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Older person’s health

Anticholinergic burden in older people

Older people, particularly those who are frail and with multiple morbidities, are most susceptible to the cumulative effects... View Article

March 2024

Osteoarthritis: a focus on exercise

Three main aspects form the foundation of a management strategy for patients with osteoarthritis: education, exercise and weight... View Article

March 2023

National report: The use of antipsychotic medicines in older people

The purpose of this report is to provoke thought and discussion about how and why antipsychotic medicines are prescribed to older... View Article

May 2020

Symptom management in palliative dementia care

Physical symptoms commonly experienced by people with advanced dementia include pain, difficulties with hydration and nutrition,... View Article

April 2020

Understanding the role of palliative care for people with advanced dementia

Advanced dementia is a terminal condition for which palliative care is appropriate, however, knowing when to initiate this process... View Article

April 2020

Managing the behavioural and psychological symptoms of dementia

Most people with dementia develop behavioural and psychological symptoms (BPSD) at some point during their journey, which can... View Article

April 2020

Recognising and managing early dementia

Dementia (mate wareware - see below) is a growing healthcare challenge. There are an estimated 70,000 people with dementia in... View Article

February 2020

Age-related cognitive decline: prevention and future planning

Declining cognitive function can be a difficult topic to raise with patients and their families. It is important to reassure older... View Article

February 2020

Dialling back treatment intensity for older people with type 2 diabetes

Type 2 diabetes management in older people can be complex due to the wide variations in co-morbidities, physical and cognitive... View Article

May 2019

Managing constipation in older people

Constipation is common in older people due to factors such as multimorbidity, polypharmacy, frailty, dehydration, a lack of exercise... View Article

February 2019

Prescribing for a trial period: when and how?

When initiating or changing the dose of a medicine, simple changes to the prescription can allow pharmacists to dispense a trial... View Article

February 2019

Bisphosphonates: addressing the duration conundrum

Bisphosphonates accumulate within bone tissue where they help rebalance the remodelling cycle to increase bone mineral density.... View Article

January 2019

Stopping proton pump inhibitors in older people

Over one-third of people aged 65 years and older in New Zealand were dispensed a proton pump inhibitor (PPI) in the last year.... View Article

January 2019

Stopping medicines in older people: the flip side of the prescribing equation

Older people are generally prescribed more medicines than younger people, which contributes to a higher risk of adverse effects.... View Article

December 2018

Frailty in older people: a discussion

The concept of frailty identifies vulnerable people who have an increased risk of adverse health outcomes. Frailty is not defined... View Article

November 2018

News item: Discussion on Zostavax

Since publication of our article on Zostavax vaccine in March, 2018, we have received feedback from several readers seeking clarification... View Article

April 2018

Zostavax vaccine: now fully subsidised

Zostavax is a herpes zoster (shingles) vaccine that will become fully subsidised from 1 April, 2018 for people aged 65 years.... View Article

March 2018

Managing pain in osteoarthritis: focus on the person

The progression of osteoarthritis varies from person to person. Functional decline and worsening of symptoms is not inevitable,... View Article

January 2018

Polypharmacy Update

This report provides prescribers with details about patients in their practice who are taking ten or more medicines over a 12... View Article

July 2016

Age-related macular degeneration – what should a General Practitioner know?

Age-related macular degeneration is a progressive condition which results in loss or distortion of the central visual field, and... View Article

September 2015

Research Update: Testosterone use and cardiovascular risk in older males

In the previous edition of Best Practice Journal, we covered the appropriate use of testosterone in older male patients (see:... View Article

September 2015

Prescribing testosterone in ageing males: why you shouldn’t read this article

Testosterone supplementation may be an appropriate treatment for males with clinical features of androgen deficiency and early... View Article

August 2015

“Steady as she goes”: helping older people Stay Independent

This month we release a range of resources aimed at falls prevention within the community, developed in partnership with the Health... View Article

August 2015

A pragmatic guide to asymptomatic bacteriuria and testing for urinary tract infections (UTIs) in people aged over 65 years

Asymptomatic bacteriuria and urinary tract infections (UTIs) frequently occur in people aged over 65 years. Bacteriuria in older... View Article

July 2015

Prevention is better than cure: five tips for keeping older people healthy and out of hospital during winter

With winter upon us it is a timely reminder of the importance of implementing strategies to keep older people healthy, independent... View Article

June 2015

The Year in Review - What did we learn in 2014?

In 2014 we published over 60 medical education articles in Best Practice Journal, spanning more than 450 pages. Context is crucial... View Article

February 2015

Medicine updates

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

December 2014


Polypharmacy is a marker of potential problematic prescribing. In clinical practice, defining polypharmacy purely by a specific... View Article

November 2014

Polypharmacy in primary care: Managing a clinical conundrum

Polypharmacy can be appropriate and beneficial for patients. However, polypharmacy also increases the risk of problematic prescribing... View Article

October 2014

“Seventh age itch”: Preventing and managing dry skin in older people

As skin ages, increased transepidermal water loss leads to dry skin (xerosis) and reduced barrier function. Dry skin is often... View Article

September 2014

Vulvovaginal health in post-menopausal women

Age-related changes in women can result in an increased occurrence of vulvovaginal dermatological conditions such as vulval dermatitis... View Article

September 2014

Upfront: Responding to the challenge of falls in older people

Contributed by the Health Quality & Safety Commission View Article

March 2014

The diagnosis and management of herpes zoster and its complications

Herpes zoster (shingles) is a self-limiting condition caused by reactivation of the Varicella zoster virus. Shingles most frequently... View Article

March 2014

The management of Parkinson’s disease: Which treatments to start and when?

The treatment of patients with Parkinson’s disease usually involves a multidisciplinary approach to care. The role of the general... View Article

February 2014

Managing patients with dementia: What is the role of antipsychotics?

Concerns have been raised, both in New Zealand and internationally, about the increasing off-label use of antipsychotics, and... View Article

December 2013

Giant cell arteritis: Always keep it in your head

Giant cell arteritis, also referred to as temporal arteritis, is a form of vasculitis which predominantly affects older people.... View Article

June 2013

Polypharmacy in people aged over 75 years

This report focuses on continuous polypharmacy, which is the chronic use of multiple medicines over a long period of time. View Article

October 2012

Managing medicines in older people

It is increasingly recognised that health care for older people is improved when one prescriber takes responsibility for all of... View Article

October 2012

Monitoring diabetes in people over 75

In the March 2012 issue of Best Tests, bpacnz published an article discussing testing for CVD, diabetes and renal disease in elderly... View Article

July 2012

Age-related testosterone decline in males

Testosterone levels naturally decline with age in males. Some health professionals claim that a clinical syndrome of testosterone... View Article

June 2012

Testing for CVD, diabetes and renal disease in elderly people

Consideration of laboratory testing and interpretation of subsequent results should be guided by a patients “drugs, diseases and... View Article

March 2012

A primary care approach to sodium and potassium imbalance

Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice.... View Article

September 2011

Treatment for the dying patient: The Liverpool Care pathway

This article has been removed as the Liverpool Care Pathway was discontinued in 2014 following a national review in the United... View Article

June 2011

Vitamin D supplementation: Navigating the debate

Despite the increasing focus on vitamin D levels and claimed associations with many health conditions, there is no evidence to... View Article

June 2011

Strategies to improve nutrition in elderly people

The incidence and impact of malnutrition in older people is underestimated. The best option for treating malnutrition is to enhance... View Article

May 2011

Prescription Kitchen videos

Links to video files of the TV show broadcast on Sky channel 950, Thursday May 5th View Article

May 2011

The warfarin dilemma

Evidence suggests that warfarin is under utilised in older people. The dilemma is that in older people with atrial fibrillation,... View Article

October 2010

The pharmacological management of Alzheimer’s disease: The place of donepezil

From November 1, 2010 donepezil will be funded without Special Authority, on the Pharmaceutical Schedule. Donepezil and other... View Article

August 2010

Snippets: Dextropropoxyphene & Donepezil

Donepezil to be funded on pharmaceutical schedule | Dextropropoxyphene - finding alternatives View Article

July 2010

A practical guide to stopping medicines in older people

The majority of older people who require drug therapy take multiple medicines. Polypharmacy increases the risk of adverse effects... View Article

April 2010

Upfront: When is enough enough? Stopping medicines in older people

In New Zealand, it is estimated that 30% of people aged over 75 years are taking five or more medicines and around 10% are taking... View Article

April 2010

Antipsychotics in people with dementia: an update

The Antipsychotics in Dementia (A4D) programme was launched in October 2008. Since then, the use of antipsychotics in older people... View Article

March 2010

Driving rules and assessment for older people

The incidence of medical conditions that can affect safe driving increases with age. Older people should be regularly assessed... View Article

March 2010

Falls in older people: causes and prevention

Approximately one-third of New Zealander’s aged over 65 years fall each year and this can result in considerable morbidity.... View Article

March 2010

Secondary stroke prevention

People who have had a stroke or transient ischaemic attack are at increased risk of future stroke, especially in the first few... View Article

March 2010

Having a senior moment?

Differentiating normal age-related memory loss from early onset dementia Normal age-related memory loss affects everybody. Assessing... View Article

September 2009

Antipsychotics for dementia

Notification and details of an educational programme on the use of antipsychotics for symptoms associated with dementia View Article

August 2008

Strategies to improve nutrition in elderly people

Many older people suffer from the “anorexia of ageing”. The best option for treating malnutrition is to enhance normal... View Article

August 2008

Antioxidants and ageing: harmless placebo or dangerous to your health?

A new study suggests that taking antioxidant supplements, especially vitamin A, vitamin E or beta-carotene, does not prevent ageing... View Article

June 2008

Dilemmas: Alternative remedies and lifestyle measures for longevity

The development and marketing of anti-ageing products is a multi-million dollar industry. There is no shortage of remedies and... View Article

February 2008

Dilemmas: Depression in elderly people

Depression in elderly people can be a significant cause of disability and is under-recognised and often complex to treat. A SSRI... View Article

February 2008

Dilemmas: Exploring the everyday experiences of older Māori and their medication

When prescribing for older Māori people, it is important to take their views and beliefs into consideration and provide information... View Article

February 2008

Dilemmas: Managing cardiovascular risk in elderly people

Older people have a higher cardiovascular risk and therefore appear to have the most potential to benefit from risk reduction,... View Article

February 2008

Dilemmas: Principles of prescribing for elderly people

Several key principles should be considered when prescribing for elderly people. Quality of life is the most relevant outcome.... View Article

February 2008

Dilemmas: Recognition and treatment of pain in elderly people

Chronic pain is common in elderly people, however it is often unrecognised, treated sub-optimally or not treated at all. Regular... View Article

February 2008

Dilemmas: Why is it difficult

Prescribing for elderly people is difficult because the risks of polypharmacy, adverse drug effects and drug interactions are... View Article

February 2008

Upfront: Impacts of an ageing population on New Zealand society

A Māori perspective on impacts on New Zealand society of an ageing population. View Article

February 2008

Upfront: The manner of our Dying

Preventive health care aims to prevent premature deaths and delay the onset of the suffering caused by illness and disease (compression... View Article

October 2007

Parkinson's disease

Covers diagnosis and management of Parkinson's disease View Article

August 2007

Practice Debate: antipsychotics in the treatment of dementia

This article covers the role and safety concerns of antipsychotics in the treatment of behavioural and psychological symptoms... View Article

February 2007

Polypharmacy at the Primary-Secondary interface

Polypharmacy due to multiple physician involvement in patient care increases the risk of serious adverse drug event. View Article

October 2006

Nocturnal leg cramps: is there any relief?

Nocturnal leg cramps are common, particularly in older people and in women who are pregnant. Is there an effective treatment?... View Article

December 2012