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

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

During National Women’s Health Week, Honor Your Own Health

National Women’s Health Week (May 13-19, 2018) is a perfect reminder to female healthcare providers to practice what we preach. As caregivers and as women who serve our communities’ health, we all too often focus on the health needs of others before our own. In the immortal words of every flight attendant, “Put on your oxygen mask before assisting others.” Meaning, of course, that if you’re neglecting your own well-being, it will be difficult for you to help your clients and loved ones.

And as we age, it becomes increasingly important to monitor our health. That’s because older women are more likely than men to have chronic health conditions, including arthritis, high blood pressure, and osteoporosis.

Happily, a great deal of what it takes to boost your chances for staying physically and mentally healthy is within your power. Below is what the experts with the American Geriatrics Society’s Health in Aging Foundation recommend.

See your healthcare provider regularly. Even if you feel perfectly healthy, get a check-up at least once a year, or as often as your provider recommends.

Take medications, vitamins, and supplements only as directed. When you visit your provider, bring all the pills and other supplements you take—even those you buy over the counter without a prescription. Your provider should check all of your pills to make sure they’re safe for you, and you should check with her before taking any new medication or supplement.

Let your provider know right away if a medication or supplement seems to be causing a problem or a side effect. Continue reading

Are High-Risk Anticholinergic Medicines Prescribed Too Often for Older Adults?

Journal of the American Geriatrics Society Research Summary

Anticholinergics are a class of medications that are often prescribed for allergies, lung disease, and urinary incontinence. They also often can increase health risks for older adults. These medicines can affect your memory and ability to think, and they can even lead to increases in the risk for falls, dementia, and death. Additionally, older adults often have a difficult time tolerating anticholinergics because of age-related physical changes, such as reduced liver and kidney function, and because medications can impact our brain chemistry more strongly as we age.

Experts use tools to help older adults and healthcare professionals understand the risks associated with medications like anticholinergics. One of these tools is the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The AGS Beers Criteria details medications with risks that may outweigh their benefits for older adults. The AGS Beers Criteria identifies 52 “high-risk” anticholinergics. Thirty-five of these are included on a list of medications worth avoiding altogether for older people, unless a healthcare professional has a compelling reason for prescribing them on a case-by-case basis.

Recently, a team of researchers decided to study how frequently healthcare providers prescribe potentially inappropriate medications like anticholinergics in light of recommendations like those from the AGS Beers Criteria. Their study was published in the Journal of the American Geriatrics Society. Continue reading