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Jun 20, 2024 · To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer's disease and vascular dementia in individuals with late-life depression in population-based prospective studies. Method. A total of 23 studies were included in the meta-analysis.
- Breno S. Diniz, Meryl A. Butters, Steven M. Albert, Mary Amanda Dew, Charles F. Reynolds
- 2013
- Introduction
- Otc Medications
- Older Adults’ Use of Otc Medications
- Factors Influencing Otc Medication Use Among Older Adults
- Health Literacy and Otc Behavior
- Decision Making and Otc Medications Among Older Adults
- The Role of Clinicians in Otc Medication Behavior
- Older Adult Otc Behavior and Family Care
- Technology to Promote Optimal Use of Otc Medications
- Conclusions and Policy Action Steps
Older adults aged 65 and older comprise 13% of the population but account for 34% of prescription (Rx) and 30% of nonprescription over-the-counter (OTC) medication use in the United States (National Center for Patient Information and Education, n.d.). Regular use of OTC medications among older adults in the National Social life, Aging, and Health P...
The FDA Center for Drug Evaluation and Research (CDER) regulates both OTC and prescription medications. These medications are defined by the Federal Food Drug and Cosmetic Act as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” (FD&C Act, sec. 201(g)(1); Food and Drug Administration, 2013). OTC dru...
Older adults are major OTC consumers. As mentioned earlier, the National Health and Social Life Survey (NSHAP) examined the prevalence of both OTC and Rx drug use among adults aged 57 through 85 years in the past 12 months. The survey determined that 81% of participants took at least one Rx medication (29% reported concurrent use of five or more) a...
Older adults, like other age groups, use OTC medications to manage common self-diagnosable symptoms, such as pain, diarrhea, coughs, or fever. The common use of these medications suggests that OTC medications are an important component of self-care. Indeed, qualitative studies suggest that patients may selectively adhere to medication regimens (and...
What is Known
Low health literacy is associated with medical errors and adverse events, which in turn are responsible for poor outcomes in chronic disease care. The Institute of Medicine (IOM) defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Institute of Medicine, 2004). The workgroup considered the effects of low health literacy on OTC behaviors. The 2003 Nati...
Needed Research
The Panel identified the following research questions as critical for a better understanding of health literacy and its role in OTC behaviors: 1. Would marketing efforts that more strongly stressed active ingredients, as opposed to symptom relief alone, reduce unintentional misuse in low-literate consumers? 2. What kind of redesign of products and labeling will most effectively ensure safe OTC medication use in low-literate consumers?
What is Known
Research rarely addresses the actual process people use when making a decision to purchase an OTC medicine, that is, what steps people go through, whether they consider all pertinent options, and how much weight is given to each factor. For example, much of the existing literature demonstrates that older adults are slower in processing medication information. Reasons for this slowness are unclear. Is it a sensory deficit, perhaps inability to see the small print on the label? Is it inability...
Needed Research
The workgroup identified the following research questions as most critical for a better understanding of decision making relevant to OTC behaviors: 1. What experimental paradigms for search and choice tasks involving drug labels will allow the best view of the OTC decision-making process? 2. What packaging innovations are most likely to lead consumers to encode key information from warning labels?
What is Known
Younger people are more likely to rely on their friends or family for information about OTC medications. Older adults are more likely to seek advice from a learned intermediary, such as a pharmacist or other health care provider. When examining the influence of others on OTC medication use, it is important to differentiate the perspectives of professional clinicians, patients, and family caregivers (Stephens & Johnson, 2000). Consumers’ health care decisions have become more complex in recent...
Needed Research
The Panel identified the following research questions as most critical for a better understanding of clinician behaviors relevant to safe and effective OTC use: 1. Will current interventions that assist clinicians in improving the safety and effectiveness of Rx medications work as well for OTC medications? 2. What training solutions are required to help clinicians elicit patients’ use of OTC medications? How can this information make its way into the patient electronic health record? What pol...
What is Known
Between 80% and 90% of long-term care is provided by lay caregivers (Coleman & Boult, 2003; Coleman & Pandya, 2002; Gitlin & Wolff, 2011). This group includes not only relatives but also friends or neighbors who provide some form of assistance to older adults. A 2009 study from the National Alliance for Caregiving and the American Association of Retired Persons (AARP) estimated a total of 66 million caregivers in the United States (National Alliance of Caregivers, 2009). Older adults receivin...
Needed Research
The Panel identified the following research questions as most critical for a better understanding of the role of lay caregivers in promoting safe and effective use of OTC medications: 1. How can medication management be integrated into available caregiver education? 2. How do caregivers decide which OTC products are appropriate for an older person? When do they consult pharmacists as opposed to other sources of information?
What is Known
Well-designed, usable technology offers the potential to improve the medication behaviors of older adults. Emerging technologies bring opportunities to promote optimal OTC medication behavior among all patients, including older people. Technology offers clinicians a way to monitor drug-taking behavior and reconcile medications in care transitions. Technological interventions, such as smartphone applications, can enhance accessibility to relevant information when and where it is needed, provid...
Needed Research
The Panel identified the following research questions as most critical for a better understanding of the role of new technologies in promoting safe and effective OTC use: 1. How can electronic health records be enhanced to include OTC medications? Often the most important piece of information—how the patient is using his or her prescription drugs as well as any other OTC medications or supplements—is missing. 2. Do smartphone or other Internet applications promote safe and effective OTC medic...
The GSA-CHPA workgroup could not cover all areas relevant for promoting safe and effective OTC medication use. For example, marketing was not a direct focus of the workgroup. Clearly, direct-to-consumer marketing and advertising play a central role in choice of OTC medications. A more complete treatment of the topic would also have to examine the i...
- Steven M. Albert, Laura Bix, Mary M. Bridgeman, Laura L. Carstensen, Margaret Dyer-Chamberlain, Patr...
- 2014
To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer’s disease and vascular dementia in individuals with late-life depression in...
Sep 1, 1994 · While cognitive and functional deficits are the hallmark of Alzheimer's disease (AD), loss of social function (and the dependence this implies) is also critical, especially in early stages of disease. Little attention has been directed to this facet of dementing disease.
- Yaakov Stern, Steven M. Albert, Mary Sano, Marcus Richards, Lisa Miller, Marshal Folstein, Marilyn A...
- 1994
May 1, 2013 · To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer's disease and vascular dementia in individuals with late-life depression in ...
The authors describe the dietary coaching program (highlighted in a case example) as well as the feasibility and potential efficacy of the program within the context of evidence-based interventions for preventing episodes of major depression and mitigating symptoms of depression.
Article contents. Steven M. Albert and Maria G. Calteli, Old Age in Global Perspective: Cross-Cultural and Cross-National Views, G. K. Hall, New York, 1994, 287pp., hbk $26.95, ISBN 0816 17393 1, Pbk $15.95, ISBN 0816 116040. Published online by Cambridge University Press: 14 November 2008.
