Journal of the American Geriatrics Society
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Review Meta Analysis
Association of frailty with outcomes in individuals with COVID-19: A living review and meta-analysis.
Frailty leaves older adults vulnerable to adverse health outcomes. Frailty assessment is recommended by multiple COVID-19 guidelines to inform care and resource allocation. We aimed to identify, describe, and synthesize studies reporting the association of frailty with outcomes (informed by the Institute for Healthcare Improvement's Triple Aim [health, resource use, and experience]) in individuals with COVID-19. ⋯ Frailty is associated with a substantial increase in mortality risk in COVID-19 patients, even after adjustment. Delirium risk is also increased. Frailty assessment may help to guide prognosis and individualized care planning, but data relating frailty status to patient-reported outcomes are urgently needed to provide a more comprehensive overview of outcomes relevant to older adults.
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Meta Analysis
Medications That Cause Dry Mouth As an Adverse Effect in Older People: A Systematic Review and Metaanalysis.
To assess and quantify the risk of drug-induced dry mouth as a side effect in older people. ⋯ Medication use was significantly associated with xerostomia and salivary gland hypofunction in older adults. The risk of dry mouth was greatest for drugs used for urinary incontinence. Future research should develop a risk score for medication-induced dry mouth to assist with prescribing and medication management.
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To examine the comparative effectiveness and safety of cognitive enhancers for Alzheimer's disease (AD). ⋯ An exhaustive review of the literature involving 142 studies demonstrated that cognitive enhancers in general have minimal effects on cognition according to minimal clinically important difference and global ratings. The drugs appear safe, but this must be interpreted cautiously because trial participants may have less comorbidity and fewer adverse effects than those treated with these drugs in clinical practice.
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Review Meta Analysis
A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition.
With an aging population and no cure for dementia on the horizon, risk factor modification prior to disease onset is an urgent health priority. Therefore, this review examined the effect of low vitamin D status or vitamin D supplementation on cognition in midlife and older adults without a diagnosis of dementia. ⋯ Observational evidence demonstrates low vitamin D is related to poorer cognition; however, interventional studies are yet to show a clear benefit from vitamin D supplementation. From the evidence to date, there is likely a therapeutic age window relevant to the development of disease and therefore vitamin D therapy. Longitudinal lifespan studies are necessary to depict the optimal timing and duration in which repletion of vitamin D may protect against cognitive decline and dementia in aging, to better inform trials and practice towards a successful therapy.
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To examine whether the benefit of statins varied according to cardiovascular (CV) and non-CV mortality of the treated population. ⋯ Benefits of statins may depend on the non-CV mortality risk of the treated population. This should be confirmed using individual-level data.