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  • 1
    Online Resource
    Online Resource
    Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis
    Oxford University Press (OUP) ; 2022
    In:  Age and Ageing Vol. 51, No. 9 ( 2022-09-02)
    Details
    In: Age and Ageing, Oxford University Press (OUP), Vol. 51, No. 9 ( 2022-09-02)
    Abstract: our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods   Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome. Study records title/abstract and full-text screening by two reviewers. Risk of bias Cochrane Collaboration revised tool. Data synthesis results reported separately for different settings and sufficiently comparable studies meta-analysed. Results forty-nine heterogeneous studies were included. Community meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85–1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70–1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69–1.14, I2 = 0%, 2 s) for injurious falls. Hospital meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74–1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07–3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively. Long-term care meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72–1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64–1.35, I2 = 92%, 7 s) for number of falls. Conclusions the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls. PROSPERO registration number: CRD42020218231
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    URL: Article
    DOI: 10.1093/ageing/afac191
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2065766-3
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  • 2
    Online Resource
    Online Resource
    Incidence and outcomes of head injuries in people with and without Parkinson disease
    Wiley ; 2023
    In:  European Journal of Neurology Vol. 30, No. 6 ( 2023-06), p. 1648-1657
    Details
    In: European Journal of Neurology, Wiley, Vol. 30, No. 6 ( 2023-06), p. 1648-1657
    Abstract: Fall‐related injuries are a major health concern among people with Parkinson disease (PD). We compared the incidence and postinjury mortality of head injuries and traumatic brain injury (TBI) among persons with and without PD. Methods This register‐based study was conducted on the FINPARK cohort, which includes 22,189 persons who were diagnosed with PD in Finland during 1996–2015. We excluded persons with a previous head injury, leaving 20,514 persons with PD. For each person with PD, 1–7 matching persons without PD and previous head injury were identified with respect to age, sex, and residence. The Cox proportional hazard model was used to estimate hazard ratios for head injury. A logistic regression model was used to compare mortality. Results Persons with PD had 2.16‐fold (95% confidence interval [CI] = 2.06–2.26) risk of all head injuries and 1.97‐fold (95% CI = 1.84–2.10) risk of TBI after adjustment for age, sex, and comorbidities. Persons with PD had higher 1‐year mortality after any type of head injury (adjusted odds ratio [aOR] = 1.44, 95% CI = 1.28–1.62), TBI (aOR = 1.33, 95% CI = 1.14–1.57), or non‐TBI head injury (aOR = 1.72, 95% CI = 1.42–2.07) than persons without PD. The higher risk of mortality was observed 6 months after TBI and 1 month after non‐TBI injury in persons with PD. Persons with PD and head injury also had higher 1‐year mortality than persons with PD and without head injury. Conclusions Persons with PD have a higher risk of head injury and higher postinjury mortality than persons without PD.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v30.6
    DOI: 10.1111/ene.15782
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2020241-6
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  • 3
    Online Resource
    Online Resource
    The Association of Long-Term Opioid Use With Health Care and Home Care Service Use Among Aged Home Care Clients
    Elsevier BV ; 2023
    In:  Journal of the American Medical Directors Association Vol. 24, No. 6 ( 2023-06), p. 798-803.e1
    Details
    In: Journal of the American Medical Directors Association, Elsevier BV, Vol. 24, No. 6 ( 2023-06), p. 798-803.e1
    Type of Medium: Online Resource
    ISSN: 1525-8610
    URL: Article
    DOI: 10.1016/j.jamda.2022.11.023
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
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  • 4
    Online Resource
    Online Resource
    Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer’s disease – exposure-matched cohort study
    Springer Science and Business Media LLC ; 2016
    In:  BMC Geriatrics Vol. 16, No. 1 ( 2016-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2016-12)
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-016-0383-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2059865-8
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  • 5
    Online Resource
    Online Resource
    Use of anti-dementia drugs in home care and residential care and associations with neuropsychiatric symptoms: a cross-sectional study
    Springer Science and Business Media LLC ; 2015
    In:  BMC Geriatrics Vol. 15, No. 1 ( 2015-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 15, No. 1 ( 2015-12)
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-015-0102-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2059865-8
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  • 6
    Online Resource
    Online Resource
    Recent hospitalization and risk of antidepressant initiation in people with Parkinson’s disease
    Springer Science and Business Media LLC ; 2022
    In:  BMC Geriatrics Vol. 22, No. 1 ( 2022-12-17)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12-17)
    Abstract: People with Parkinson’s disease (PD) are more likely to be hospitalized and initiate antidepressant use compared to people without PD. It is not known if hospitalization increases the risk of antidepressant initiation. We studied whether a recent hospitalization associates with antidepressant initiation in people with PD. Methods A nested case-control study within the nationwide register-based FINPARK cohort which includes community-dwelling Finnish residents diagnosed with PD between years 1996 and 2015 ( N  = 22,189) was conducted. Initiation of antidepressant use after PD diagnosis was identified from Prescription Register with 1-year washout period (cases). One matched non-initiator control for each case was identified ( N  = 5492 age, sex, and time since PD diagnosis-matched case-control pairs). Hospitalizations within the 14 day-period preceding the antidepressant initiation were identified from the Care Register for Health Care. Results The mean age at antidepressant initiation was 73.5 years with median time since PD diagnosis 2.9 years. Selective serotonin reuptake inhibitors (48.1%) and mirtazapine (35.7%) were the most commonly initiated antidepressants. Recent hospitalization was more common among antidepressant initiators than non-initiators (48.3 and 14.3%, respectively) and was associated with antidepressant initiation also after adjusting for comorbidities and use of medications during the washout (adjusted OR, 95% CI 5.85, 5.20–6.59). The initiators also had longer hospitalizations than non-initiators. PD was the most common main discharge diagnosis among both initiators (54.6%) and non-initiators (28.8%). Discharge diagnoses of mental and behavioral disorders and dementia were more common among initiators. Conclusions Hospitalisation is an opportunity to identify and assess depressive symptoms, sleep disorders and pain, which may partially explain the association. Alternatively, the indication for antidepressant initiation may have led to hospitalisation, or hospitalisation to aggravation of, e.g., neuropsychiatric symptoms leading to antidepressant initiation.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-022-03698-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059865-8
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  • 7
    Online Resource
    Online Resource
    The effect of comorbidities on survival in persons with Alzheimer’s disease: a matched cohort study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Geriatrics Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Alzheimer’s disease (AD) is one of the leading causes of death world-wide, but little is known on the role of comorbidities on mortality among people with AD. We studied how comorbidities and age at AD diagnosis impact the survival of people with AD. Methods The Medication Use and Alzheimer’s disease (MEDALZ) cohort study included 70,718 community-dwelling persons in Finland with AD diagnosis from 2005 to 2011 and were matched 1:1 (age, gender, and hospital district) to people without AD (mean age 80 years, 65% women, and the mean follow-up 4.9 and 5.6 years, respectively). Covariates (age, gender, and socioeconomic position), comorbidities (cardiovascular disease, stroke, diabetes, asthma/ chronic obstructive pulmonary disease (COPD), hip fracture, cancer treatment, and mental or behavioral disorders excluding dementia) and survival data were obtained from nationwide registers. Cox proportional hazard models were used to compare risk of death between people with and without AD. Results During the follow-up period a greater proportion of the AD cohort died compared to the non-AD cohort (63% versus 37%) . In both cohorts, older age, male gender, lower socioeconomic position, and history of comorbidities were associated with shorter survival and higher risk of death. The associations of comorbidities with survival is weaker in the older age groups and people with AD. Hip fracture (adjusted HR 1.35, 95% CI 1.30–1.41), stroke (1.30, 1.27–1.34), and recent cancer treatment (1.29, 1.26–1.32) had the strongest associations in the AD cohort. Age modified the associations in both cohorts (weaker associations among older people). Conclusion Alzheimer’s disease is the major factor affecting survival, but comorbidities further decrease survival also in individuals with Alzheimer’s disease. Therefore, appropriate management of care of these comorbidities might affect not only survival but also the wellbeing of this vulnerable population.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-021-02130-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059865-8
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  • 8
    Online Resource
    Online Resource
    Number of teeth and myocardial infarction and stroke among elderly never smokers
    Springer Science and Business Media LLC ; 2009
    In:  Journal of Negative Results in BioMedicine Vol. 8, No. 1 ( 2009-12)
    Details
    In: Journal of Negative Results in BioMedicine, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2009-12)
    Type of Medium: Online Resource
    ISSN: 1477-5751
    URL: Article
    DOI: 10.1186/1477-5751-8-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2009
    detail.hit.zdb_id: 2091480-5
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  • 9
    Online Resource
    Online Resource
    Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among community-dwelling persons
    Royal College of Psychiatrists ; 2015
    In:  British Journal of Psychiatry Vol. 207, No. 5 ( 2015-11), p. 444-449
    Details
    In: British Journal of Psychiatry, Royal College of Psychiatrists, Vol. 207, No. 5 ( 2015-11), p. 444-449
    Abstract: Behavioural and psychological symptoms of dementia are frequently treated with antipsychotics. Aims To determine the incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease. Method Cohort of all community-dwellers in Finland diagnosed with Alzheimer's disease in 2005 and matched controls. All antipsychotics dispensed between 1995 and 2009 were extracted from the Finnish National Prescription Register. Results Altogether 1996/6087 (32.8%) persons with Alzheimer's disease initiated antipsychotic use. The incidence of antipsychotic use was fivefold among persons with Alzheimer's disease compared with controls, started to increase 2–3 years before diagnosis and was highest during the first 6 months after diagnosis. Conclusions A distinct increase in antipsychotic initiations occurs in the same time window as Alzheimer's disease diagnosis.
    Type of Medium: Online Resource
    ISSN: 0007-1250 , 1472-1465
    URL: Article
    DOI: 10.1192/bjp.bp.114.162834
    RVK:
    XA 10000
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2015
    detail.hit.zdb_id: 2021500-9
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  • 10
    Online Resource
    Online Resource
    Association between Frailty and Dementia: A Population-Based Study
    S. Karger AG ; 2014
    In:  Gerontology Vol. 60, No. 1 ( 2014), p. 16-21
    Details
    In: Gerontology, S. Karger AG, Vol. 60, No. 1 ( 2014), p. 16-21
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The study included a total of 〈 b 〉 〈 /b 〉 654 persons aged 76-100 years (mean 82 ± 4.6). 〈 b 〉 〈 /b 〉 Frailty status of the participants was assessed using the Cardiovascular Health Study criteria. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Clinically diagnosed dementia was assessed by specialists using diagnostic criteria. The associations between frailty and cognition were investigated using logistic regression. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 93 (14%) participants were classified as frail. Cognitive impairment (MMSE score 〈 25) was observed among 171 (26%) persons and 134 (21%) persons had clinically diagnosed dementia. 97 (15%) persons had Alzheimer's disease, 19 (3%) had vascular dementia, 12 (2%) had dementia with Lewy bodies and 8 persons (1%) had some other type of dementia. Multivariate logistic regression models showed that frail persons were almost 8 times more likely to have cognitive impairment (OR 7.8, 95% CI 4.0-15.0), 8 times more likely to have some kind of dementia (OR 8.0, 95% CI 4.0-15.9), almost 6 times more likely to have vascular dementia (OR 5.6, 95% CI 1.2-25.8) and over 4 times more likely to have Alzheimer's disease (OR 4.5, 95% CI 2.1-9.6) than persons who were robust. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among persons aged 76 and older. It is possible that cognitive impairment is a clinical feature of frailty and therefore should be included in the frailty definition.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    URL: Article
    DOI: 10.1159/000353859
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482689-6
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