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Analgesic use among community-dwelling people aged 75 years and older: A population-based interview study.

https://arctichealth.org/en/permalink/ahliterature142226
Source
Am J Geriatr Pharmacother. 2010 Jun;8(3):233-44
Publication Type
Article
Date
Jun-2010
Author
Niina Pokela
J Simon Bell
Katri Lihavainen
Raimo Sulkava
Sirpa Hartikainen
Author Affiliation
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Source
Am J Geriatr Pharmacother. 2010 Jun;8(3):233-44
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Analgesics - therapeutic use
Analgesics, Opioid - therapeutic use
Cross-Sectional Studies
Data Collection
Depression - complications
Female
Finland
Health status
Humans
Male
Multivariate Analysis
Pain - drug therapy
Polypharmacy
Residence Characteristics - statistics & numerical data
Sex Factors
Abstract
Pain is often underrecognized and undertreated among older people. However, older people may be particularly susceptible to adverse drug reactions linked to prescription and nonprescription analgesics.
The aims of this study were to assess the prevalence of analgesic use among a random sample of community-dwelling people aged >or=75 years, and to investigate factors associated with daily and as-needed analgesic use.
A random sample of people aged >or=75 years was drawn from the population register in Kuopio, Finland, in November 2003. Data on prescription and nonprescription analgesic use were elicited during nurse interviews conducted once for each participant in 2004. Self-reported drug utilization data were verified against medical records. The interview included items pertaining to sociodemographic factors, living conditions, social contacts, health behavior, and state of health. Physical function was assessed using the Instrumental Activities of Daily Living Scale, and the 10-item Barthel Index. Self-rated mobility was assessed by asking whether respondents could walk 400 meters (yes, yes with difficulty but without help, not without help, or no). Cognitive function was assessed using the Mini-Mental State Examination. The presence of depressive symptoms was assessed using the 15-item Geriatric Depression Scale. Respondents' self-rated health was determined using a 5-point scale (very poor, poor, moderate, good, or very good).
Of the initial random sample of participants (N = 1000), 700 provided consent to participate and were community dwelling. Among the participants, 318 (45.4%) were users of >or=1 analgesic on a daily or as-needed basis. Only 23.3% of analgesic users took an analgesic on a daily basis. Factors associated with any analgesic use included female sex (odds ratio [OR], 1.78 [95 degrees % CI, 1.17-2.71]), living alone (OR, 1.46 [95 degrees % CI, 1.02-2.11]), poor self-rated health (OR, 2.6 [95% CI, 1.22-3.84]), and use of >or=10 nonanalgesic drugs (OR, 2.21 [95% CI, 1.26-3.87]). Among users of >or=1 oral analgesic, factors associated with opioid use included moderate (OR, 2.46 [95% CI, 1.175.14]) and poor (OR, 2.57 [95% CI, 1.03-6.42]) self-rated health. Opioid use (OR, 0.19 [95% CI, 0.04-0.86]) and daily analgesic use (OR, 0.16 [95% CI, 0.34-0.74]) were inversely associated with depressive symptoms. Pain in the previous month was reported by 71.4% of analgesic users and 26.4% of nonusers of analgesics.
Analgesics were used by approximately 50% of community-dwelling people aged >or=75 years. However, age was not significantly associated with increased use of analgesics in multivariate analysis. The majority of analgesic drugs were used on an as-needed rather than a daily basis (76.7% vs 23.3%, respectively). Factors most significantly associated with analgesic use were female sex, living alone, poor self-rated health, and use of >or=10 nonanalgesic drugs.
PubMed ID
20624613 View in PubMed
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Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature130396
Source
Clin Rehabil. 2012 Apr;26(4):314-26
Publication Type
Article
Date
Apr-2012
Author
Katri Lihavainen
Sarianna Sipilä
Taina Rantanen
Markku Kauppinen
Raimo Sulkava
Sirpa Hartikainen
Author Affiliation
Gerontology Research Centre, Department of Health Sciences, University of Jyväskylä, Finland. katri.lihavainen@jyu.fi
Source
Clin Rehabil. 2012 Apr;26(4):314-26
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Counseling
Female
Finland
Geriatric Assessment - methods
Health status
Humans
Individualized Medicine
Male
Mobility Limitation
Motor Activity
Musculoskeletal Pain - diagnosis
Outcome and Process Assessment (Health Care) - statistics & numerical data
Resistance Training
Abstract
To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain.
Three-year geriatric development project with randomized assignment to intervention and control group.
Research centre, community and assisted living facilities.
Seven hundred and eighty-one Finnish persons aged 75-98 years were assigned to an intervention (n = 404) or control (n = 377) group.
A comprehensive geriatric assessment with a multifactorial intervention lasting two years. The intervention included individualized referrals, recommendations, physical activity counselling and supervised resistance training.
Perceived limitation in walking 400m was gathered annually during the intervention and at the one-year post-intervention follow-up.
The proportion of persons with mobility limitation at the beginning, at the two-year intervention and at the one-year post-intervention follow-up was 16%, 15%, 12% and 14%, respectively, in the intervention group. In the control group, the corresponding proportions were 19%, 18%, 23% and 26%. The treatment effect was significant at the end of the two-year intervention (odds ratio 0.82, 95% confidence interval 0.70-0.96, P = 0.013), and at the one-year post-intervention follow-up (0.84, 0.75-0.94, P = 0.002). The parallel positive effect of the intervention on mobility was even greater among persons with musculoskeletal pain.
The comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people.
PubMed ID
22007041 View in PubMed
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