The Charted Care Collection (02/01/2022)
[ photo by Pixabay ]
The Chartered Care Collection (02/01/2022)
The Chartered Care Collection provides a review of the latest, pertinent publications from the medical literature on aging. I have selected interesting articles that describe some of the most current research that may be relevant to the loved one in your care. Each article will be referenced if you desire to read more of the study, but I will give a brief synopsis of each study so you are aware of the latest research. Let’s get to The Collection!
The Chartered Care Collection
For February, I am going to summarize four different studies that I thought were interesting and pertinent to the aging population and care of aging parents.
The first article, published in Journal Of The American Geriatrics Society, looked at the relationship between gabapentinoid drugs and lower extremity edema. These medications include gabapentin, Lyrica, and Neurontin. These are very commonly prescribed in treatment of nerve pain and this often includes management of back pain. As a physician, I also often prescribe these medications for the management of multiple pain issues in my patients. One of the more common side effects of this particular drug class is swelling in the legs, also known as peripheral edema. This particular article reviewed the incidence of diuretic use in patients with new low back pain who were treated with gabapentinoids. This was a retrospective study, looking back at nearly seven thousand elderly patients with new low back pain. The main finding was there was a nearly 44% increase in the use of diuretics by these patients. I do not report this study’s findings to deter the use of a medication that I find to be a very beneficial tool in the management of pain, but instead I want to help users of these medications to be aware of the possibility of this as a side effect. If this does occur, then it is important to discuss this with your loved one’s treating physician.
(Related blog post: Options For Medication Management)
The next article I want to discuss looked at the association between depressive symptoms, physical activity and fatigue in those with knee osteoarthritis (OA). It was printed in Scandinavian Journal Of Rheumatology. It found that higher levels of physical activity are related to lower levels of fatigue in those with knee OA. The researchers followed 484 patients with knee OA, getting baseline data and then follow-up at two years. The data collected included physical activity level, fatigue with activity, and depressive symptoms. There was a significant inverse relationship found between baseline physical activity and fatigue two years later. Part of the physical activity measures taken were gait speed. I found it interesting that gait speed and depressive symptoms at baseline did not show a specific association with fatigue at the two year follow-up. The important take-away point from this study, in my opinion, is no matter how fast or slow you or your loved one are, get and stay active to stave off fatigue and pain from knee OA.
(Related blog posts: Should I Get A Knee Replacement, What To Expect After Knee Replacement)
Staying in the vein of arthritis, the next study comes from The Journal Of Bone & Joint Surgery and followed the progression of hip disease after corticosteroid injection. Corticosteroid injections are commonly used to help bring down the pain in an arthritic joint. This study specifically looked at the risk of developing rapidly worsening hip arthritis after a steroid injection in the hip joint. The rate was 5.4% in those who received a steroid injection. The risk was very low in those who received a low single dose but was higher after a higher dose or after multiple injections. As I said when I talked about the use of gabapentinoids in the management of pain, I do not want the report of the results of this study to deter anyone from this method of pain management. Instead, I want my readers to know there are risks with any medical intervention and to discuss the risks and benefits with their treating physicians.
The last journal article I want to review touches on the giving and receiving of social support and how it relates to mortality. If you are reading this blog, there is a great likelihood you either provide care to or receive care from someone. This study, by Chen and colleagues, looked at the level in which support is provided and received and how it relates to mortality. Instrumental caregiving (unpaid) and emotional support were identified. Those who disproportionately received or gave instrumental support had increased risk of mortality compared with those who were more balanced in giving and receiving care. Sometimes it is easier said than done, I know, but finding balance in the support that is given and received can truly be life-saving.
(Related blog post: Caring For Dementia Caregivers, Respite Care Services)
References:
Read, S., et al. Evidence of a Gabapentinoid and Diuretic Prescribing Cascade among Older Adults with Lower Back Pain. J Am Geriatr Soc. 2021, October; 69(10): 2842-2850.
Fawole, H., et al. Is the Association between Physical Activity and Fatigue Mediated by Physical Function or Depressive Symptoms in Symptomatic Knee Osteoarthritis? The Multicenter Osteoarthritis Study. Scand J Rheumatol. 2021, Oct; 50(5): 372-380.
Okike, K., et al. Rapidly Destructive Hip Disease following Intra-Articular Corticosteroid Injection of the Hip. J Bone Joint Surg. 2021. DOI: 10.2106/JBJS.20.02155.
Chen, E., et al. The Balance of Giving Versus Receiving Social Support and All-Cause Mortality in a US National Sample. Proc Natl Acad Sci USA. 2021, June; 118 (24). e2024770118.
That sums it up for the Chartered Care Collection for this month. Take the time to read each of these articles in full, and feel free to leave your comments or questions below!
© 2022 Jessica Kluetz, DO