate use is paramount. Patterns of prescribing in community-dwelling older adults in New Zealand remain unknown. AIM: This study aimed to determine the prevalence and the pattern of psychotropic use amongst community-dwelling older people in New Zealand and to identify any association between depressive symptomatology and psychotropic medication use. METHODS: Data were collected on the demographics, medication use and mood status of community-dwelling older adults from two New Zealand studies: the BRIGHT trial, which recruited potentially disabled participants (N=141) and the DeLLITE trial, which recruited potentially depressed participants (N=193). The prevalence and the pattern of psychotropic use were established and the gender, age and level of depression assessed using regression analysis. RESULTS: The use of any psychotropic medication was 28.9% in the BRIGHT trial and 43.5% in the DeLLITE trial. Antidepressants were the most commonly used psychotropic medication in the two studies, followed by hypnotics and sedatives. Psychotropic use was highly correlated with the presence of depressive symptoms in the BRIGHT trial and with female gender in the DeLLITE trial. Age was not associated with psychotropic medication use. In both studies, there is possible underdiagnosed, undertreated and inappropriately treated depression. DISCUSSION: The prevalence of psychotropic medication use is high in community-dwelling older people with disability and very high in community-dwelling older people with depressive symptoms, but varies by gender and level of depression. KEYWORDS: Aged; depression; independent living; New Zealand; psychotropic drugs

scholarly journals 90 The Effectiveness of Volunteer-Led Physical Activity Interventions in Improving Health Outcomes for Community-Dwelling Older People: A Systematic Review

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Older People ◽  
Health Outcomes ◽  
Grip Strength ◽  
Community Dwelling ◽  
Frailty Status ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.

scholarly journals Effects of a Multicomponent Exercise Program on Groups of Community-Dwelling Older Adults with Low Schooling: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Neildja Maria da Silva ◽  
Monalisa Silva de França ◽  
Dellis Kariny Freitas Holanda de Almeida ◽  
Evelin Suyany Guedes de Lima ◽  
Vinícius Hugley Brito dos Santos ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Dual Task ◽  
Group Intervention ◽  
Exercise Program ◽  
Community Dwelling ◽  
Hemodynamic Stability ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults ◽  
Control Balance

The aim of this study was to analyze the effects of a multicomponent exercise program on the physical and hemodynamic functions of community-dwelling older adults with low schooling levels in relation to simple multicomponent group exercises. Twenty-one older people were randomly assigned to two groups: G1 (n = 11) and G2 (n = 10); sixteen of whom completed the sixteen sessions over a six-week period, three times a week. During eight sessions, G1 performed adapted dual-task multicomponent exercises (strengthening, balance, and cognition) and G2 simple multicomponent exercises (strengthening and balance), and both groups engaged in eight additional sessions of simple multicomponent exercises. The dual-task multicomponent exercises exhibited similar effects to those of their simple multicomponent counterparts. The older adults from both groups improved mobility, frailty, static postural control, balance, and hemodynamic stability. The adapted program was beneficial to the community-dwelling older people with low schooling in the group intervention.

scholarly journals Potentially inappropriate medication use: the Beers’ Criteria used among older adults with depressive symptoms

2013 ◽  
Vol 5 (3) ◽  
pp. 182 ◽  
Author(s):  
Daphne Lee ◽  
Nataly Martini ◽  
Simon Moyes ◽  
Karen Hayman ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Older People ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Community Dwelling ◽  
Potentially Inappropriate Medication ◽  
Beers Criteria ◽  
Chi Square ◽  
Inappropriate Medication Use

INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers’ Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3) years and 59% were women. The median number of medications used was 6 (range 1–21 medications). The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49%) of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale =5) and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54). DISCUSSION: Potentially inappropriate medication use, as per the modified Beers’ Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers’ Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed. KEYWORDS: Depression; depressive symptoms; inappropriate prescribing; older adults

scholarly journals A qualitative exploration of the experiences of community dwelling older adults with sensory impairment/s receiving polypharmacy on their pharmaceutical care journey

2019 ◽  
Vol 48 (6) ◽  
pp. 895-902 ◽  
Author(s):  
Annetta Smith ◽  
Leah Macaden ◽  
Thilo Kroll ◽  
Nour Alhusein ◽  
Andrea Taylor ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Pharmaceutical Care ◽  
Developed Countries ◽  
Community Dwelling ◽  
Health Board ◽  
Sensory Impairment ◽  
Care Provision ◽  
Community Dwelling Older People ◽  
Community Dwelling Older Adults

AbstractBackgroundMost developed countries have increasing numbers of community dwelling older people with both multi-morbidity and sensory impairment that includes visual, hearing or dual impairment. Older people with sensory impairment are more likely to have chronic health conditions and to be in receipt of polypharmacy (>4 medicines). It is important to understand their experience of pharmaceutical care provision to facilitate a safe, appropriate and person centred approach.Aimthis study explored the pharmaceutical care experiences and perspectives of older people with sensory impairment receiving polypharmacy.Design and settingexploratory qualitative study with semi-structured telephone or face-to-face interviews with community dwelling older adults with sensory impairment receiving polypharmacy in Scotland in 2016.Methodsin total, 23 interviews were conducted with older people from seven of the 14 Scottish Health Board areas.Subjectsover half the participants (n = 12) had dual sensory impairment, six had visual impairment and five had hearing impairment.Resultsthree overarching themes were identified reflecting different stages of participants’ pharmaceutical care journey: ordering and collection of prescriptions; medicine storage; and administration. At each stage of their journey, participants identified barriers and facilitators associated with their pharmaceutical care.Conclusionsthis is the first comprehensive, in-depth exploration of the pharmaceutical care journey needs of older people with sensory impairment. As the number of community dwelling older people with sensory impairment and polypharmacy increases there is a requirement to identify challenges experienced by this population and offer solutions for safe and effective pharmaceutical care provision.

scholarly journals Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041578
Author(s):  
Linglin Kong ◽  
Huimin Zhao ◽  
Junyao Fan ◽  
Quan Wang ◽  
Jie Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Community Health ◽  
Community Dwelling ◽  
Central China ◽  
Chinese Community ◽  
Cross Sectional ◽  
Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

scholarly journals Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4520
Author(s):  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Tsuyoshi Hamano ◽  
Miwako Takeda ◽  
Masayuki Yamasaki ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Rural Setting ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact ◽  
Community Dwelling Older Adults

Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.

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