Does Chemotherapy Harm Ability to Function for Older Women with Breast Cancer?

Journal of the American Geriatrics Society Research Summary

Older women are at higher risk for developing breast cancer than younger women are—almost half of all breast cancer cases, and most breast cancer deaths, occur in women who are 65 or older. Despite this, we know very little about how breast cancer and its treatments affect older women. In particular, we don’t fully understand how the disease and chemotherapy treatments affect a woman’s ability to function and perform daily activities.

For older adults, knowing how chemotherapy may affect you is important, especially if there’s a chance it could affect your ability to live independently. Understanding your risk for such problems would be good information to have when it comes to choosing treatments.

To learn more about how breast cancer and its treatments might affect older women’s abilities to function, a team of researchers designed a study. They published their results in the Journal of the American Geriatrics Society. Continue reading

Physical Therapy in the Emergency Department after a Fall May Help Reduce Future Fall-Related Visits to the Emergency Department

Journal of the American Geriatrics Society Research Summary

Falls are the leading cause of illness and death among Americans aged 65 and older. In 2014, some 2.8 million older adults visited the emergency department (ED) for a fall-related injury. And over time, the ED visit rate for falls among older adults has grown to 68.8 per 1,000 older adults (as of 2010).

Older adults who visit the ED for a fall are at high risk for both revisiting the ED and dying. In fact, some estimates show that 25 percent of older adults visiting the ED for a fall returned for at least one additional fall-related visit. Fifteen percent of those older adults died within the following year.

Because so many older adults visit an ED due to falls, many experts see an opportunity for EDs to play a role in reducing future falls among older adults who are at high risk.

In a new study, published in the Journal of the American Geriatrics Society, researchers explored whether older adults who received physical therapy (PT) services while in the ED for a fall experienced fewer fall-related repeat visits to the ED.

The research team used Medicare claims data representing Medicare beneficiaries from across the country. The information examined differences in 30-day and 60-day ED repeat visit rates among older adults who visited the ED for a fall and who received PT services in the ED. The researchers compared that to older adults who did not receive PT services in the ED after a fall. Continue reading

Antipsychotic Use in Older Adults After Heart Surgery

Journal of the American Geriatrics Society Research Summary

Delirium is the medical term for an abrupt, rapid change in mental function that goes well beyond the typical forgetfulness of aging. Delirium can cause you to become confused, potentially aggressive, agitated, sleepy, and/or inactive. Post-operative delirium can occur after you’ve had an operation, and is the most common complication older adults experience after they have surgery. Older adults are at high risk for post-operative delirium after they have heart surgery.

When older adults have post-operative delirium, they are often given antipsychotic medications (APMs).  However, these drugs are not proven to be effective for treating delirium and may be harmful. Experts suggest that these drugs do not reduce how often or for how long older adults may experience delirium, or how serious the effects of delirium may be.

Additionally, some studies in older adults with dementia have found that APMs may cause heart rhythm problems and other drug-related side effects. Taking these drugs can increase the effects of anesthesia, and can cause stroke, pneumonia, and even death. Older adults who have had heart surgery are more likely to experience these dangerous events.

In a new study published in the Journal of the American Geriatrics Society, researchers looked into the use of APMs in older adults following heart surgery. Continue reading

Recognizing and Diagnosing Obstructive Sleep Apnea in Older Adults

Journal of the American Geriatrics Society Research Summary

Obstructive sleep apnea (OSA) is a common condition that causes brief, repeated pauses in breathing throughout the night as you sleep. OSA is linked to several serious health problems, including heart disease, difficulties with thinking and memory, depression, car crashes, heart disease, stroke, and diabetes. Having OSA can also cause a decline in quality of life, and increase the risk of motor vehicle crashes.

Until now, researchers have not explored on a national scale how many older adults may be at risk for OSA, or how often healthcare providers evaluate and treat the condition in older people. Recently, a team of researchers from the University of Michigan designed a first-of-its-kind study to answer those questions. Their work was published in the Journal of the American Geriatrics Society.

The researchers studied information from the National Health and Aging Trends Study (NHATS), a survey of Medicare beneficiaries that assesses the impact of aging on health and well-being. Funded by the National Institute on Aging, NHATS has conducted five annual face-to-face interviews in older adults’ homes since 2011. The NHATS research team has collected detailed information about participants’ health, physical and mental capabilities, living conditions, daily activities, and social support. In 2013, NHATS interviews also asked beneficiaries questions about sleep disturbances and symptoms of sleep apnea. Many of the NHATS sleep questions resembled questions from a common sleep apnea screening questionnaire known as the “STOP-Bang” questionnaire, which got its name from the symptoms it assesses: snoring, tiredness, observed apneas (pauses in breathing), high blood pressure, body mass index (BMI, a ratio of weight to height that assesses levels of under/overweight and obesity), age, neck circumference, and gender. Continue reading

Avoiding Dangerous Side Effects of Medications in Nursing Homes

Journal of the American Geriatrics Society Research Summary

Experts from the University of Iowa recently published a study in the Journal of the American Geriatrics Society examining the kind of medication errors and side effects that nursing home residents experience. They also looked at staffing and work systems in nursing homes that could affect medication errors and side effects. This is important because more than 1.4 million older adults lived in nursing home facilities as of 2015. Of these, 85 percent were 65-years-old and older and 41 percent were 85-years-of-age or older. In 2014, there were 15,600 nursing homes in the United States.

Older adults who live in nursing homes are at greater risk for injuries related to the medications we might take as we age (these injuries are also known as “adverse drug events”). There is a greater risk for adverse drug events for this population due to age, frailty, disability, and the multiple chronic illnesses we may be managing at any given time. For these illnesses, nursing home residents usually need several medicines, sometimes including riskier medicines like antipsychotics, antidepressants, and antiepileptics.

Some adverse drug events are due to preventable errors. Others are considered “non-preventable” because they can occur even when the medications are correctly given at normal doses. Continue reading