Anticholinergic burden in inpatient psychogeriatric population – Do we care?

2016 ◽  
Vol 33 (S1) ◽  
pp. S187-S187
Author(s):  
M. Lee ◽  
A. Warren ◽  
B. Zolotarev ◽  
J. Henderson ◽  
M. George
Keyword(s):  
Mental Health ◽  
Cognitive Impairment ◽  
Elderly Population ◽  
The Elderly ◽  
Prescribing Patterns ◽  
Therapeutic Effects ◽  
Older Person ◽  
Health Records ◽  
Competing Interest ◽  
Anticholinergic Burden

BackgroundAlthough recent studies have found that there is significant association between anticholinergic and cognitive impairment, especially in the elderly population, there seems to be minimal emphasis on anticholinergic burden (ACB) when prescribing medications to the inpatient psychogeriatric population.AimTo evaluate the prescribing patterns in Older Person Mental Health Inpatient Unit (OPMHU), whether the ACB Score on admission has been reviewed for lowest possible ACB while maintaining therapeutic effects. A protocol will be developed to ensure that ACB is reviewed for future admissions and discharges.MethodologyFifty patients admitted and discharged from OPMHU are recruited retrospectively from 30th September 2015, excluding outliers and deceased patients. For those who had multiple admissions during that period, only the most recent admission would be included for evaluation. Individual ACB score is calculated on admission and discharge based on pharmacist final medication summary. Their mental health records are also audited for any documented ACB review by the treating team, while making note for any pre-existing cognitive impairment.ResultACB has not been taken into consideration in all patients by the treating team on admission as well as when prescribing medications on discharge. Hence, it is unsurprising that the ACB score showed an increment of 30% on discharge (3.25) when compared to the admission score (2.5).ConclusionThe study found that although ACB poses significant risks on cognitive impairment, this knowledge has not been employed pragmatically. A protocol should be developed to ensure that ACB is evaluated and managed accordingly.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence and Pattern of Psychiatric Morbidity Among Community-Dwelling Elderly Populations in Abeokuta, Nigeria

2020 ◽  
Vol 33 (6) ◽  
pp. 353-362
Author(s):  
Gbolagade Amoo ◽  
Adefolakemi Temitope Ogundele ◽  
Abayomi Oluseye Olajide ◽  
Maroh Great Ighoroje ◽  
Adedunmola Oluwaseun Oluwaranti ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Impairment ◽  
Elderly Population ◽  
Mental Health Problems ◽  
Psychiatric Morbidity ◽  
The Elderly ◽  
Community Dwelling ◽  
Psychological Disorder ◽  
Medical Illness ◽  
Elderly Persons

Background: Many elderly persons in Nigeria are having mental health challenges and there is a lack of commensurate increase in services to attend to such. Aim: To assess the prevalence, pattern and correlates of psychiatric morbidity among community dwelling elderly persons (≥ 60 years) in Abeokuta, Nigeria. Methods: 532 respondents were selected using a multistage, stratified cluster sampling method from the elderly population in Abeokuta. First, participants were administered the socio-demographic questionnaire, General Health Questionnaire-12 (GHQ-12), and the Mini-Mental State Examination (MMSE). Those with a score of ≥ 3 in GHQ-12 were assessed with the Mini International Neuropsychiatric Interview (MINI PLUS), while those with ≤ 16 in MMSE were assessed with the Diagnostic Statistical Manual (DSM) IV criteria for Dementia and the Petersen’s criteria for Mild Cognitive Impairment (MCI). Results: 36.3% of the respondents had a probable psychological disorder, while 25.4% had a probable cognitive impairment. 9.8% had a current definitive psychiatric disorder. The commonest disorders were major depressive disorder and dementia. The female gender, the oldest old (≥ 80 years), having a chronic medical illness and bereavement in the last 1 year were most significantly associated with having mental health problems. Conclusion: A significant number of the elderly population in the studied community suffers from a psychiatric illness. It is hoped that studies as these will inform stakeholders on the need to pay closer attention to the mental health needs of the elderly, as their overall wellbeing plays a role in determining the overall health of the community.

Anticholinergic burden in older inpatients on psychotropic medication: do we care?

2017 ◽  
Vol 25 (6) ◽  
pp. 566-570 ◽  
Author(s):  
Mei Shiang Lee ◽  
Steve Kisely ◽  
Boris Zolotarev ◽  
Andrew Warren ◽  
Jack Henderson ◽  
...  
Keyword(s):  
Scale Score ◽  
The Elderly ◽  
Prescribing Patterns ◽  
Anticholinergic Medication ◽  
Therapeutic Effects ◽  
Scale Scores ◽  
Burden Scale ◽  
Older Inpatients ◽  
Discharged Patients ◽  
Anticholinergic Burden

Objectives: This quality activity explored the prescribing patterns in an Older Persons Mental Health Inpatient Unit in order to establish whether the Anticholinergic Cognitive Burden Scale (ACB Scale) score on admission was reviewed to minimise anticholinergic cognitive burden (ACB) while maintaining therapeutic effects. Methods: A retrospective electronic chart review of 50 discharged patients for any documented ACB review by the treating team, as well as the ACB Scale scores on admission and discharge. Findings: ACB was rarely considered. On average, the total ACB Scale scores on admission and discharge were high. At the time of discharge, the proportion of patients on at least one anticholinergic medication had significantly increased, and only 10% of patients were on no anticholinergic medication. Approximately 50% of patients had an increased ACB Scale score by discharge as opposed to only 8% who had reduced scores. Conclusions: Anticholinergic polypharmacy should be minimised when prescribing to the elderly population to reduce potential anticholinergic burden.

scholarly journals Health risk assessment and countermeasure analysis of the elderly population exposed to PM2.5 microenvironment

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Yan Xu ◽  
Wantian Cui
Keyword(s):  
Mental Health ◽  
Health Risk ◽  
Elderly Population ◽  
Mental Health Problems ◽  
Negative Impact ◽  
The Elderly ◽  
Exposure Concentration ◽  
Physical Diseases ◽  
The Impact

BACKGROUND: China’s atmospheric PM2.5 pollution is serious, and PM2.5 exerts a negative impact on the human respiratory system, cardiovascular, and mental health, and even more serious health risk for the elderly with weak immunity. OBJECTIVE: This work aims to analyse the impacts of PM2.5 microenvironment exposure on the health of the elderly and provide corresponding countermeasures. METHODS: The survey subjects are 118 retired elderly people in the community. PM2.5 exposure concentrations are monitored in summer (June 10 ∼ July 10, 2019) and winter (November 25 ∼ December 25, 2019). RESULTS: The exposure concentration in winter is higher than that in summer, with statistical difference (P <  0.05). Under the impact of PM2.5 microenvironment exposure, smoking in the elderly can increase the concentration of PM2.5, and long-term exposure to PM2.5 in the elderly can cause mental health problems. CONCLUSION: Long-term exposure of the elderly to the PM2.5 microenvironment leads to physical diseases and even psychological problems, which requires attention.

scholarly journals The Association between Physical Activity and Selected Parameters of Psychological Status and Dementia in Older Women

2021 ◽  
Vol 18 (14) ◽  
pp. 7549
Author(s):  
Angelika Cisek-Woźniak ◽  
Kinga Mruczyk ◽  
Rafał W. Wójciak
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Cognitive Functions ◽  
Protective Factor ◽  
The Elderly ◽  
Regular Physical Activity ◽  
Psychological Status ◽  
The Impact

Physical activity has an unquestionable impact on broadly understood human health. One interesting issue related to this is the importance of movement on mental health and cognitive functioning. Research shows that regular physical activity improves the cognitive functioning of adults and people with mental disorders. Regular physical activity can be an important and powerful protective factor in cognitive impairment and dementia in the elderly, and exercise is an important non-pharmacological treatment for mild cognitive impairment or neurodegenerative diseases. This study aims to present the impact of physical activity on selected cognitive functions in physically active women over 60 years of age. The research was carried out in a group of 110 generally healthy women from the area of western Poland over 60 years of age, who were divided into four groups based on the intensity of their physical activity. A pedometer (sport watch) and a physical activity diary were used to measure physical activity. Body Mass Index was assessed. Selected cognitive functions were assessed using the MMSE test, motor and psychomotor skills were measured, and Luria’s auditory memory test and recall test, a clock drawing test, and a GDS test were performed. There were statistically significant relationships between the level of physical activity and the effectiveness of cognitive processes. These results show that about 5000 steps a day is enough to see a positive effect on the mental health and cognitive functioning of this group of the elderly population. The women had an average BMI of 28.1 ± 4.7. BMI, indicating an overweight condition (over 30 kg/m2), was observed in 31% of women. The results of this study lead the authors to conclude that physical activity positively influences cognitive function and can be recommended for all seniors who do not have other serious comorbidities that would prevent them from playing sports.

Psychological and Physical Problems in Elderly People with Problems of Falls

2017 ◽  
Vol 41 (S1) ◽  
pp. S659-S660
Author(s):  
M. Mentis ◽  
M. Gouva ◽  
E. Antoniadou ◽  
K. Mpourdoulis ◽  
I. Kesoudidou ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Elderly People ◽  
The Elderly ◽  
Poor Mental Health ◽  
University Hospital ◽  
Psychological State ◽  
Physical Damage ◽  
The Difference ◽  
Competing Interest

IntroductionFalls of the elderly to a degree been associated with poor mental health, poor social support and poor physical health.ObjectivesTo investigate the falls of elderly people in relation to their mental and physical healthy.AimsTo compare the effects of falls in the elderly in the areas of mental and physical health.MethodsThe current study used purposive sampling compromised from 48 people that visited the emergency department at the Patras University Hospital in 2016. The inclusion criterion for participation was age (> 65 years). Data was collected using WHO's questionnaire, the WHOQUOL-BREF. Finally, data was analyzed using the test t test for independent samples.ResultsThe sample constituted by 39.6% of male and 61.4% of female. The average age of the sample was M = 75.89 years. In relation to mental health, the average of the elderly with a history of falls found M = 57.26 (SD = ± 22.87), while the other was found M = 74.45 (SD = ± 15.81). The difference between the two groups was statistically significant (P < 0.05), while physical health although again the first group found to have a smaller average (M = 56.65, SD = ± 22.13) relative to the second group (M = 63.78, SD = ± 12.59) no statistical difference was observed.DiscussionsThese results demonstrates that falls beyond the physical damage that are immediately visible can as well create significant issues in the psychological state of the elderly exacerbating anxiety, fear and social isolation, which has been associated with depression event.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide and Aging in Japan: An Examination of Treated Elderly Suicide Attempters

1995 ◽  
Vol 7 (2) ◽  
pp. 239-251 ◽  
Author(s):  
Yoshitomo Takahashi ◽  
Hideto Hirasawa ◽  
Keiko Koyama ◽  
Osamu Asakawa ◽  
Matazo Kido ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Elderly Population ◽  
Total Population ◽  
Suicide Attempts ◽  
The Elderly ◽  
The Public ◽  
Geriatric Hospital ◽  
Elderly Japanese ◽  
Elderly Suicide

Although individuals aged 65 and over accounted for 12% of the total population of Japan in 1990, suicides in this age group consisted of 29% of all suicides. The elderly population of Japan is expected to grow rapidly to 24% of the total population by the year 2020, and suicide prevention for the elderly is an urgent mental health problem. Among a total of 1,216 elderly patients who were admitted to the Department of Psychiatry at Tokyo Metropolitan Geriatric Hospital between April 1980 and March 1990, 50 were hospitalized immediately after suicide attempts in order to study their psychosociomedical problems. Because early diagnosis of depression and initiation of proper treatment are indispensable—even if patients do not show obvious depressive symptoms—those who develop persistent somatization and/or delirium should be considered highly suicidal and given special attention. With the cooperation of mental health professionals, it is necessary to educate general practitioners, the public, and the elderly themselves about characteristics of psychiatric disorders and various problems associated with aging. Further research on other elderly Japanese populations, as well as research that examines suicide completion, is needed to confirm the findings of the present study.

A Short Mental Status Questionnaire

1982 ◽  
Vol 1 (1-2) ◽  
pp. 16-20 ◽  
Author(s):  
Duncan Robertson ◽  
Kenneth Rockwood ◽  
Paul Stolee
Keyword(s):  
Cognitive Impairment ◽  
Mental Status ◽  
Clinical Assessment ◽  
Elderly Population ◽  
The Elderly ◽  
False Positives ◽  
False Negatives ◽  
Institutionalized Elderly ◽  
Severe Cognitive Impairment ◽  
Mild Impairment

ABSTRACTA mental status questionnaire (MSQ) developed tor use in surveys of the non-institutionalized elderly has been validated against clinical assessment. The MSQ identities moderate and severe cognitive impairment in the elderly. However, using the suggested scoring subjects with mild impairment cannot be separated from normals.The test is short, acceptable and reproducible and rate for false-positives and false-negatives fall well within acceptable limits for use in estimating the prevalence of dementia in the non-institutionalized elderly population.

scholarly journals Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Longbing Ren ◽  
Yongtao Zheng ◽  
Lezhou Wu ◽  
Yijun Gu ◽  
Yusheng He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Elderly Population ◽  
The Elderly

scholarly journals Resveratrol Mitigates Hippocampal Tau Acetylation and Cognitive Deficit by Activation SIRT1 in Aged Rats following Anesthesia and Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Jing Yan ◽  
Ailin Luo ◽  
Rao Sun ◽  
Xiaole Tang ◽  
Yilin Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Population ◽  
Cognitive Deficit ◽  
Neurological Complication ◽  
Postoperative Cognitive Dysfunction ◽  
The Elderly ◽  
Dependent Manner ◽  
Promising Avenue ◽  
Tau Acetylation

Postoperative cognitive dysfunction (POCD) is a sever postsurgical neurological complication in the elderly population. As the global acceleration of population ageing, POCD is proved to be a great challenge to the present labor market and healthcare system. In the present study, our findings showed that tau acetylation mediated by SIRT1 deficiency resulted in tau hyperphosphorylation in the hippocampus of the aged POCD model and consequently contributed to cognitive impairment. Interestingly, pretreatment with resveratrol almost restored the expression of SIRT1, reduced the levels of acetylated tau and hyperphosphorylated tau in the hippocampus, and improved the cognitive performance in the behavioral tests. What is more, we observed that microglia-derived neuroinflammation resulting from SIRT1 inhibition in microglia probably aggravated the tau acetylation in cultured neurons in vitro. Our findings supported the notion that activation SIRT1 provided dually beneficial effect in the aged POCD model. Taken together, our findings provided the initial evidence that tau acetylation was associated with cognitive impairment in the aged POCD model and paved a promising avenue to prevent POCD by inhibiting tau acetylation in a SIRT1-dependent manner.

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