Antipsychotic medications are associated with increased mortality in older adults dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear.To determine the increase and number needed harm (NNH) (ie, of patients who receive that would be 1 death) antipsychotic, valproic acid its derivatives, antidepressant use dementia either treatment.A retrospective case-control study was conducted Veterans Health Administration from October 1, 1998,...

Buprenorphine Treatment Divide by Race/Ethnicity and PaymentOpioid mortality rates continue to increase throughout the United States 1 ; however, growth in buprenorphine hydrochloride treatment for opioid use disorder (OUD) might be limited communities with higher income low percentages of racial/ethnic minorities. 2 Buprenorphine, a partial agonist, is 3 evidence-based medications treating OUD can legally prescribed office-based settings.To our knowledge, no national studies have examined...

Objective: Goals were to determine the prevalence of benzodiazepine use (as prescribed and misuse), characterize misuse, examine variation by age. Methods: A cross-sectional analysis was conducted 2015 2016 National Survey on Drug Use Health data limited adults ≥18 (N=86,186) from those respondents reporting (N=10,290). Measurements included past-year prescription misuse (“any way a doctor did not direct”), substance disorders, mental illness, demographic characteristics. Misuse compared...

Importance Dementia affects 10% of those 65 years or older and 35% 90 older, often with profound cognitive, behavioral, functional consequences. As the baby boomers subsequent generations age, effective preventive treatment strategies will assume increasing importance. Observations Preventive measures are aimed at modifiable risk factors, many which have been identified. To date, no randomized clinical trial data conclusively confirm that interventions any kind can prevent dementia....

The Centers for Medicare & Medicaid Services' National Partnership to Improve Dementia Care in Nursing Homes (hereafter referred as the partnership) was established improve quality of care patients with dementia, measured by rate antipsychotic prescribing.To determine association partnership trends prescribing and other psychotropic medication among older adults long-term care.This interrupted time-series analysis a 20% sample from January 1, 2009, December 31, 2014, conducted 637 426...

<h3>Importance</h3> Community-dwelling older adults with dementia have a high prevalence of psychotropic and opioid use. In these patients, central nervous system (CNS)–active polypharmacy may increase the risk for impaired cognition, fall-related injury, death. <h3>Objective</h3> To determine extent CNS-active among community-dwelling in US. <h3>Design, Setting, Participants</h3> Cross-sectional analysis all (identified by<i>International Classification Diseases, Ninth Revision, Clinical...

The COVID-19 pandemic may intensify loneliness among older adults with chronic conditions who are at high risk of severe illness, but little is known about factors associated during the pandemic. We considered linked to 701 aged 50 years and from Michigan (82.5%) 33 other U.S. states. Participants completed an anonymous online survey between May 14 July 9, 2020. About two thirds (66.4%) reported moderate loneliness. fully adjusted regression model revealed that being a person color, having...

Abstract Background Many U.S. caregivers provide care to the generation above and below simultaneously, described as “sandwich” caregivers. We seek first national estimates characterizing sandwich older adults for whom they care. Methods used 2015 National Study of Caregiving (NSOC) Health Aging Trends (NHATS) compare individual (demographic, socio‐economic, health, caregiving characteristics) caregiving‐related experience (financial emotional difficulties, caregiver role overload gains,...

Abstract INTRODUCTION Coordinating care for people living with dementia (PLWD) requires understanding which clinicians deliver and the settings of that care. METHODS We used Medicare Carrier file to characterize in PLWD, clinician types providing care, whether record a diagnosis. RESULTS A total 1,934,318 PLWD received from 783,225 unique 2019; saw median eight (interquartile range 5, 14). The most common were office (74.8% PLWD), emergency room (63.9%), inpatient hospital (52.1%), skilled...

To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time visits to primary care providers psychiatrists.Data were from the National Ambulatory Medical Care Survey (years 2003-2005 2010-2012), a nationally representative cross-section outpatient physician visits. Analysis focused on (n = 14,282) psychiatrists 1,095) at which an antidepressant, benzodiazepine, or anxiolytic/sedative-hypnotic was...

To determine the national prevalence of psychotropic use and association with neuropsychiatric symptoms among patients dementia.Participants diagnosed dementia (n = 414) in Aging, Demographics, Memory Study, a nationally representative survey US adults >70 years old. Diagnosis was based on in-person clinical assessment informant interview. Information collected included demographics, place residence, 10-item Neuropsychiatric Inventory (NPI), prescribed medications (antipsychotic,...

The Centers for Medicare and Medicaid Services (CMS) is promoting formation of accountable care organizations (ACOs). In these population-based models, CMS aligns a beneficiary population to an ACO with associated expenditure quality targets, transitioning away from purely volume-based revenue fee-for-service Medicare. Patients mental illness are among high-cost beneficiaries, but this has received little attention in implementation. Although the goals providing chronic preventive...

To determine patterns of and trends in contributions to central nervous system (CNS) polypharmacy, defined by the Beers Criteria as three or more CNS-active medications each medication class, adults aged 65 older seen U.S. outpatient medical practices.National Ambulatory Medical Care Survey (2004-2013).U.S. care.Visits physicians (N = 97,910).Visits including CNS antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics (NBRAs), tricyclic antidepressants...

To establish the rate of new and continuation benzodiazepine use in older adults seen by nonpsychiatrist physicians to identify subpopulations at risk use.Cross-sectional analysis.National Ambulatory Medical Care Survey (2007-10).Adults visiting office-based (n = 98,818) who were prescribed a (new or continuation).Percentage visits all outpatient encounters according patient age corresponding annual visit per 1,000 population. Analysis was then limited aged 65 older, demographic, clinical,...

Receiving a diagnosis of Alzheimer's disease or related dementias (ADRD) can be pivotal and stressful period. We examined the risk suicide in first year after ADRD relative to general geriatric population.

Gabapentinoids are commonly used medications for numerous off-label conditions. The 2002-2021 Medical Expenditure Panel Survey (MEPS) was to investigate the proportion of adult population who were gabapentinoid users, ages these and diagnoses associated with likelihood starting, stopping, or continuing gabapentinoids. Gabapentinoid users continued increase since our last publication from 4.0% in 2015 4.7% 2021. use much more likely among individuals other chronic pain. Between 2017-2021,...

This study uses data from the National Ambulatory Medical Care Survey to describe central nervous system polypharmacy practices among outpatient older adults.

This pharmacoepidemiology study uses Medicare data to estimate US prescription fills for antidepressants, anxiolytics, antipsychotics, opioids, and antiepileptics among community-dwelling older adults with dementia in 2014-2015, identifies the most commonly prescribed medications.

ObjectiveTo better understand and compare resident family nursing home staff experiences perceptions of licensed unlicensed direct care turnover.DesignDescriptive qualitative design.Setting ParticipantsNursing members registered nurses (RNs), practical (LPNs), certified assistants (CNAs), administrative staff.MethodsWe conducted semistructured interviews with between September 2019 July 2020. Using a rapid analysis approach, we compared member, RNs, LPNs, CNAs, related to turnover, ways...

Abstract Background Over 6 million Americans have Alzheimer's Disease or Related Dementia (ADRD) but whether spikes in spending surrounding a new diagnosis reflect pre‐diagnosis morbidity, diagnostic testing, treatments for comorbidities is unknown. Methods We used the 1998–2018 Health and Retirement Study linked Medicare claims from older (≥65) adults to assess incremental quarterly changes just before versus after clinical (diagnosis cohort, n = 2779) and, comparative purposes, cohort...

Importance There is interest in reducing long-term benzodiazepine prescribing given harms associated with use, but the cumulative risks or benefits of discontinuation are unknown. Objective To identify association mortality and other adverse events among patients prescribed stable therapy, stratified by baseline opioid exposure. Design, Setting, Participants This comparative effectiveness study a trial emulation approach included data from US commercial insurance database between January 1,...