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Drugs & Aging

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01.09.2010 | Review Article

Vulnerable Elderly Patients and Overactive Bladder Syndrome

verfasst von: Dr Stephen R. Kraus, Tamara Bavendam, Tiffany Brake, Dr Tomas L. Griebling

Erschienen in: Drugs & Aging | Ausgabe 9/2010

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Abstract

Overactive bladder (OAB) prevalence increases with age, and the elderly population is rapidly increasing worldwide, particularly those aged ≥75 years. OAB symptoms may be associated with co-morbid conditions, particularly bowel symptoms and falls related to nighttime lavatory trips, as well as with higher rates of mortality in elderly persons. Physical changes associated with age that result in altered bladder function and altered drug solubility, metabolism and clearance, as well as increased polypharmacy, may impact disease management in elderly patients. Clinical trial data indicate that current treatments for OAB are generally effective and well tolerated in elderly patients. However, clinical trial participants have generally been relatively healthy persons aged ≥65 years, which may not reflect the true elderly population. Limited data exist that are specific to the vulnerable elderly, who have been defined as patients aged ≥65 years who are at increased risk of functional decline or death over a 2-year period. Identification and treatment of vulnerable elderly patients with OAB is important, because intervention may limit functional deterioration. Antimuscarinics are associated with improvement in OAB symptoms and health-related quality of life in older patients, although adverse effects such as constipation may be of particular concern in vulnerable elderly patients. Additional research is needed on the potential impact of antimuscarinics on cognition in vulnerable elderly persons. Behavioural interventions, including biofeedback, prompted voiding and pelvic floor muscle exercises, may be effective in some elderly patients without risk of adverse events, and they may enhance the efficacy of antimuscarinic treatment. The International Consultation on Incontinence has recommended behavioural interventions with the cautious addition and trial of antimuscarinic drugs for the treatment of urinary incontinence in frail elderly individuals or those already in a state of decline; these recommendations may also be useful for vulnerable individuals. Greater representation of vulnerable elderly individuals in clinical trials, the development and inclusion of outcomes relevant to this population, and the creation and testing of validated, evidence-based models to guide treatment decisions in vulnerable elderly individuals are needed.

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Titel: Vulnerable Elderly Patients and Overactive Bladder Syndrome
verfasst von: Dr Stephen R. Kraus
Tamara Bavendam
Tiffany Brake
Dr Tomas L. Griebling
Publikationsdatum: 01.09.2010
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 9/2010
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.2165/11539020-000000000-00000

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Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

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