Search results for ‘Subject term:"older people"’ Sort:
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The effects of multiple dedication in the elderly
- Authors:
- RAJAEI-DEHKORDI Ziba, McPHERSON Gail
- Journal article citation:
- Nursing Times, 2.7.97, 1997, pp.56-58.
- Publisher:
- Nursing Times
This article is the first of two looking at medication-related problems in the elderly. The processes through which drugs are handled by the body are briefly described and common problems associated with medication and the elderly are discussed. A case study is presented to illustrate some of these issues.
Interventions for generalized anxiety disorder in older adults: systematic review and meta-analysis
- Authors:
- GONCALVES Daniela C, BYRNE Gerard J
- Journal article citation:
- Journal of Anxiety Disorders, 26(1), January 2012, pp.1-11.
- Publisher:
- Elsevier
This meta-analysis and systematic review examined the efficacy of controlled interventions for Generalised Anxiety Disorder (GAD) in adults aged 55 years and older. Twenty-seven trials (14 pharmacological, 13 psychotherapeutic) fulfilled the inclusion criteria, reporting results from 2373 baseline participants. There were no differences between trials in their overall quality. Pooled treatment effects for pharmacological and psychotherapeutic trials were similar, with findings in each case favouring active interventions over control conditions. Older adults with GAD benefited from both pharmacological and psychotherapeutic interventions.
Cholinesterase inhibitors and Alzheimer’s disease: patient, carer and professional factors influencing the use of drugs for Alzheimer’s disease in the United Kingdom
- Authors:
- HUTCHINGS Deborah, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 9(3), August 2010, pp.427-443.
- Publisher:
- Sage
Cholinesterase inhibitors are a major breakthrough in the treatment of Alzheimer’s disease. Between 2001 and 2006 guidance in the United Kingdom recommended that people with mild to moderate Alzheimer’s disease were eligible for treatment with donepezil, rivastigmine and galanatamine on the National Health Service (NHS). However, previous research has shown a considerable variation in uptake of and access to treatment. This study investigated which factors influence decisions to initiate, continue and discontinue treatment with the drugs. The views and experiences of 12 older people referred for memory problems or receiving treatment, 11 family carers and 16 health and social care professionals were obtained using a combination of semi-structured interviews and focus groups. Findings revealed four factors outside UK guidance and prescribing budgets influenced decisions to utilise the drug treatments – perceptions of treatment availability and effectiveness, resource capacity, carer perceived benefits, and professional ethics. In conclusion, the authors suggest that unequal access to treatment and ethical concerns remain key issues in the distribution of these medications.
Treating late-life depression with interpersonal psychotherapy in the primary care sector
- Authors:
- SCHULBERG Herbert C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(2), February 2007, pp.106-114.
- Publisher:
- Wiley
Interpersonal psychotherapy (IPT) is an empirically-validated intervention for treating late-life depression. The objective was to determine the manner in which IPT is utilized by primary care physicians in relation to antidepressant medications. The authors reviewed treatment logs prepared by care managers during the first 12 months of a patient's participation in the PROSPECT clinical trial to determine initial and longitudinal treatment patterns utilized by physicians, and clinical outcomes associated with initial treatment assignment. Primary care physicians in practices randomized to PROSPECT's intervention arm initially prescribed an antidepressant medication for 58% of eligible patients and referred only 11% of them to IPT. Over time, however, 27% of patients participated in IPT as monotherapy or augmentation therapy. Initial treatment assignment was not associated with depressive status at 4 and 12 months nor with suicidal ideation at 4, 8, and 12 months. IPT is an effective treatment for late-life depression whose greater use by primary care physicians should be encouraged.
The relevance of guidelines for treatment mania in old age
- Author:
- SNOWDON John
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(9), September 2000, pp.779-783.
- Publisher:
- Wiley
Reviews three sets of guidelines for the treatment of patients with bipolar disorder, in order to assess their adequacy in relation to treatment of older persons with mania. One of the three referred to differences encountered when treating elderly people, but none gave adequate attention to age-related changes in pharmacokinetics and whether it is appropriate to prescribe lithium as a first-line mood stabiliser for older persons. Concludes that the guidelines do not give clear guidance on initial management of acutely manic patients who refuse medication. Nor do they give consideration to secondary mania. Recommended that evidence be gathered in order to develop guidelines specifically for management of mental disorders presenting in old age.
How to promote drug compliance in the elderly
- Author:
- SEAL Richard
- Journal article citation:
- Community Nurse, 6(1), February 2000, pp.41-42.
- Publisher:
- Emap Healthcare
A high number of patients, particularly the elderly, fail to take their medication correctly. This article explains the reasons for non-compliance and what nurses can do to help improve the situation.
Psychopharmacological treatment of dementia
- Author:
- CALLAWAY Janice T.
- Journal article citation:
- Research on Social Work Practice, 8(4), July 1998, pp.452-474.
- Publisher:
- Sage
This article provides an overview and description of dementia, explores current and investigational agents used in the treatment of accompanying cognitive and noncognitive symptoms, and suggests considerations for assessing certain aspects of pharmacological management.
Augmentation strategies in geriatric depression
- Author:
- FLINT Alastair J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(2), February 1995, pp.137-146.
- Publisher:
- Wiley
Approximately 30-40 per cent of elderly patients with major depression have inadequate response to an initial therapeutic trial of antidepressant medication. In these cases augmentation of the anti depressant has been recommended as one way of improving the rate of response. A review of the Canadian literature on augmentation strategies in treatment-resistant geriatric depression shows that it is difficult to draw conclusions about the efficacy of these strategies in late life, especially since treatment failures seldom get reported. Other factors such as side-effects may also limit the usefulness of some augmentation regimens in old age. Argues for the need to have controlled studies to better determine the clinical utility of augmentation strategies in physically well depressed elderly, as well as those with depression complicating medical illness, dementia and other neurological disorders.
A systematic review of older adults’ attitudes towards depression and its treatment
- Authors:
- NAIR Pushpa, et al
- Journal article citation:
- Gerontologist, 60(1), 2020, pp.e93-e104.
- Publisher:
- Oxford University Press
Background and Objectives: Late-life depression is a major societal concern, but older adults’ attitudes toward its treatment remain complex. This review aimed to explore older adults’ views regarding depression and its treatment. Research Design and Methods: A systematic review and thematic synthesis of qualitative studies that explored the views of older community-dwelling adults with depression (not actively engaged in treatment), about depression and its treatment. The review searched 7 databases (inception–November 2018) and 2 reviewers independently quality-appraised studies using the CASP checklist. Results: Out of 8,351 records, researchers included 11 studies for thematic synthesis. Depression was viewed as a normal reaction to life stressors and ageing. Consequently, older adults preferred self-management strategies (e.g., socialising, prayer) that aligned with their lived experiences and self-image. Professional interventions (e.g., antidepressants, psychological therapies) were sometimes considered necessary for more severe depression, but participants had mixed views. Willingness to try treatments was based on a balance of different judgements, including perceptions about potential harm and attitudes based on trust, familiarity, and past experiences. Societal and structural factors, including stigma, ethnicity, and ageism, also influenced treatment attitudes. Discussion and Implications: Supporting older adults to self-manage milder depressive symptoms may be more acceptable than professional interventions. Assisting older adults with accessing professional help for more severe symptoms might be better achieved by integrating access to help within familiar, convenient locations to reduce stigma and increase accessibility. Discussing treatment choices using narratives that engage with older adults’ lived experiences of depression may lead to greater acceptability and engagement. (Edited publisher abstract)
Substance abuse and co-occurring psychiatric disorders in older adults: a clinical case and review of the relevant literature
- Authors:
- SALMON Joanna Marie, FORESTER Brent
- Journal article citation:
- Journal of Dual Diagnosis, 8(1), January 2012, pp.74-84.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Substance misuse is predicted to become an increasing problem in the older adult population in the United States. This article uses a brief clinical case study to illustrate the issues and to introduce a review of the literature related to substance use and psychiatric illness in older adults. The review looks at prevalence of substance use disorders, psychiatric illness and co-occurrence in older adults, drug interactions and sensitivity and tolerance to alcohol and drugs, neurobiological consequences and cognitive impairment, including alcoholism, depression and brain changes, identification and assessment, and treatment of co-occurring disorders in older people. The article notes the unique challenges relating to treatment of older adults with co-occurring disorders. The authors suggest that further research into the older adult population with substance use disorders and co-occurring illness is required.