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

Helping Older Adults Discontinue Using Sedatives

Journal of the American Geriatrics Society Research Summary

Older adults, especially those who are admitted to hospitals, are at risk for potentially dangerous side effects if they are taking multiple medicines. Taking several medications at the same time is called polypharmacy. Of special concern are benzodiazepine and non-benzodiazepine sedative hypnotics. These medications, which include lorazepam, clonazepam, zopiclone, and others, are often prescribed for sleep—despite the fact that organizations like the American Geriatrics Society recommend that they not be used as a first choice for sleep problems, agitation, or delirium (the medical term for an abrupt, rapid change in mental function).

As many as one in three older adults receive sedatives while they are hospitalized, and many are given new prescriptions for them when they leave the hospital. This can put older adults at risk for falls, fractures, problems with thinking and making decisions, and even death.

In a new study, published in the Journal of the American Geriatrics Society, researchers looked at a way to help older adults taper off and stop using sedatives. This was based on an earlier study that suggested giving older adults the following:

  • an educational brochure outlining the problems that sedatives pose
  • instructions for safely taking themselves off the medication.

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For Older Adults, Dry Mouth Symptoms can be a Side Effect of Certain Medications

JAGS graphicJournal of the American Geriatrics Society Research Summary

For older adults, dry mouth can be a common side effect of prescribed medications. Having dry mouth means you don’t have enough saliva, or spit, to keep your mouth wet. The condition can lead to problems chewing, eating, swallowing, and even talking. What’s more, dry mouth puts you at higher risk for tooth decay and oral infections.

However, there’s much we don’t understand about the connection between medications and dry mouth in older adults. Recently, researchers examined 52 related studies to learn more. Their research was published in the Journal of the American Geriatrics Society. Continue reading

Some Frail Older Adults May Receive Potentially Inappropriate Medications When Admitted to Nursing Homes

JAGS graphicJournal of the American Geriatrics Society Research Summary

Medical experts know that older adults who have dementia or other mental health concerns that impact thinking or decision making should avoid certain “potentially inappropriate medications” (PIMs). PIMs can worsen confusion and raise the risks for falls, fractures, and even death, particularly for people with complex health needs.

PIMs may include treatments like:

  • Benzodiazepines (medications sometimes called “tranquilizers” and used to treat sleep problems, anxiety, or to relax muscles)
  • Antipsychotics (medications sometimes used to address mental health conditions)
  • H2-blockers (medications sometimes used to decrease the production of stomach acid)
  • Anticholinergics (medications that block a substance called acetylcholine, a “neurotransmitter” that transfers signals between certain cells to impact how your body functions. Anticholinergics have been used to treat several different conditions, including incontinence and chronic obstructive pulmonary disorder, or COPD).

A Canadian research team investigated how often healthcare providers prescribed PIMs to older adults living with dementia or other mental health concerns and who were being admitted to nursing homes. The research team examined records from more than 40,000 people with dementia or cognitive impairments who were over the age of 66 and had been admitted to nursing homes between 2011 and 2014. The team published their study in the Journal of the American Geriatrics Society.

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New Study: Proton Pump Inhibitors Do Not Contribute to Dementia or Alzheimer’s Disease

JAGS graphicJournal of the American Geriatrics Society Research Summary

Proton pump inhibitors (PPIs) are medications used to treat digestive problems such as ulcers and reflux disease by reducing the body’s production of the acid that helps us digest food. Ulcers are sores that develop on the lining of our digestive system; when they develop in the upper part of the small intestine they are called “duodenal ulcers.” Reflux disease is a condition in which stomach acid or other fluids in the digestive system irritate our food pipe, also known as the esophagus.

Recently, safety questions about these medications have been raised in several studies. These studies suggested that PPIs increased the risk for dementia and Alzheimer’s disease in people 75-years-old or older. Noting that the prescription of PPIs is on the rise among middle-aged and older adults, a team of researchers designed a new study to examine PPIs and the risk of dementia, mild cognitive impairment, and Alzheimer’s disease. They published their study in the Journal of the American Geriatrics Society. The researchers also examined whether people with mild cognitive impairment who took PPIs were at higher risk for developing dementia or Alzheimer’s disease. Continue reading