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

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.

Continue reading