What Should Clinicians Do for Older Adults with Polypharmacy and Depression? [Letter] DOI Creative Commons
Lingling Zhu, Quan Zhou

Clinical Interventions in Aging, Journal Year: 2022, Volume and Issue: Volume 17, P. 507 - 508

Published: April 1, 2022

We have read with great interest the study by Cheng et al, 1 which determined that older adult patients polypharmacy were at greater risk of developing depression.We would like to share our perspectives based on experience from an academic medical center hospital 4000 beds in China international peers.First, clinicians should pay closer attention drug-drug interactions (DDIs) caused antidepressants geriatric and experienced a case gastrointestinal bleeding 89-year-old polymedicated patient who had been prescribed 18 types medications February 2022.Although there two other causes (ie, lack using protective agents, inappropriate prescribing rivaroxaban aged over 75 years, is associated higher hemorrhage compared warfarin, apixaban edoxaban), 2 concurrent use anticoagulant sertraline was third culprit.Prescribing information for requires be warned about when used combination drugs could affect blood coagulation.The serotonin syndrome may increase due DDIs between tramadol serotonergic such as amitriptyline, selective reuptake inhibitors (SSRIs) (eg, citalopram, escitalopram, fluoxetine, paroxetine, sertraline, fluvoxamine), norepinephrine duloxetine, venlafaxine), mirtazapine.Buprenorphine oxycodone are alternatives because their therapeutic advantages unnecessary dose adjustment adults).SSRIs not co-administered monoamine oxidase linezolid selegiline.Fluvoxamine, strong cytochrome P450 enzyme 1A2 (CYP1A2) inhibitor, seriously pharmacokinetics tizanidine intensity duration its effects.Other SSRIs fluvoxamine co-medicating CYP1A2 substrates commonly adults clozapine, flutamide, haloperidol, melatonin, mexiletine, olanzapine, riluzole, tacrine, theophylline, tizanidine).Duloxetine, venlafaxine, fluoxetine CYP2D6 inhibitors, thus inhibit drug metabolism substrates.For example, plasma exposure beta-blocking action metoprolol increased.The conversion prodrug tamoxifen into active metabolite endoxifen via significantly inhibited, resulting reduced benefits therapy breast cancer patients.Non-CYP2D6-inhibitor alternatives, or necessary.St John's Wort popular herbal remedy widely depression many countries; however, herb-drug interaction potential prominent potent induction human CYP3A4 P-glycoprotein. 3Clinicians must high alert they learn receiving planning receive St treatment.Secondly, Chen al's meaningful finding inspire community further investigate whether deprescribing help alleviate occurrence symptoms depression.So far, only very few studies addressed effectiveness relevant interventions.For deprescription

Language: Английский

Latent profile analysis of depression among older adults living alone in China DOI

Bailing Hou,

Huijun Zhang

Journal of Affective Disorders, Journal Year: 2023, Volume and Issue: 325, P. 378 - 385

Published: Jan. 11, 2023

Language: Английский

Citations

30
The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety DOI Creative Commons

Mina T. Huang,

Kun Liu,

Chunguang Liang

et al.

BMC Geriatrics, Journal Year: 2023, Volume and Issue: 23(1)

Published: Aug. 22, 2023

With modernization and ageing in China, the population of older adults living alone is increasing. Living may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated mediating factors or not (living arrangements) symptoms.This cross-sectional study included total number 10,980 participants from Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 whom lived 9281 did live alone. Binary logistic regression effect were used to explore relationship between symptoms possible effects. Bootstrap was examine on symptoms.Compared who alone, group had higher rate The binary showed that after adjusting other covariates, approximately 0.21 times compared (OR = 1.21, 95% CI: 1.06, 1.37). Further, results bootstrap supported partial role sleep quality anxiety. Mediation revealed anxiety partially mediate (β 0.008, CI [0.003, 0.014]; β 0.015, [0.008, 0.024], respectively).Sleep identified as mediators Older with poorer more pronounced positively associated levels should encouraged engage social activities improve quality, relieve anxiety, feelings loneliness caused by Meanwhile, receive attention support alleviate their

Language: Английский

Citations

17
The Mediating Role of Emotional Self-Efficacy in the Relationship Between the Number of Medications and Psychological Distress Among Older Adults with Chronic Illness DOI
Huoba Li, Cheng Cheng

Journal of Community Health Nursing, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 14

Published: March 17, 2025

The present study aimed to examine the associations between number of medications, emotional self-efficacy, and psychological distress in older adults with chronic illness. A cross-sectional was conducted a convenience sample 191 Anhui, China. Those participants completed structured questionnaire that included sociodemographic data, status. Pearson correlation analysis used variables. bootstrap method employed analyze mediating role self-efficacy. results showed 10.5% 14.1% might be experiencing symptoms anxiety depression, respectively. Correlation revealed self-efficacy negatively correlated depression. partially mediated relationship medications accounting for 51.9% total effect. Additionally, anxiety, 50.8% However, suppressor effect established polypharmacy-related distress. findings suggested play an important Chinese

Language: Английский

Citations

0
From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated with Dry Mouth in Older Adults with Polypharmacy DOI
India Cannon, Anna Robinson, Gillian McLellan

et al.

Drugs & Aging, Journal Year: 2023, Volume and Issue: 40(4), P. 307 - 316

Published: March 21, 2023

Language: Английский

Citations

10
The association between the number of teeth and frailty among older nursing home residents: a cross-sectional study of the CLHLS survey DOI Creative Commons
Xiaoming Zhang, Jing Jiao, Jing Cao

et al.

BMC Geriatrics, Journal Year: 2022, Volume and Issue: 22(1)

Published: Dec. 30, 2022

Abstract Background Given that few studies have explored the association between oral health and frailty among older nursing home residents, purpose of this study was to assess (i.e., number teeth behaviors) in population using Chinese Longitudinal Healthy Longevity Survey (CLHLS). Methods This a national cross-sectional derived from seventh wave CLHLS 2018, consisting 365 residents aged 65 years or older. The index constructed based on 32 variables self-rated status, anxiety, depression, ADL IADL. Oral measured through natural tooth brushing behavior. Multiple logistic regression used identify teeth, behaviors, frailty. Results mean age sample 87.6 (SD = 9.5), with 154 (42.2%) males. prevalence edentulism 71.2% 33.4%, respectively. analysis found likelihood decreased an increased OR 0.94 (95% CI: 0.91–0.98). Compared participants edentulism, adults 1 20 had lower (OR 0.39, 95% 0.17–0.88); these results were also more than 0.20, 0.07–0.57). Additionally, who brush their regularly those never 0.37, 0.13–0.99). Conclusion Older maintain can help risk frailty, regular toothbrushing contributes decreasing Our emphasizes importance health, cohort large-scale samples address important issue are warranted future.

Language: Английский

Citations

14
Prevalence of depression and clinical depressive symptoms in community‐dwelling older adults with cognitive frailty DOI
Aisyah Mohd Safien, Norhayati Ibrahim, Ponnusamy Subramaniam

et al.

Geriatrics and gerontology international/Geriatrics & gerontology international, Journal Year: 2024, Volume and Issue: 24(2), P. 225 - 233

Published: Jan. 10, 2024

Aim The present study determines the prevalence of depression and extent clinical symptoms among community‐dwelling older adults with cognitive frailty its associated factors. Methods A total 755 aged ≥60 years were recruited. Their performance was determined using Clinical Dementia Rating. Fried's criteria applied to identify physical frailty, Beck Depression Inventory assessed their mental states. Results 39.2% ( n = 304) participants classified as frail. In this frail subpopulation, 8.6% 26) had depressive symptoms, which mostly somatic such disturbance in sleep pattern, work difficulty, fatigue, lack appetite. Older also showed significantly higher levels compared noncognitive (t (622.06) −3.38; P 0.001). There are significant associations between multimorbidity 0.009), polypharmacy vision problems 0.046), hearing 0.047). likelihood who experience impairments hearing, polypharmacy, be depressed increased by 2, 3, 5, 7‐fold. Conclusions majority Malaysian a good state. However, more susceptible due vision, multimorbidity, polypharmacy. As common somatic, it is crucial for health professionals recognize these not disregard them only illness. Geriatr Gerontol Int 2024; 24: 225–233 .

Language: Английский

Citations

2
Association between polypharmacy and chronic kidney disease among community-dwelling older people: a longitudinal study in southern China DOI Creative Commons
Bowen Zhang, Jingrui Wang, Nan Liu

et al.

BMC Nephrology, Journal Year: 2024, Volume and Issue: 25(1)

Published: May 17, 2024

Abstract Background Polypharmacy would increase the risk of adverse drug events and burden renal excretion among older people. Nevertheless, association between number medication chronic kidney disease (CKD) remains controversial. Therefore, this study aims to investigate incidence CKD in Methods This investigates medications 2672 elderly people (≥ 65 years older) community health service center southern China 2019 2022. Logistic regression analysis was used evaluate relationship polypharmacy CKD. Results At baseline, average age subjects 71.86 ± 4.60, 61.2% were females, 53 (2.0%) suffer from polypharmacy. During an follow-up 3 years, new-onset developed 413 (15.5%) participants. revealed that taking a higher associated with Compared who didn’t take medication, observed taken more than five (OR 3.731, 95% CI 1.988, 7.003), followed by those four 1.621, 1.041, 2.525), three 1.696, 1.178, 2.441), two drugs 1.585, 1.167, 2.153), or one 1.503, 1.097, 2.053). Furthermore, age, systolic blood pressure (SBP), white cell (WBC), urea nitrogen (BUN) triglyceride (TG) also independent factors ( P < 0.05). Conclusion The As increased, increased.

Language: Английский

Citations

2
Factors associated with anxiety and depression among patients with chronic obstructive pulmonary disease DOI
Anan S. Jarab, Walid Al‐Qerem, Shrouq Abu Heshmeh

et al.

Expert Review of Respiratory Medicine, Journal Year: 2024, Volume and Issue: 18(1-2), P. 59 - 65

Published: Feb. 1, 2024

Objectives This study investigated factors associated with anxiety and depression in COPD outpatients.

Language: Английский

Citations

1
Analysis of longitudinal patterns and predictors of medicine use in residential aged care using group‐based trajectory modelling: The MEDTRAC‐Polypharmacy longitudinal cohort study DOI Creative Commons
Nasir Wabe, Rachel Urwin, Karla Seaman

et al.

British Journal of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: 90(12), P. 3308 - 3319

Published: Aug. 25, 2024

Abstract Aims Polypharmacy serves as a quality indicator in residential aged care facilities (RACFs) due to concerns about inappropriate medication use. However, aggregated polypharmacy rates at single time offer limited value. Longitudinal analysis of patterns provides valuable insights into identifying potential overuse medicines. We aimed determine long‐term trajectories (≥9 medicines) and factors associated with each trajectory group. Methods This was longitudinal cohort study using electronic data from 30 RACFs New South Wales, Australia. conducted group‐based modelling identify characterize over 3 years. evaluated the model fitness Bayesian Information Criterion, entropy (with value ≥0.8 considered ideal) several other metrics. Results The included 2837 permanent residents (median age = 86 years, 61.7% female 47.4% had dementia). identified five groups: group 1 (no polypharmacy, 46.0%); 2 (increasing 9.4%); (decreasing 9.2%); 4 (increasing‐then decreasing 10.0%), 5 (persistent 25.4%). showed excellent performance (e.g., 0.9). Multinomial logistic regressions revealed profile higher odds chronic respiratory disease compared 1). Conclusions Our groups, including one quarter following persistently high trajectory, signalling concerning overuse. Quality programs should adopt tailored metrics monitor diverse moving beyond current one‐size‐fits‐all approach better capturing evolving dynamics residents' regimens.

Language: Английский

Citations

1
ANXIETY, DEPRESSION AND QUALITY OF LIFE IN ELDERLY PEOPLE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE DOI Open Access

Luís Eduardo Costa Nora,

Paulo Roberto Gneipel Neto,

Vitor Last Pintarelli

et al.

International Journal of Health Science, Journal Year: 2024, Volume and Issue: 4(34), P. 2 - 13

Published: April 1, 2024

The morbidity and mortality associated with chronic obstructive pulmonary disease implies a significant reduction in the quality life expectancy of its sufferers, fact heightened by presence comorbidities these patients.Anxiety depression are increased frequency this population.OBJECTIVES: To establish relationships between anxiety, elderly patients an outpatient population Curitiba.METHODS: Cross-sectional study, 54 volunteers aged 60 or over, both genders any ethnicity, city Curitiba, Brazil, disease.Screening for anxiety was carried out using Hospital Anxiety Depression Scale questionnaire, while assessed WHOQOL-OLD questionnaire.Data on clinical variables were obtained through consented access to volunteers' medical records.Statistical analysis adopted values p < 0.05 significance.RESULTS: Progressively higher (p 0.001) = scores related lower indicators.The concomitant use 8 more medications positive screening 0.019).Physical inactivity predisposing factor 0.008) 0.035).CONCLUSIONS: It can be concluded that, among people disease, physical inactivity, than eight high correlated indicators.

Language: Английский

Citations

0