Acetaminophen Safe for Most Older Adults—But May Increase Stroke Risk for Those with Diabetes

Journal of the American Geriatrics Society Research Summary

Acetaminophen (otherwise known by brand names such as Tylenol) is one of the most widely used pain relievers. Almost 60 years of widespread use have made acetaminophen a household product. It’s distributed over the counter (OTC) in most countries and judged safe by the scientific community. However, acetaminophen is also one of the most common medications involved in overdoses (the medical term for taking more of a medicine than you should) and is the most common cause of drug-induced liver failure.

Surprisingly, we are only now coming to understand how acetaminophen works—and recent research shows that we may need to develop a better understanding of the need for caution when using acetaminophen, especially when it comes to avoiding some of the risks associated with its use. Past research suggests these can range from increased asthma to interactions with other medications or the risk for developing other health concerns (such as kidney toxicity, bone fractures, or blood cancers).

Another important reason to look more carefully at all medications is that our bodies may react to these treatments differently as we age. Older adults experience physical changes as they age including, for example, reduced muscle mass, more fat tissue, changes in body composition, and less fluid in the body systems. Older people may also have multiple chronic conditions and take several different medications. These issues affect many different body functions, and that can raise your risk of having an unwanted reaction to a medication.

For all these reasons, a team of researchers decided to study the safety of acetaminophen in a nursing home setting. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Caring for an Older Adult with Cancer Comes with Emotional Challenges for Caregivers, Too

Journal of the American Geriatrics Society Research Summary

The number of informal caregivers who look after older adults with cancer is on the rise. Caregivers could be relatives, partners, or even friends who provide assistance to people in order to help them function.

Most older people with cancer live at home and are dependent on informal caregivers for support with their cancer treatment, symptom management, and daily activities. Caregiving itself can also take a toll on a caregiver’s own physical and emotional well-being, which makes it important to ensure the proper supports are in place.

Until now, no large study has evaluated whether or not caring for older adults with advanced cancer is linked to caregivers’ emotional health or to their quality of life. Recently, researchers studied a group of adults aged 70 or older who had advanced cancer (as well as other challenges). This study used information from older patients with advanced cancer and their caregivers from local oncology practices enrolled in the “Improving Communication in Older Cancer Patients and Their Caregivers” study conducted through the University of Rochester National Cancer Institute Community Oncology Research Program Research Base between October 2014 and April 2017. Results from the study were published in the Journal of the American Geriatrics Society. Continue reading

AGS Releases New Action Steps to Guide Care for Older Adults with Multiple Chronic Illnesses

Journal of the American Geriatrics Society Research Summary

Caring for older adults with multiple chronic conditions can create challenging situations. For example, some treatments may be harmful to older adults who live with and manage several chronic conditions. In some cases, several treatments might be available but healthcare providers may not know which are best for a particular individual. In other cases, older adults and caregivers could even receive different treatment recommendations depending on the healthcare providers who offer guidance. Most important of all, managing care for multiple chronic conditions can make it difficult to focus on what matters most to us as individuals—a key priority when we think about the high-quality, person-centered care we all want and need as we age.

In 2010, the American Geriatrics Society (AGS) convened a panel of medical experts to address how to provide the best care for older adults living with multiple chronic conditions. The panel reviewed a host of clinical studies and developed the AGS Guiding Principles for the Care of Older Adults with Multimorbidity as a result.

The expert panel identified five “key principles” that healthcare providers should follow to support the best care for older adults with multiple chronic conditions:

  1. Include personal preferences in care decision-making. Older adults who have multiple chronic health conditions should be asked how they wish to make medical decisions affecting their care. Whenever appropriate, caregivers and family members should also be involved in these discussions.
  2. Understand the limits of evidence on treatment options. Clinicians must understand that specific, evidence-backed answers to questions about the best medical choices for individual older adults may not exist. That’s because every older adult and every health situation is unique.
  3. Weigh benefits versus harms. When addressing multiple chronic conditions for an older individual, clinicians must consider how a person might be burdened by one medical plan or treatment versus others. They also must weigh the benefits of treatment options, as well as information on the person’s functional status (their ability to perform daily activities such as bathing and eating), life expectancy (how long they are likely to live), and quality of life.
  4. Consider if treatment is manageable. When sharing recommendations, clinicians must account for the complexity of a treatment and whether it suits an older adult’s particular situation.
  5. Make the best informed choice possible. Ultimately, healthcare professionals also must try to choose therapies that have the most benefit, pose the least harm, and will work to enhance an older person’s quality of life.

Now, an expert group of geriatricians, cardiologists, and general physicians have identified a set of action steps based on those guiding principles to help healthcare providers work with older adults and caregivers to make the best treatment choices possible when addressing multiple chronic conditions.

These steps include: Continue reading

Depression Increases Risk of Death in Older Adults

Journal of the American Geriatrics Society Research Summary

As we age, we become more likely to experience symptoms of depression. Research shows that depression’s symptoms can be linked to a higher risk for death. Yet often, older adults’ symptoms of depression may be missed by healthcare professionals.

What’s more, symptoms of depression have been linked to heart disease and stroke in middle-aged and older adults. Researchers suggest that the depression-heart disease link could play a role in the increased risk of death among older adults who have symptoms of depression. There’s also a known link between depression and deaths from cancer and falls in older adults. These connections might contribute to an increased risk of death for older adults, researchers suggest.

Since depression symptoms change over time, it’s possible that studying those symptoms during an older adult’s doctor visits could provide more information. To learn more, a research team designed a study to investigate the role depression symptoms play in an increased risk of death over time. The team also examined the role heart disease and stroke play in the link between depression symptoms and increased risk of death. Their study was published in the Journal of the American Geriatrics Society. Continue reading

New Wisdom about High Cholesterol Treatment for Adults Aged 80 and Older

Journal of the American Geriatrics Society Research Summary

Experts know that in adults younger than 65, having high cholesterol levels in your blood can raise your risk for heart attacks and strokes. However, in adults 80 years old and older, researchers have not—until now—thoroughly studied high cholesterol’s impact on heart disease, your ability to function well, or your risk for death.

In fact, some research shows that a higher level of total cholesterol and a lower level of so-called “bad” cholesterol (also known as “low-density lipoprotein” or LDL cholesterol) might be helpful in protecting your ability to perform daily activities and preserving your life for longer.

What’s more, it appears that having low cholesterol is linked to a higher risk of death from cancer, respiratory disease, and accidents in adults aged 80 and older. It also appears that the benefits of taking medications known as statins, which lower cholesterol, may lessen as people age. Researchers even have a phrase for this phenomenon. They call it the “risk factor paradox.” This describes the fact that for adults aged 80 and older, having some conditions that are considered health risks in younger adults predicts better survival. These conditions include having higher total cholesterol, higher blood pressure, and higher body mass index (BMI, a ratio of body weight to height that helps determine whether you are overweight or obese). Continue reading