Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 28, 2024
Abstract
Background
People
with
chronic
kidney
disease
(CKD)
have
an
elevated
risk
of
cognitive
impairment
(CI).
Medications
anticholinergic
activity
are
recognized
for
their
adverse
reactions
on
central
nervous
system.
The
putative
association
between
the
burden
and
CI
has
not
previously
been
evaluated
in
patients
CKD.
study
aimed
to
(i)
describe
prescriptions
medications
activity,
(ii)
analyze
factors
associated
these
prescriptions,
(iii)
evaluate
burden's
performance.
Methods
CKD‐REIN,
a
prospective
cohort
study,
enrolled
nephrology
outpatients
confirmed
diagnosis
CKD
(eGFR
<60
mL/min/1.73m
2
).
Drug
were
recorded
prospectively
during
5‐year
follow‐up.
Mini
Mental
State
Examination
(MMSE)
was
assessed
at
baseline
defined
as
MMSE
score
<24/30.
For
each
patient,
determined
by
summing
Anticholinergic
Cognitive
Burden
(ACB)
scores
all
prescription
drugs
baseline.
Multinomial
logistic
regression
used
ACB
score.
Logistic
Results
At
baseline,
3007
(median
age
[IQR],
69[60–76];
65%
men)
had
data
included.
1549
(52%)
taking
least
one
drug
properties.
Most
(1092;
70%)
low
burden,
294
(19%)
moderate
163
(11%)
high
burden.
A
history
neurological/psychiatric
disorders
higher
number
daily
greater
probability
having
(odds
ratio
(OR)
[95%
confidence
interval
(95%
CI)]
=
1.88[1.29;2.74]
1.53[1.45;1.61],
respectively).
Patients
significantly
presenting
impairment,
compared
without
(OR[95%
CI]
1.76[1.12;2.75])
after
adjustment
sociodemographic
factors,
comorbidities,
laboratory
data,
taken
daily.
Conclusions
results
our
emphasize
need
caution
properties
Journal of the American Geriatrics Society,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 3, 2025
Abstract
Background
In
older
people,
medications
with
anticholinergic
or
sedative
properties
are
associated
falls,
frailty,
and
functional
cognitive
impairment.
These
often
described
as
a
subset
of
potentially
inappropriate
(PIMs).
We
examined
the
prevalence
to
avoid
in
people
France
2023.
Methods
This
cross‐sectional
study
used
anonymized
data
from
large
electronic
healthcare
database,
French
National
Health
Data
System
(Système
des
Données
de
Santé,
SNDS).
All
aged
65
years
January
1,
2023,
December
31,
were
included
this
study.
Dispensations
identified
according
PIM
criteria
(2023
American
Geriatrics
Society
Beers
Criteria
REMEDI[e]S
tool).
The
was
assessed
for
population
by
age
(65–84
85
older)
living
place
(home
institutionalized
patients)
subgroups
terms
number
percentage
patients.
Results
16,938,152
patients
(55%
women).
Among
all
patients,
79.8%
between
84
20.2%
older.
Most
lived
at
home
(97.0%),
3.0%
institutionalized.
32.8%
among
32.3%
65–84
34.8%
32.1%
54.5%
most
commonly
dispensed
oxazepam
(5.27%),
alprazolam
zopiclone
(4.85%),
bromazepam
(4.23%),
metopimazine
(2.88%),
paroxetine
(2.70%),
nefopam
(2.57%),
hydroxyzine
(2.17%).
Conclusions
highlighted
that
still
frequently
prescribed
despite
development
regular
updating
criteria.
Future
studies
needed
assess
whether
has
led
worsened
outcomes
adults
who
utilized
these
medications,
new
initiatives
should
be
developed
further
promote
deprescribing
prescribers
pharmacists.
Journal of Geriatric Psychiatry and Neurology,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 10, 2025
Among
neuropsychiatric
sequelae
of
Parkinson's
disease
(PD),
psychosis
may
have
the
most
adverse
impacts
on
prognosis
and
quality
life.
To
summarize
critically
review
literature
potential
risk
factors
for
in
PD,
with
particular
focus
potentially
modifiable
factors.
We
conducted
a
using
PubMed
EMBASE.
included
articles
if:
(1)
study
population
was
comprised
patients
(2)
presence
systematically
ascertained
through
clinician
diagnosis,
clinical
outcome
assessments
and/or
administrative
data,
(3)
were
examined
prior
to
onset
psychosis.
Twenty-six
studies
(15
prospective
cohort,
10
retrospective
1
case-control)
21
patient
cohorts
(n
=
15,535
unique
patients)
review.
Ten
minor
phenomena
their
definition
The
consistent
sleep
disturbances,
particularly
rapid
eye
movement
behavior
disorder
autonomic
dysfunction.
Potentially
excessive
daytime
sleepiness
exposure
anticholinergic
medications
levodopa.
Possible
biomarkers
PD
reduced
striatal
dopamine
transporter
binding
imaging
mutations
GBA
gene.
Several
identified
development
PD.
Future
should
utilize
consistent,
validated
definitions
increasing
understanding
of,
developing
interventions
for,
ABSTRACT
Objectives
The
increase
in
polypharmacy
among
older
adults
increases
the
risk
of
drug‐related
problems,
making
multidisciplinary
interventions
essential.
This
study
evaluated
impact
a
consultation
on
medication
management
and
outcomes
outpatients.
Methods
prospective
observational
at
Spanish
teaching
hospital
involved
geriatricians,
clinical
pharmacists,
nurses.
Older
(≥
75
years)
with
underwent
review
baseline
3
6
months.
Data
use,
adherence
to
Screening
Tool
Person's
Prescriptions
(STOOP)
criteria,
anticholinergic
burden
were
analyzed.
Results
included
104
(mean
age
86.2
years;
66%
female).
An
average
3.6
recommendations
per
participant
was
made
(63.8%
acceptance
rate).
Common
problems
adverse
effects
(20%),
non‐adherence
(18.1%),
incorrect
dose/regimen
(14.4%).
Interventions
led
an
reduction
1.7
medications
patient,
1.3
dosage
or
regimen
changes
1.1
new
prescriptions.
mean
number
decreased
from
9.6
8.9
months
(
p
<
0.001)
remained
below
STOPP
criteria
violations
patient
dropped
1.2
1.0
=
0.036).
Of
126
flagged
by
68.3%
addressed,
24.6%
discontinued,
mainly
psychotropics,
89.3%
these
discontinuations
maintained.
0.036)
Conclusions
A
clinic
effectively
managed
reducing
load
improving
appropriateness
highlighting
importance
proactive
management.
Trial
Registration
ClinicalTrials.gov
:
NCT05408598
(March
1,
2022)
Geriatrics and gerontology international/Geriatrics & gerontology international,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 6, 2025
Given
the
adverse
effects
of
anticholinergic
drugs
and
necessity
for
medication
evaluation
tools
in
aging
population,
a
comprehensive
scale
to
assess
total
burden
Japan
was
developed.
We
examined
longitudinal
association
between
burden,
quantified
using
Japanese
Anticholinergic
Drug
Risk
Scale,
development
frailty
sarcopenia
older
adults.
In
this
population-based
cohort
study,
2044
residents
without
long-term
care
needs
were
randomly
selected
from
community
Kashiwa,
Japan.
Baseline
data
collected
2012,
with
follow-ups
2013,
2014,
2016,
2018,
2021.
Medications
identified
through
interviews
assessed
Screening
Tool
Older
Persons'
Appropriate
Prescriptions
Japanese.
The
Scale.
evaluated
new-onset
Cardiovascular
Health
Study
Index
Asian
Working
Group
Sarcopenia
2019
criteria,
respectively.
Of
1549
participants
or
at
baseline
(age
72.5
±
5.5
years;
49.1%
women;
median
follow-up
6.0
years),
274
230
developed
sarcopenia,
respectively,
during
follow-up.
After
adjusting
potential
confounders,
an
score
≥3
strongly
associated
(adjusted
hazard
ratio
[95%
confidence
interval]:
2.45
[1.52-3.94]
2.01
[1.20-3.35],
respectively).
is
predictor
community-dwelling
Effective
management
Scale
are
crucial
promoting
healthy
mitigating
health
outcomes.
Geriatr
Gerontol
Int
2025;
••:
••-••.
European Geriatric Medicine,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 9, 2025
Abstract
Purpose
To
summarise
the
association
between
potentially
inappropriate
prescribing
(PIP)
and
health-related
quality
of
life
(HRQOL)
in
older
adults,
with
a
special
focus
on
those
atrial
fibrillation
(AF)
multimorbidity,
while
exploring
potential
interventions
to
improve
their
impact
HRQOL.
Methods
A
comprehensive
search
strategy
was
conducted
MEDLINE
using
PubMed
interface
August
16th,
2024,
focusing
key
terms
related
“potentially
prescribing”
“quality
life”.
Additionally,
reference
lists
included
studies
were
screened.
Only
utilising
validated
assessment
tools
for
HRQOL
or
measuring
global
self-perceived
health
status
considered.
Studies
involving
populations
an
average
age
≥
65
years
included.
Results
Of
1810
articles
screened,
35
The
findings
indicate
that
prescribing,
independent
polypharmacy,
may
negatively
influence
review
identified
range
aimed
at
improving
among
including
pharmacist-driven,
general
practitioner-driven,
multidisciplinary
approaches.
Interventions
assessed
distinct
population
groups
specifically
residential
care
homes.
While
some
demonstrated
improvements
quality,
overall
evidence
regarding
remains
limited.
Conclusion
relationship
underexplored
adults
AF
despite
high
prevalence
PIP.
Effective
pharmacotherapy
should
be
coupled
patients'
clinical
functional
parameters,
considering
Adopting
multidisciplinary,
integrated,
patient-centred
approach
is
essential
sustainable
appropriate
practices
enhance
Alzheimer s Research & Therapy,
Год журнала:
2024,
Номер
16(1)
Опубликована: Июль 23, 2024
Long-term
exposure
to
anticholinergic
and
sedative
drugs
could
be
a
modifiable
risk
factor
for
cognitive
decline.
The
objective
of
this
study
was
measure
the
association
between
previous
cumulative
drug
(Drug
Burden
Index)
International Journal of Clinical Pharmacy,
Год журнала:
2024,
Номер
46(6), С. 1352 - 1361
Опубликована: Июль 15, 2024
Abstract
Background
Anticholinergic
medications
are
now
widely
acknowledged
for
their
unfavorable
risk-to-benefit
profile
owing
to
adverse
effects.
Health-related
quality
of
life
(HRQoL)
is
commonly
regarded
as
a
crucial
person-centered
outcome.
Aim
This
study
aimed
investigate
the
association
between
anticholinergic
burden
and
HRQoL
in
hospitalized
ambulatory
patients
seen
Ethiopia.
Method
cross-sectional
utilized
questionnaire
medical
records
collect
data
from
convenience
sample
adult
attending
both
inpatient
wards
clinic
University
Gondar
Comprehensive
Specialized
Hospital
April
September
2022.
was
measured
by
cognitive
burdens
scale
(ACBS),
while
using
EQ5D-index
(Euroqol-5
dimensions-5-Levels
index)
EQ5D-VAS
(visual
analogue
scale).
Linear
regression
used
assess
influence
high
(ACBS
score
≥
3)
on
EQ5D-VAS,
with
adjustments
made
sociodemographic
clinical
confounders.
Results
A
total
828
participated
this
(median
(IQR)
age
45.0
(30,
60)
55.9%
were
female).
On
multiple
linear
analysis,
associated
statistically
significant
decline
HRQoL,
evidenced
reductions
EQ5D
index
(−
0.174
0.250,
−
0.098))
scores
9.4
13.3,
5.2)).
Conclusion
diminished
found
among
relatively
younger
cohort
resource-limited
setting,
even
after
adjustment
important
confounding
variables.
Clinicians
should
be
cognizant
cumulative
impact
outcomes
strive
minimize
burden.
