International psychogeriatrics
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Given the potential adverse effects of antipsychotics, high use in nursing homes creates concern. Our study goal was to explore the use of antipsychotics in relation to resident characteristics, and to assess the appropriateness of antipsychotic prescribing in Belgian nursing homes. ⋯ The indicator-driven analysis of antipsychotic prescribing quality revealed a need for improvement, with the main prescribing problems relating to duration and combination of therapies. Risks/benefits of off-label use need to be evaluated more consciously at the start of therapy, and at periodic re-evaluations.
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There is a high prevalence of subjective memory complaints (SMCs) amongst older adults, many of whom experience significant distress. It remains unclear why some older adults with SMCs experience more distress than others. The Common Sense Model of Illness Perceptions has been used to explain patients' differential response to illness based on the beliefs they hold about their illness and subsequent selection of coping strategies. The present study aimed to examine the role of perceptions and coping styles in predicting anxiety and depression in older adults with SMCs. ⋯ Illness perceptions predicted depression and anxiety in older adults with SMCs. Contrary to the Common-Sense Model coping style was not found to be an important determinant of psychological distress. The findings provide a basis for developing interventions to reduce psychological distress in older adults with subjective memory complaints. Targeting causal attributions and perceived consequences of SMCs may help to improve well-being.
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Clinical Trial
A 12-month follow-up study of "RedUSe": a trial aimed at reducing antipsychotic and benzodiazepine use in nursing homes.
To assess the long-term impact of the "Reducing Use of Sedatives" (RedUSe) trial on antipsychotic and benzodiazepine prevalence and dosage. ⋯ Both benzodiazepine usage and mean daily diazepam equivalence continued to decline in intervention nursing homes in the year following the RedUSe trial. However, the effect of the RedUSe intervention on antipsychotic prevalence and dosage was not sustained.
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The prevalence of psychotropic drug use is high among the elderly, but research on how psychotropic drugs are used among individuals aged 90 years and older is limited. An increased knowledge on this topic may contribute to improved prescribing patterns in this vulnerable population. The aim of this study was to assess the use of psychotropic drugs in relation to mental disorders and institutionalization among 95-year-olds and to identify use of potentially inappropriate psychotropic drugs. ⋯ The high prevalence of psychotropic drug use and the nonspecific nature of these treatments among 95-year-olds indicate a need for improvement in prescribing patterns.
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The aging population in prison is growing rapidly in the United Kingdom. This trend is also found in other countries worldwide. As this population increases prison authorities will need to adjust the custody process to accommodate increasing mental and physical frailty. ⋯ Mental disorders in older prisoners are common, but despite recent training initiatives they often go undetected and untreated. Prisoners themselves accurately self-report mental disorder, but the best way of detecting dementia in the prison population remains unclear. The psychological and physical health of this prison population was poorer than that of their community-based peers.