Comparative analysis of psychiatric medications and their association with falls and fractures: A systematic review and network meta-analysis.

An association between psychiatric medications and falls and fractures in people taking them has been demonstrated, but which class or medication leads to the greatest risk of falls or fractures should be further investigated. The aim of this study was to compare and rank the magnitude of risk of falls and fractures due to different psychiatric medications. Eight databases were searched for this meta-analysis and evaluated using a frequency-based network meta-analysis. The results included a total of 28 papers with 14 medications from 5 major classes, involving 3,467,314 patients. The results showed that atypical antipsychotics were the class of medications with the highest risk of falls, and typical antipsychotics were the class of medications with the highest risk of resulting in fractures. Quetiapine ranked first in the category of 13 medications associated with risk of falls, and class Z drugs ranked first in the category of 6 medications associated with risk of fractures. The available evidence suggests that atypical antipsychotics and typical antipsychotics may be the drugs with the highest risk of falls and fractures, respectively. Quetiapine may be the medication with the highest risk of falls, and class Z drugs may be the medication with the highest risk of fractures.

The Level of Expectations Regarding Aging Among Older Adults: A Systematic Review and Meta-analysis.

OBJECTIVE: To systematically review the level of expectations regarding aging (ERA) among older adults. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Adults aged 60 years and older in any setting. METHODS: We searched 11 databases for cross-sectional studies that reported ERA scores among older adults using the ERA survey from inception to May 1, 2022, without language restrictions. Two researchers independently selected studies, extracted data, and assessed quality. The mean scores and standard deviations of the ERA survey and its subscales were pooled using the Stata software (version 17.0). RESULTS: Twelve studies with 3664 participants were included in this study. The pooled mean scores of overall ERA were 37.85 (95% CI, 33.54-42.16). Specifically, the pooled scores for expectations regarding physical health, mental health, and cognitive function were 31.67 (95% CI, 27.42-35.92), 43.69 (95% CI, 38.99-48.39), and 33.28 (95% CI, 29.56-37.00), respectively. No statistically significant differences between groups were observed in any subgroup analysis. CONCLUSIONS AND IMPLICATIONS: The level of ERA among older adults is relatively low, particularly concerning cognitive function and physical health dimensions. These findings may provide a valuable reference for public health professionals and policymakers to intervene and manage the health problems of older adults.

Effectiveness of reminiscence therapy interventions for older people: Evidence mapping and qualitative evaluation.

WHAT IS KNOWN ON THE SUBJECT?: Reminiscence therapy is a common psychosocial intervention in mental health nursing. Numerous secondary studies have explored the effects of reminiscence therapy interventions in older adults, and while the effects are significant, conflicting results remain. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To date, research on reminiscence therapy has examined different disorders in isolation from one another. By illustrating the evidence gaps between studies, this paper highlights the need for a new evidence-based summary overview of reminiscence therapy research. The results suggest that reminiscence therapy can be beneficial to the improvement of mental health and quality of life for older people. However, we found that the secondary studies were not of high quality and that further high-quality literature supporting the evidence is still needed. WHAT ARE THE IMPLICATION FOR PRACTICE?: Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. However, there is a lack of normative guidelines for reminiscence therapy in terms of intervention time, frequency, and form. The development of a global standard protocol for the application of reminiscence therapy may be necessary for future randomized controlled trials (RCTs). ABSTRACT: INTRODUCTION: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long-term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. AIM: The present study aimed to systematically identify, synthesize and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence-mapping approach. METHODS: Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP and SinoMed, were searched from inception till 31 March 2022. The study type was restricted to SRs with or without meta-analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesize information on the study population, intervention category, original study sample size and classification of findings. RESULTS: A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomized controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications) and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorized as either "beneficial" or "potentially beneficial." The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life and categories of positive psychology (e.g., life satisfaction, happiness and self-esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual) and intervention intensity. The intervention settings/contexts were mainly community and long-term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either "Low" or "Critically Low." DISCUSSION: Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardize the reporting process for the evaluation of reminiscence intervention systems. IMPLICATIONS FOR PRACTICE: Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies.