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INTRODUCTION: Psychotropic medications have a significant adverse drug event profile, particularly in older adults, and appropriate use is paramount. Patterns of prescribing in community-dwelling older adults in New Zealand remain unknown. AIM: This study aimed to determine the prevalence and the pattern of psychotropic use amongst community-dwelling older people in New Zealand and to identify any association between depressive symptomatology and psychotropic medication use. METHODS: Data were collected on the demographics, medication use and mood status of community-dwelling older adults from two New Zealand studies; the BRIGHT trial, which recruited potentially disabled participants (N=141) and the DeLLITE trial, which recruited potentially depressed participants (N=193). The prevalence and the pattern of psychotropic use were established and the gender, age and level of depression assessed using regression analysis. RESULTS: The use of any psychotropic medication was 28.9% in the BRIGHT trial and 43.5% in the DeLLITE trial. Antidepressants were the most commonly used psychotropic medication in the two studies, followed by hypnotics and sedatives. Psychotropic use was highly correlated with the presence of depressive symptoms in the BRIGHT trial and with female gender in the DeLLITE trial. Age was not associated with psychotropic medication use. In both studies, there is possible underdiagnosed, undertreated and inappropriately treated depression. DISCUSSION: The prevalence of psychotropic medication use is high in community-dwelling older people with disability and very high in community-dwelling older people with depressive symptoms, but varies by gender and level of depression. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3) years and 59% were women. The median number of medications used was 6 (range 1-21 medications). The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49%) of the participants were prescribed at least one potentially inappropriate medication; 2996 were considered to suffer significant depressive symptoms (Geriatric Depression Scale >5) and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54). DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed. [ABSTRACT FROM AUTHOR]

The article presents a study which assesses the effectiveness of the Depression in Late Life Intervention Trial of Exercise (DeLLITE), a home based physical activity program for improving quality of life and mood in older people with depressive symptoms. The study employs a randomized controlled trial which involves 193 people aged 75 years and older with depressive symptoms. The study's results suggest improved mood and mental health quality of life after the implementation of the program.

Background: Physical activity shows potential in combating the poor outcomes associated with depression in older people. Meta-analyses show gaps in the research with poor trial design compromising certainty in conclusions and few programmes showing sustained effects. Methods/design: The Depression in Late Life: an Intervention Trial of Exercise (DeLLITE) is a 12 month randomised controlled trial of a physical activity intervention to increase functional status in people aged 75 years and older with depressive symptoms. The intervention involves an individualised activity programme based on goal setting and progression of difficulty of activities delivered by a trained nurse during 8 home visits over 6 months. The control group received time matched home visits to discuss social contacts and networks. Baseline, 6 and 12 months measures were assessed in face to face visits with the primary outcome being functional status (SPPB, NEADL). Secondary outcomes include depressive symptoms (Geriatric Depression Scale), quality of life (SF-36), physical activity (AHS Physical Activity Questionnaire) and falls (self report). Discussion: Due to report in 2008 the DeLLITE study has recruited 70% of those eligible and tests the efficacy of a home based, goal setting physical activity programme in improving function, mood and quality of life in older people with depressive symptomatology. If successful in improving function and mood this trial could prove for the first time that there are long term health benefit of physical activity, independent of social activity, in this high risk group who consume excess health related costs. Trial registration: Australian and New Zealand Clinical Trials Register ACTRN12605000475640 [ABSTRACT FROM AUTHOR]