Aim: To identify patterns and characteristics of polypharmacy among elderly residents in Danish nursing homes in the Northern region of Denmark. Materials & methods: Twenty-five nursing homes were contacted, where each supplied 20 randomly selected anonymized residents’ information. Residents were 65 years or older, concurrently taking five or more medications. Drug–drug interactions and potential adverse effects were investigated. Results: One hundred residents (68% females; 32% males) were included. The most prevalent co-morbid condition was cardiovascular disease, and the most prevalent medications were for gastrointestinal- and metabolism-related conditions. Age influenced the number of drugs (p = 0.013) and drug–drug interactions per resident (p = 0.039), with a positive correlation. Conclusion: Elderly residents of the studied nursing homes were potentially affected by an inappropriate polypharmacy.
Introduction
Previous studies suggest that cognitive impairment is more prevalent in individuals with painful and painless diabetic peripheral neuropathy (DPN). However, the current evidence is not well described. This study investigated cognitive function in adults with type 1 diabetes mellitus (T1DM) and the association to painful/painless DPN and clinical parameters.
Methods
This cross‐sectional, observational, case–control study included 58 participants with T1DM, sub‐grouped into 20 participants with T1DM and painful DPN, 19 participants with T1DM and painless DPN, 19 participants with T1DM without DPN, and 20 healthy controls were included. The groups were matched for sex and age. The participants performed Addenbrooke's examination III (ACE‐III), which assesses attention, memory, verbal fluency, language and visuospatial skills. Working memory was evaluated using an N‐back task. Cognitive scores were compared between the groups and correlated to age, diabetes duration, HbA1c and nerve conduction measurements.
Results
Compared to healthy controls, T1DM participants showed lower total ACE‐III (p = .028), memory (p = .013) and language scores (p = .028), together with longer reaction times in the N‐back task (p = .041). Subgroup analyses demonstrated lower memory scores in those with painless DPN compared with healthy controls (p = .013). No differences were observed between the three T1DM subgroups. Cognitive scores and clinical parameters were not associated.
Conclusions
This study supports the notion of cognitive alterations in T1DM and indicates that cognitive function is altered in T1DM regardless of underlying neuropathic complications. The memory domain appears altered in T1DM, particularly in those with painless DPN. Further studies are needed to verify the findings.
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