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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

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

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

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

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

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

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

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

Limited Data: Deprescribing is Safe, But at the Risk of Symptom Recurrence - POEMs - ...

May 15, 2019 - The limited rigorous data on deprescribing suggest that many patients can safely stop unnecessary medication, but symptom relapse is significant.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od2.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

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

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

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.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

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

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p820.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

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

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

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 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

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