Chronic benzodiazepine usage among older people: prevalence, indications, and treatment modifications in patients admitted to an acute geriatric unit.

AIM: To investigate the prevalence and indications of benzodiazepines (BZD) usage among patients admitted to an acute geriatric unit and assess changes in prescriptions. METHODS: BZD indications were documented reviewing clinical records, with appropriateness assessed based on the STOPP-START criteria. Changes in BZD prescriptions were recorded at discharge and 3 months later. RESULTS: Among the 366 patients included (mean age: 92.8 years, 68% females), 91 (24.9%) were on BZD upon admission, being inappropriate in 93.4%. At discharge, BZD discontinuation was observed in 40.7% and dose reduction initiated in 57.4%. Among patients discharged without prescriptions, 10.8% resumed their use at 3 months. Of those discharged with BZD tapering, 74.1% were still on them 3 months later. CONCLUSIONS: The majority of patients employing BZD lacked a medical indication. Admission to a geriatric ward resulted in successful discontinuation or dose reduction for most patients but was not maintained in the outpatient setting.

[Improving drug prescribing in the elderly: a new edition of STOPP/START criteria]. / Mejorando la prescripción de medicamentos en las personas mayores: una nueva edición de los criterios STOPP-START.

Inappropriate use of drugs in older patients may have an adverse impact on several individual health outcomes, such as increasing the prevalence of adverse drug reactions, morbidity and mortality, and geriatric syndromes, as well as on health care systems, such as increased costs and longer hospital stays. Explicit criteria of drug appropriateness are increasingly used to detect and prevent inappropriate use of drugs, either within a comprehensive geriatric assessment or as tool used by different multidisciplinary geriatric teams. STOPP-START criteria, first published in 2008 (in Spanish in 2009), are being adopted as reference criteria throughout Europe. The Spanish version of the new 2014 edition (recently published in English) of the STOPP-START criteria is presented here. A review of all the papers published in Spain using the former version of these criteria is also presented, with the intention of promoting their use and for research in different health care levels.

Importance of nutritional support in older people.

Proper nutrition is an essential part of successful aging and may delay the onset of diseases. Nutrition-related problems in older subjects have been long-time ignored; good nutritional status is an essential component of health and a relevant part of therapeutic plans of most chronic diseases. Moreover, food and nutrition are a relevant aspect of most cultures and are strongly linked with individual lifestyles. Research has proved that nutritional intervention can improve outcomes in many clinical scenarios. This is especially true for older individuals with different acute and chronic conditions and diseases, or with malnutrition. Nutritional intervention can provide sufficient energy, protein and micronutrients, maintain or improve nutritional status, reduce morbidity and increase survival. Evidence is still lacking on the impact of nutritional intervention on physical and mental function, and on quality of life, very relevant outcomes for older individuals. Nutritional screening and assessment should become part of health care of both healthy and sick older people. Nutritional counseling and intervention should be embedded in a general care plan that takes into account all aspects of an aging person. Nutritional programs that aim for high compliance should be individualized, and would have to consider every aspect of old age: beliefs, attitudes, preferences, expectations, and aspirations.