A critical review of drug efficacy and safety data is necessary to effectively advocate for geriatric patients and their caregivers.
Healthcare professionals should be aware that violence increases vulnerability to a broad range of physical and mental health problems over the course of a life.
Estrogen deficiency that occurs following menopause is known to cause atrophic changes and may be associated with lower urinary tract symptoms such as urgency and dysuria.
Elderly or debilitated patients may be put at risk of developing a type of central sleep apnea when opioids and other central nervous system depressants are administered.
Age-related macular degeneration is the leading cause of irreversible visual impairment in the elderly.
Chronic morbidity and age-related changes in the foot place the elderly at very high risk for foot problems that cause pain and impair balance and function.
Typically accelerating around age 75 years, sarcopenia plays a predominant role in frailty, which increases the likelihood of falls, fractures, and hospitalizations that are associated with morbidity, disability, and death.
Clinicians have relied on short-term use of these high-risk agents for insomnia in the elderly.
It has been estimated that treatment of new and recurrent cases of HSV keratitis costs the U.S. $17.7 million annually.
PLMD and RLS may interrupt sleep and may contribute to pain in seniors; drug-induced causes should be minimized or eliminated.
The TRUST Project has the potential to significantly improve the health and well-being of older adults with subclinical hypothyroidism and resolve uncertainties about how best to manage it.
A philosophy of minimizing or eliminating medications that do not support the primary goal of care should be advocated.
While fecal transplantation is effective at eradicating CDI, more randomized controlled trials are needed. Will this procedure become a primary mode of treatment?
Commonly seen in all medical settings, BPD may complicate treatment of comorbidities and adversely affect quality of life.
Educating clinicians through academic detailing is an effective way of enhancing clinical decision making to optimize therapeutic outcomes.
The most common gynecologic malignancy in the elderly may become more common as the metabolic
syndrome increases. Is metformin a promising adjuvant therapy?
Pharmacists, as collaborators in geriatric urologic care, can identify medication etiologies of urinary incontinence, raise awareness of these issues, and provide caregiver guidance.
In the elderly, dyspnea on exertion is a more common manifestation of myocardial ischemia than is chest pain.
The pain, stiffness, and reduced mobility of this condition can contribute to functional disability in seniors.
Adverse drug events are thought to account for more than 10% of ED visits and 25% of hospital admissions in older patients.
According to the CDC, 75% of patients
with hepatitis C are baby boomers; testing, early diagnosis, and
treatment can prevent liver damage, cirrhosis, and liver cancer.
Pain may be under-recognized in patients who have cognitive or sensory impairments or difficulties with language or speech;
it is frequently undertreated in cognitively impaired patients.
Aging can cause weak or stenotic valves.
Dabigatran is more problematic than warfarin regarding side effects in
patients with mechanical heart valves.
Repetitive brain trauma is associated
with progressive neurologic deterioration in some individuals; later
stages of disease are associated with dementia.
Ulcerative colitis and Crohn’s disease are associated with a late, secondary peak incidence between 60 and 80 years of age.
Is rasagiline neuroprotective in Parkinson’s disease? Pharmacists need to rely on current clinical factors.
Navigating across cultures requires tools such as learning
how to listen, empathize, and negotiate a treatment and pharmaceutical
plan with patients.
Since generalized edema is the major
clinical manifestation of this condition, it is often misdiagnosed as
congestive heart failure in geriatric patients.
In conjunction with the rising median age of the U.S.
population, an increase in the use of pneumotoxic drugs to treat
malignancies and cardiovascular diseases in the elderly contributes to
an increased incidence of interstitial lung disease.
The presence of more than 20 moles indicates a higher-than-average risk for melanoma; self-monitoring for warning signs and skin surveillance by a clinician are imperative.
Age-associated physiological changes
render the elderly more susceptible to infection and also predispose
them to antibiotic toxicity.
Degenerative changes of the cervical spine, associated with chronic neck pain
and stiffness, have a strong association with aging.
Age-related alterations in cardiovascular
structure and function, current prescribing trends, and “post-hospital
syndrome” require pharmacists’ attention and expertise.
Laryngopharyngeal reflux, or “silent reflux,” differs from
gastroesophageal reflux disease in that it is frequently not associated
with symptoms of heartburn and regurgitation.
Also called vascular cognitive impairment and most
often related to cerebrovascular disease, this type of dementia is the
second most common cause of age-related dementia, following Alzheimer’s
Age-related changes of the foot and
manifestations of systemic disease cause problems including pain,
infection, and reduced range of motion.
Certain vitamins and nutrients can protect the eye from various ocular diseases, such as cataracts, macular degeneration, and glaucoma.
As women age, they are at greater physiological risk for alcohol-related health problems.
The risk of this serious disorder
increases with age and certain comorbidities, such as diabetes, cancer,
and immunosuppression with corticosteroids.
This process encompasses consideration of various paths an
illness may take and contingencies for responding to them, based on a
patient’s values and care goals.
While many seniors believe that this potentially disabling
condition is normal and that seeking treatment is futile, in actuality
UI is never normal and in most cases can be treated.
Familiarity with exercise and pain
management guidelines can help direct pharmacists’ clinical
recommendations for senior patients.
From years of exposure, rough, dry, and scaly precancerous lesions develop on sun-exposed skin.
Surgical closure aims to reverse hemodynamic abnormalities and prevent
complications such as heart failure, paradoxical embolization, and
irreversible pulmonary vascular disease.
In the elderly, acute pancreatitis is most commonly caused by gallstones,
is more likely to be severe, and is associated with higher mortality.
Although people with intellectual disability exhibit considerable
morbidity, the numbers surviving into old age are rapidly increasing.
Even mild or moderate OA hand pain may negatively impact an individual’s
physical and emotional status, with the potential to significantly
reduce quality of life.
Urogenital symptoms, such as vaginal dryness and/or discomfort during
intercourse, recurrent bladder infections, and stress incontinence, need
not reduce quality of life nor be suffered in silence.
A decline in immune function with aging may be viewed as a form of acquired immunodeficiency.
The challenge of developing guidelines for the diagnosis, management,
treatment, and prevention of urinary tract infections is a
Some patients, particularly the elderly, have persistent or
recurrent pain in the involved nerve distribution that may be permanent
Since progression of this condition is so gradual, and symptoms may be attributed to normal aging, its severity is often underestimated.
Professionals facilitate and guide, rather than dictate, treatment.
About 50% to 70% of acute cholecystitis occurs in seniors; use of
estrogen replacement therapy in post-menopausal women also increases
Seniors experience more adverse effects with psychoactive medications,
and the effects tend to be more serious, than those seen in younger
Focusing on vaccination status can help prevent this inflammatory infection in the elderly. Invasive pneumococcal disease can also be avoided through immunization.
Without intervention, a 50% loss of skeletal muscle is likely by age 75 due to the aging process.
Anemia, cognitive impairment, infections, and poor wound healing are among the associated manifestations of mild vitamin deficiencies in the elderly.
This condition is an independent risk factor for atherosclerosis and myocardial infarction in elderly women.
The classic form of this disease occurs most often in men over 60 years old of Italian, Jewish, or Eastern European lineage.
This device senses the heart's rate and rhythm and transmits an electrical impulse to normalize an abnormal heartbeat.
Anticoagulants are one of the most common medications associated with preventable adverse drug events in this population.
Difficulty looking up without extending the neck or trouble climbing up and down stairs are some of the Parkinson's-like symptoms may signal this debilitating condition.
Pharmacists should be familiar with the concepts regarding end-of-life care so that they may better guide seniors, their families, and caregivers.
There has been a significant increase in obesity in the United States within the last 2 decades, and excess body weight contributes to the development of chronic conditions in later years.
This disorder is more common in men and in people over 40 years of age.
By optimizing medication use and reducing the risks of polypharmacy, the pharmacists plays a key role in decreasing morbidity and mortality in this patient population.
Various resources can assist pharmacists in honing the skills necessary to serve American seniors with quality care.
Dry or red eye, allergic conjunctivitis, and foreign bodies in the eye are secondary ocular conditions common in older patients.
To successfully help seniors make appropriate nonprescription drug choices, it is essential for pharmacists to correctly assess their symptoms.
Age-related physiologic changes frequently lead to high blood pressure in aging adults and affect the pharmacokinetics of medications used to treat it, so therapy should be carefully individualized and implemented.
In 2007, 37.9 million Americans, constituting 12.6% of the U.S. population, were over the age of 65.
Widespread administration of immunizations in the United States have
helped eradicate such diseases as smallpox and poliomyelitis and can
help prevent other serious illnesses and complications.
Medication compliance, or adherence, has been described as a patient's
actions regarding medication administration that are in accordance with
Pharmacists may help caregivers provide appropriate
care by educating them on the use of pain scales and observational
Osteomalacia is less common than osteoporosis, can be insidious, and may present comorbidly with osteoporosis.
With advancing age greater than 60 years a known risk, deep vein thrombosis is the primary cause of pulmonary embolism.
Visualizing organs of the gastrointestinal (GI) tract, such as the liver and gallbladder, and detecting cysts, abscesses, tumors, and obstructions can be achieved through radiographic imaging.
The FDA has determined new data provide evidence concluding the conventional antipsychotic agents share the increased risk of death in elderly patients with dementia-related psychosis that has been documented with the atypical antipsychotics.
Beta-Blockers for the Treatment of Hypertension
A lthough relatively common, vaginal bleeding is considered abnormal when reported in a woman who has passed the onset of menopause.
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A research team from the University of Reading and the Peninsula Medical School in southwestern England that is studying memory loss in the elderly think they have discovered a means of reversing the forgetfulness of aging.
In the future, robots could be taking the place of traditional caregivers of the elderly.
S exually transmitted diseases (STDs) ( TABLE 1 ) can be contracted later in life--a fact too often overlooked by seniors and health care providers alike.
Oral health is an integral part of general health and well-being, but older adults often neglect it.
In 1991, Mark Beers and an expert panel developed explicit criteria
Almost all health care providers care for seniors to some extent at one point or another
There are numerous consequences of persistent pain in older adults ( TABLE 1 )...
Some illnesses are found to take varied courses in geriatric patients.
Warfarin, the oral anticoagulant most frequently used to control and prevent thromboembolic disorders, is increasingly common among seniors.
A variety of neurologic conditions present more often in individuals of advancing age.
A study reported in the Journal of Gerontology showed that drivers age 70 and older might benefit from a driver's-education program.
Researchers at Duke University and the University of Michigan report that approximately 14% of Americans age 71 and older have some form of dementia.
Heartburn, one of the classic symptoms of gastroesophageal reflux disease (GERD), is a very common occurrence among the general population.
One of the many ways that pharmacists make a difference in the care of their patients is through educating themselves about, monitoring for, and raising awareness of preventable medication-related conditions.
Astonishingly, it is frequently observed that the efficacy and safety of new pharmaceuticals are evaluated in patient populations with significantly different characteristics from some of the patients for whom the treatments will be prescribed in clinical practice.
Dementia can devastate the lives of patients and their families.
In the United States, suicide ranks 11th among causes of death.
Sexuality and sexual function are important indicators of quality of life in all stages of adulthood.
In the United States, the most common infectious cause of death is pneumonia.
Pain is a common and often undertreated phenomenon in patients 65 and older that is often attributed to physical injuries and trauma or may stem from a range of disease states.
According to surveys by the Pharmaceutical Research and Manufacturers of America, older Americans have high hopes of more drugs being available in the near future.
Alzheimer's disease (AD) is the most common form of dementia in the elderly.
Delirium is an acute, confused state.
Glaucoma is the leading cause of irreversible blindness in the world.
Oral diseases increase in prevalence with age and are often complicated by comorbidities, including chronic systemic diseases, and medications.
Prescription medication and alcohol misuse affect up to 17% of Americans ages 65 and older.
Urinary incontinence (UI) is best defined as a variety of abnormalities of the urinary tract that result in the inability to experience normal micturition, leading to involuntary loss of bladder control.
The term sexuality has many definitions.
Hip fractures are typical in the aging population. Although the majority of patients who break a hip eventually recover most of their ability to function, a broken hip in an older patient can mean a permanent loss of independence.
It has been said that disease is a confrontation, a triumph over which is merely a reprieve from the inevitable end.
In 1999, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced new pain management standards.
In the United States, the most common types of cancer are those affecting the skin, and most skin cancers occur in the elderly population.
Blood clotting is a very complicated process.
Atrial fibrillation is one of the most common types of arrhrythmias.
Compared with younger drivers, older drivers are less likely to drink and drive and to cause an accident resulting in a fatality.