International psychogeriatrics
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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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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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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.
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Paratonia is a progressive motor problem that is observed in individuals with dementia and is not a well-known phenomenon. This study explores the development and risk factors of paratonia in moderate stage dementia patients. ⋯ Diabetes mellitus and likely vascular damage are risk factors for the development of paratonia.