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Fracture Prevention in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ...

Mar 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2020/0315/p370.html

Adverse Events of Pharmacologic Treatments of Major Depression in Older Adults - ...

Feb 1, 2020 - What are the adverse events of antidepressants prescribed to treat major depressive disorder in adults 65 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0201/p179.html

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ...

Jan 1, 2020 - The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions, medications that ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0101/p56.html

Overuse of Statins in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ...

Dec 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/1215/p742.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

Preparing for Serious Illness: A Model for Better Conversations over the Continuum of ...

Mar 1, 2019 - How can we ensure that our seriously ill patients routinely get the right care without relying on individual sacrifice and luck?

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0301/p281.html

Deprescribing Is an Essential Part of Good Prescribing - Editorials - American Family ...

Jan 1, 2019 - There are four important medication issues to discuss with patients as they get older. Find out more and learn the five steps to individualize deprescribing practices for each patient.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0101/p7.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures...

Aug 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of vitamin D and calcium supplementation, alone or combined, for the primary prevention of fractures in men and premenopausal women.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/0815/od2.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

Treatment of Subclinical Hypothyroidism Ineffective in Older Adults - POEMs - American ...

Oct 15, 2017 - Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od3.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Testosterone Does Not Improve Cognition in Memory-Impaired Older Men with Low ...

Jun 1, 2017 - Testosterone supplementation for men 65 years or older with age-associated memory impairment and a low baseline testosterone level was not associated with significant improvements in memory or other cognitive functions.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733a.html

End-of-Life Care: Managing Common Symptoms - American Family Physician

Mar 15, 2017 - Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p356.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Nonpharmaceutical Treatment of Anxiety in Institutionalized Older Adults - FPIN's Help ...

Apr 1, 2016 - Cognitive behavior therapy (CBT) or relaxation training, alone or in combination, can be used to treat anxiety in older adults. Music therapy can also be used to reduce anxiety in older adults. Appropriate training of institutional caregivers is also helpful in reducing anxiety in older...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0401/p592.html

Management of Constipation in Older Adults - American Family Physician

Sep 15, 2015 - Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home residents. Primary constipation is also referred to as functional constipation. Secondary constipation is associated with chronic disease processes, medication use, and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p500.html

Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests - ...

Apr 1, 2015 - Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0401/p480.html

Pharmacologic Management of Pain at the End of Life - American Family Physician

Jul 1, 2014 - Although many patients experience debilitating pain at the end of life, there are many options to improve analgesia and quality of life. Pain assessment using a validated tool, with attention to patient function and specific goals, helps tailor individual treatment plans. The World ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p26.html

Complex Care: Treating an Older Patient with Multiple Comorbidities - Curbside ...

Mar 1, 2014 - Although there are guidelines for management of single chronic illnesses, the evidence base for management of multiple comorbidities is lacking. The American Geriatrics Society described a clinical approach to managing patients with multiple comorbidities in 2012.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0301/p392.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Exercise Effective for Depression in Older Patients - POEMs - American Family Physician

Dec 15, 2013 - An organized exercise program for older patients, which may include strength training, endurance training, or both, may be helpful for some patients with symptoms of depression. The results will not be striking, but exercise is an option for patients willing to participate.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/od2.html

Appropriate Use of Polypharmacy for Older Patients - Cochrane for Clinicians - American...

Apr 1, 2013 - Multidisciplinary interventions that address polypharmacy decrease inappropriate prescribing and medication-related problems in patients 65 years and older, but it is not clear if they reduce hospital admissions or improve quality of life. Most interventions studied were led by ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/0401/p483.html

Caring for Older Patients Who Have Significant Hearing Loss - Curbside Consultation - ...

Mar 1, 2013 - This scenario illustrates issues related to end-of-life care and placement in a long-term care facility for older individuals with significant hearing loss. An analysis of data from the 1999 to 2006 cycles of the National Health and Nutrition Examination Survey, and statistics from the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0301/p360.html

Primary Insomnia in Older Persons - Clinical Evidence Handbook - American Family Physician

Feb 15, 2013 - What are the effects of nondrug and drug treatments for primary insomnia in older persons (those 60 years and older)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2013/0215/p280.html

Management of Falls in Older Persons: A Prescription for Prevention - American Family ...

Dec 1, 2011 - Although falls are a common cause of injury in older persons, they are not just a normal part of the aging process. The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1267.html

Donepezil to Manage Alzheimer Disease: New vs. Standard Dosing - AFP Journal Club - ...

Mar 15, 2011 - Does donepezil benefit patients with Alzheimer disease, and is the new dosage superior to the standard dosage? This study showed benefit, but the data are misleading.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0315/p742.html

Delirium at the End of Life - Clinical Evidence Handbook - American Family Physician

May 15, 2010 - What are the effects of interventions at the end of life in persons with delirium caused by underlying terminal illness?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2010/0515/p1260.html

Treatment of Nursing Home-Acquired Pneumonia - American Family Physician

Jun 1, 2009 - Pneumonia is an important cause of morbidity and mortality in nursing home residents, with 30-day mortality rates ranging from 10 to 30 percent. Streptococcus pneumoniae is the most common cause of nursing home-acquired pneumonia, although Staphylococcus aureus and gram-negative ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0601/p976.html

Treatment of Nursing Home-Acquired Pneumonia: Dogma vs. Data - Editorials - American ...

Jun 1, 2009 - Advertisement << Previous article Next article >> Jun 1, 2009 Issue Editorials Treatment of Nursing Home–Acquired Pneumonia: Dogma vs. Data JOSEPH M. MYLOTTE, MD, State University of New York at Buffalo, Buffalo, New York Am Fam Physician. 2009 Jun 1;79(11):945-948. Related Article...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/0601/p945.html

Prescribing for Older Adults: Finding the Balance - Editorials - American Family Physician

Dec 15, 2007 - Advertisement << Previous article Next article >> Dec 15, 2007 Issue Editorials Prescribing for Older Adults: Finding the Balance ALLEN F. SHAUGHNESSY, PharmD, Tufts University Family Medicine Residency at Cambridge Health Alliance, Malden, Massachusetts Am Fam Physician. 2007 Dec...

American Family Physician : Editorials

https://www.aafp.org/afp/2007/1215/p1768.html

Exercise for Older Patients Who Are Acutely Hospitalized - Cochrane for Clinicians - ...

Jul 1, 2007 - The effects of exercise interventions on functional outcomes are unclear, but there is a trend toward functional improvement. Multidisciplinary interventions that include exercise also show several other benefits, including reduction in length of hospitalization and hospital costs; ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0701/p69.html

Monitoring Therapy for Patients with Alzheimer's Disease - FPIN's Clinical Inquiries - ...

Jun 1, 2007 - Patients with Alzheimer's disease who undergo treatment of any kind should be monitored eight weeks after initiation of therapy and at least every six months thereafter.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0601/p1703.html

Antidepressants in Older Persons - Cochrane for Clinicians - American Family Physician

Nov 1, 2006 - In older persons with depression, three classes of antidepressants are equally effective: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and tricyclic-like compounds. More patients taking classic tricyclic antidepressants stopped their medications because of...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/1101/p1503.html

Are Atypical Antipsychotics Safe in Patients with Alzheimer's Disease? - Cochrane for ...

Aug 1, 2006 - Although the atypical antipsychotic medications risperidone (Risperdal) and olanzapine (Zyprexa) are modestly efficacious in reducing aggression, routine use is not justified. Both drugs are associated with serious adverse cerebrovascular events and extrapyramidal symptoms. Use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0801/p414.html

Treatment of Constipation in Older Adults - American Family Physician

Dec 1, 2005 - Constipation is a common complaint in older adults. Although constipation is not a physiologic consequence of normal aging, decreased mobility and other comorbid medical conditions may contribute to its increased prevalence in older adults. Functional constipation is diagnosed when no ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1201/p2277.html

Management of Hypertension in Older Persons - American Family Physician

Feb 1, 2005 - Antihypertensive therapy has been shown to reduce morbidity and mortality in older patients with elevated systolic or diastolic blood pressures. This benefit appears to persist in patients older than 80 years, but less than one third of older patients have adequate blood pressure ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p469.html

Vertebral Compression Fractures in the Elderly - American Family Physician

Jan 1, 2004 - Compression fracture of the vertebral body is common, especially in older adults. Vertebral compression fractures usually are caused by osteoporosis, and range from mild to severe. More severe fractures can cause significant pain, leading to inability to perform activities of daily ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p111.html

Ambulatory Devices for Chronic Gait Disorders in the Elderly - American Family Physician

Apr 15, 2003 - Gait disorders in the elderly are common and in most cases cannot be treated medically or surgically. Therefore, treatment often relies on ambulatory devices such as canes, crutches, and walkers. Before selecting a device, the patient should be evaluated to define whether one or both ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0415/p1717.html

Appropriate Use of Psychotropic Drugs in Nursing Homes - American Family Physician

Mar 1, 2000 - The Omnibus Budget Reconciliation Act (OBRA) of 1987 limited the use of psychotropic medications in residents of long-term care facilities. Updates of OBRA guidelines have liberalized some dosing restrictions, but documentation of necessity and periodic trials of medication withdrawal ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1437.html

Hospice Care in the Nursing Home - American Family Physician

Feb 1, 1998 - Hospice care is being used more frequently to provide skills and services that are not otherwise available in nursing homes. For eligible terminally ill patients, the Medicare Hospice Benefit supplies an interdisciplinary team with skills in pain management, symptom control and ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0201/p491.html

The Integration of Hospice Programs in Nursing Homes - Editorials - American Family ...

Feb 1, 1998 - Advertisement << Previous article Next article >> Feb 1, 1998 Issue Editorials The Integration of Hospice Programs in Nursing Homes AUBREY L. KNIGHT, M.D., Carilion Family Practice Residency Program, Roanoke, Virginia Am Fam Physician. 1998 Feb 1;57(3):424-425. Related Article A...

American Family Physician : Editorials

https://www.aafp.org/afp/1998/0201/p424.html

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