Geriatrics
RCT | RSVpreF vaccine successfully prevents RSV-associated respiratory illness in seniors
10 Apr, 2023 | 13:54h | UTCEfficacy and Safety of a Bivalent RSV Prefusion F Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Review | Urinary incontinence and pelvic organ prolapse in women
10 Apr, 2023 | 13:27h | UTC
Consensus Paper | An approach to deprescribe antidepressants for depression in older adults
6 Apr, 2023 | 13:25h | UTCRelated:
Discontinuing antidepressants: Pearls and pitfalls.
A method for tapering antipsychotic treatment that may minimize the risk of relapse
Systematic Review: Managing Antidepressant Discontinuation
Randomized controlled trial: preventive cognitive therapy for prevention of depressive recurrence
RCT | Routine invasive approach fails to benefit frail older adults with non–ST-segment elevation acute myocardial infarction
6 Apr, 2023 | 13:23h | UTCEffect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non–ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentary on Twitter
A routine invasive strategy did not improve clinical outcomes in frail patients with NSTEMI. Future trials should confirm whether a policy of watchful observation rather than routine invasive management may be effective for these patients. https://t.co/N4hAXg5fid
— JAMA Internal Medicine (@JAMAInternalMed) March 6, 2023
RCT | No significant fracture reduction from monthly 60,000 IU vitamin D3 supplementation
4 Apr, 2023 | 13:58h | UTCThe effect of monthly vitamin D supplementation on fractures: a tertiary outcome from the population-based, double-blind, randomised, placebo-controlled D-Health trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)
Related:
RCT | Supplemental Vitamin D does not reduce incident fractures in midlife and older adults.
Cochrane Library | Hearing conditions: evidence, experience and resources
4 Apr, 2023 | 13:36h | UTCHearing conditions: evidence, experience and resources – Evidently Cochrane
Postoperative delirium’s linked to long-term cognitive decline in elderly patients
3 Apr, 2023 | 13:20h | UTCPostoperative Delirium’s linked to Long-term Cognitive Decline in Elderly Patients – JAMA Internal Medicine (link to abstract – $ for full-text)
News Release: Developing postoperative delirium associated with a faster rate of cognitive decline, says study – EurekAlert
Commentary: Postoperative Delirium Associated With Accelerated Cognitive Decline, Study Finds – Psychiatric News Alert
Commentary on Twitter
Delirium associated with accelerated cognitive decline that continued for 72 months following the index delirium episode; it's uncertain if delirium causes cognitive decline or if pts with preclinical brain disease are more likely to develop delirium. https://t.co/ADz7yxEZiP
— JAMA Internal Medicine (@JAMAInternalMed) March 20, 2023
SR | Etiologies of vertigo in the elderly
31 Mar, 2023 | 13:38h | UTCVertigo in the Elderly: A Systematic Literature Review – Journal of Clinical Medicine
Review | Exercise in octogenarians: how much is too little?
31 Mar, 2023 | 13:34h | UTCExercise in Octogenarians: How Much Is Too Little? – Annual Reviews of Medicine
Review | Evaluation and management of hypernatremia in adults
30 Mar, 2023 | 14:20h | UTC
Review | Insomnia diagnosis and treatment across the lifespan
30 Mar, 2023 | 13:36h | UTCInsomnia diagnosis and treatment across the lifespan – Journal of Family Practice
Cohort Study | Evaluating 5 creatinine-based formulas for eGFR estimation in older patients
29 Mar, 2023 | 13:12h | UTC
Commentary on Twitter
5 commonly-used creatinine-based equations provided different eGFR estimates in older adults in Sweden. BIS equation outperformed others in predicting 15-year mortality, but its accuracy was reduced in subgroups of low muscle mass and high age. https://t.co/DOJmp4HzZn
— JAMA Network Open (@JAMANetworkOpen) March 23, 2023
RCT | Fezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause
23 Mar, 2023 | 13:01h | UTCFezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause (SKYLIGHT 1): a phase 3 randomised controlled study – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter (thread – click for more)
70% of women experience hot flushes or night sweats during #menopause.
A new study investigates the role Fezolinetant, a non-hormonal treatment, could play in reducing these symptoms. https://t.co/zv4b9WU03h
— The Lancet (@TheLancet) March 15, 2023
M-A | eHealth-based psychosocial interventions for adults with insomnia
23 Mar, 2023 | 12:31h | UTC
Review | Diseases affecting middle-aged and elderly individuals with trisomy 21
20 Mar, 2023 | 13:44h | UTC
Guidelines on male adult testosterone deficiency, with statements for practice
16 Mar, 2023 | 13:18h | UTC
SR | Yoga may improve frailty markers in older adults
15 Mar, 2023 | 15:08h | UTCEffect of Yoga on Frailty in Older Adults: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)
Annals Video Summary: Effect of Yoga on Frailty in Older Adults: A Systematic Review
News Release: Yoga may help to prevent frailty in older adults – American College of Physicians
Deprescribing strategies for opioids and benzodiazepines with emphasis on concurrent use: a scoping review
15 Mar, 2023 | 15:06h | UTCRelated:
RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care
Deprescribing proton pump inhibitors – Australian Journal of General Practice
Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports
Deprescribing in Palliative Cancer Care – Life
Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360
Polypharmacy Management in Older Patients – Mayo Clinic Proceedings
Eliminating Medication Overload: A National Action Plan – Lown Institute
Common ED Medication Errors: Polypharmacy – emDocs
Current and future perspectives on the management of polypharmacy – BMC Family Practice
Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international
Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety
SR | Environmental interventions can reduce falls in high-risk older adults
14 Mar, 2023 | 13:58h | UTCSummary: Falls and fall-related injuries are common among older adults and can have serious consequences, such as restricting activity or institutionalization. The Cochrane review aimed to assess the effects of environmental interventions, such as fall-hazard reduction, assistive technology, home modifications, and education, on preventing falls in older adults living in the community.
The review included 22 randomized controlled trials from 10 countries involving 8,463 community-residing older people. The study found that home fall-hazard interventions, which involve evaluating potential fall hazards and implementing safety adaptations or behavioral strategies, can reduce the rate of falls by 26% and the number of people who experience one or more falls by 11% in people at a higher risk of falling.
On the other hand, the study did not find any evidence of a decrease in the rate of falls when the interventions were not targeted toward individuals at higher risk. Additionally, the study suggests that these interventions are unlikely to have a significant impact on health-related quality of life, and there may be little or no difference in the risk of fall-related fractures, hospitalizations due to falls, or the rate of falls that require medical attention.
Summary: Reducing fall hazards within the environment – Cochrane Library
Commentary: Preventing falls in older people: new evidence on what helps – Evidently Cochrane
FDA panel endorses 2 RSV vaccines for older adults, but flag at potential increased risk of Guillain-Barre
8 Mar, 2023 | 14:27h | UTCPfizer vaccine:
In close vote, FDA advisers recommend Pfizer RSV vaccine for those 60 and older – CIDRAP
GSK’s vaccine:
FDA panel recommends GSK’s RSV vaccine for ages 60 and up – CIDRAP
FDA advisors recommend GSK’s RSV vaccine for older adults, but flag potential safety risks – CNBC
See also: Rare neurological condition is ‘important potential risk’ of Pfizer’s RSV vaccine, FDA says – CNN
BTS Clinical Guidance | Aspiration pneumonia
6 Mar, 2023 | 14:36h | UTCBTS clinical statement on aspiration pneumonia – Thorax
RCT | Antipsychotic association seems better than antidepressant switch in treatment-resistant geriatric depression
6 Mar, 2023 | 14:23h | UTCSummary:
This open-label randomized trial compared the benefits and risks of augmenting therapy vs. switching antidepressants in older adults with treatment-resistant depression. In the first step, 619 patients were randomly assigned to augmentation of existing antidepressant medication with aripiprazole (an antipsychotic), augmentation with bupropion, or a switch from existing antidepressant medication to bupropion. In step 2, 248 patients who did not benefit from or were ineligible for step 1 were randomly assigned to augmentation with lithium or a switch to nortriptyline.
The aripiprazole-augmentation group showed significant improvement in well-being compared to the switch-to-bupropion group. Remission occurred in 28.9% of patients in the aripiprazole-augmentation group, 28.2% in the bupropion-augmentation group, and 19.3% in the switch-to-bupropion group. In step 2, similar remission rates occurred in the lithium-augmentation group (18.9%) and the switch-to-nortriptyline group (21.5%).
Article: Antidepressant Augmentation versus Switch in Treatment-Resistant Geriatric Depression – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
#AAGPAM23: In a pragmatic trial involving older persons with treatment-resistant depression, augmentation of existing antidepressants with aripiprazole was better than augmentation with bupropion or a switch to bupropion. Full results of the OPTIMUM trial: https://t.co/2OPOxH67Qx pic.twitter.com/g0AtrYGhKV
— NEJM (@NEJM) March 3, 2023
An overview of systematic reviews and meta-analyses on the effect of medication interventions targeting polypharmacy for frail older adults
3 Mar, 2023 | 14:07h | UTCSummary: This overview of published systematic reviews examined the effectiveness of medication reviews on managing polypharmacy in frail older adults. The overview identified 10 systematic reviews, which included 154 studies. Medication reviews were the most common intervention, and the evidence suggests that they help reduce inappropriate medication use in frail older adults, but their impact on frailty scores and hospital admission is unclear. Pharmacist-led medication interventions were the most common, reducing inappropriate prescriptions in various settings. Tools, such as clinical decision-making computer support tools, were also found to be effective. The evidence quality ranged from moderate to critically low, highlighting the need for further research to establish if interventions directed at polypharmacy could have an impact on frailty syndromes.
Related:
RCT | A deprescribing intervention reduced medication burden among older adults in post-acute care
Deprescribing proton pump inhibitors – Australian Journal of General Practice
Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports
Deprescribing in Palliative Cancer Care – Life
Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360
Polypharmacy Management in Older Patients – Mayo Clinic Proceedings
Eliminating Medication Overload: A National Action Plan – Lown Institute
Common ED Medication Errors: Polypharmacy – emDocs
Current and future perspectives on the management of polypharmacy – BMC Family Practice
Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international
Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety
Cohort Study | Association between a healthy lifestyle and memory decline in older adults
3 Mar, 2023 | 13:44h | UTCSummary: This study examined the association between a healthy lifestyle and memory decline in older adults over a 10-year period. The study included 29,072 participants aged 60 or older with normal cognition and apolipoprotein E (APOE) genotyping at baseline. Six healthy lifestyle factors were assessed: a healthy diet, regular physical exercise, active social contact, active cognitive activity, never or former smoker, and never drinking alcohol. Participants were categorized into three groups based on their lifestyle factors: favorable, average, and unfavorable. The results showed that participants in the favorable group had slower memory decline than those in the unfavorable group, even in the presence of the APOE ε4 allele. These findings have important implications for public health initiatives to protect older adults against memory decline.
Editorial: Healthy lifestyles for dementia prevention – The BMJ
News Release: Healthy lifestyle linked to slower memory decline in older adults – BMJ Newsroom
Commentary: Healthful Lifestyle May Slow Memory Loss, Even for APOE Gene Carriers – JAMA
Commentary on Twitter
A healthy lifestyle is associated with slower memory decline, even in the presence of the [high risk] APOE ε4 allele.
Most to least impactful: diet, cognitive activity, physical exercise, active social contact, never/former smoking, & never drinking.https://t.co/j21cH2wyo6 pic.twitter.com/6qgd9bJ2Gr
— Joseph C. Watso, PhD (@Joseph_Watso) January 27, 2023
Under a http://creativecommons.org/licenses/by-nc/4.0/ license
Study shows sudden cardiac arrest during sports activity is rare among older adults
3 Mar, 2023 | 13:38h | UTCSudden Cardiac Arrest During Sports Activity in Older Adults – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries:
Sports-related sudden cardiac arrest is rare in older adults – Cedars-Sinai Medical Center
Risk of Sports-Related Sudden Cardiac Arrest Low in Older Adults – TCTMD