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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Taking Proton Pump Inhibitors Not Linked to Higher Dementia Risk

JAGS graphicJournal of the American Geriatrics Society Research Summary

Proton pump inhibitors (PPIs) are medicines commonly prescribed to treat acid-related digestive problems, including gastroesophageal reflux disease (or GERD).  As of 2011, up to 1 in 5 older adults reported using a PPI. Although healthcare practitioners have long believed that PPIs are safe, recent studies have linked PPIs to potential risks, including fractures and kidney disease. Some studies also have linked PPIs to an increased risk for dementia among older adults. However, several experts have suggested that these studies may not correctly measure the connection.

In a new research article published in the Journal of the American Geriatrics Society, scientists were able to conclude that developing dementia or Alzheimer’s disease (the most common form of dementia) did not appear to be linked to taking PPIs.

The researchers reviewed information from the Adult Changes in Thought (ACT) study, which included 3,484 adults aged 65 and older. Participants did not have dementia at the beginning of the study and were followed for an average of about 7.5 years. Continue reading

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

Study Finds that Most Older Adults are Aware of Medication Risks

JAGS graphicJournal of the American Geriatrics Society Research Summary

Geriatrics experts know that certain medications may have risks for older adults that outweigh their benefits, especially when safer alternatives are available. Medications that could be “potentially inappropriate” for older adults are included on recommendation lists that your healthcare provider can consult, such as the American Geriatrics Society (AGS) Beers Criteria or the STOPP-START list.

However, despite these recommendations, 25 percent of older adults take at least one potentially inappropriate medication every year. Taking these medications can increase the risk of being hospitalized due to a medication-related problem. Although 70 percent of older adults are willing to stop taking certain medications, healthcare providers continue to prescribe some potentially inappropriate medicines to older adults.

Researchers from the Institut Universitaire de Gériatrie in Montréal, Canada, designed a survey to learn about older adults’ awareness of drug-related health risks. They conducted the survey over the telephone with 2,665 participants, aged 65 or older. 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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