Optimized Prescribing with Seniors


A joint communication of the Alberta Medical Association and the College of Physicians & Surgeons of Alberta, these articles are written by physicians for physicians prescribing in the care of older patients.

Archived articles

The archive below includes the six most recent Optimized Prescribing with Seniors articles. For older issues, please contact the AMA web team at webmaster@albertadoctors.org

Focus on Parkinson’s disease – Part 1

Amanda is 72 with an eight-year history of Parkinson’s disease. Her past medical history includes hypertension, anxiety and type 2 diabetes mellitus. She presents to you with recent falls. Her husband reports she has had a weight loss of 10 pounds over six months with poor appetite. She yells and moves in her sleep almost nightly.

Deprescribing ChEI in LTC residents with progressive dementia

Mrs. Farley is 84 and living in long-term care. She has a known major neurocognitive disorder secondary to Alzheimer’s Disease and has been on Donepezil 10 mg daily for the past eight years. She needs cueing and assistance for most of her basic activities of daily living including washing, dressing and bathing.

Reducing anticholinergic burden to improve safety

Mrs. R is 81 and was referred to the geriatric outpatient clinic for assessment of cognition and mobility. She recently fell at home and has had pain in her back and legs since that time. She has been paying less attention to conversation during meals, becomes confused when asked questions, has been losing her glasses and has been coughing frequently.

Vertigo: Considerations for management in older adults

Although vertigo involves the perception of motion, older adults may not report it as motion but as unsteadiness and falling. What are the considerations in the management of vertigo in the older adult? This article will provide an overview.

Vitamin B12 deficiency and metformin

Vitamin B12 deficiency may be easily overlooked as it can present with a wide range of non-specific symptoms. A number of conditions and medications increase the risk of vitamin B12 deficiency and periodic screening in some individuals should be considered.

Care at the end of life: Management of “death rattle”

Dr. Sarah Burton-MacLeod discusses providing comfort at the end of life, with particular focus on the symptom management of death rattle.

OPS is for you: Send us your questions and suggestions

  • Is there a particular issue you would like to see addressed?
  • Do you see a scenario frequently and want to know an ideal, yet practical, approach to management?
  • Uncertain about the role of the "latest and greatest" new drug?

Ask us! Email your questions and suggestions to webmaster@albertadoctors.org.

OPS Physician Coordinator

Dr. Lesley Charles, OPS Physician CoordinatorDr. Lesley Charles, MBChB, CCFP, is a geriatric physician at the Grey Nuns Community Hospital. Her areas of clinical interest include dementia, delirium and treatment of osteoporosis. She obtained her medical education at the University of Edinburgh then completed her family medicine residence at the University of Alberta.

Dr. Charles is an associate professor with the Department of Family Medicine (Division of Care of the Elderly) at the University of Alberta. Her research interests include the Care of the Elderly Program; Decision-Making Capacity Assessment and Implementation and Sustainability Framework; Care of the Elderly Graduates Research; Developing and the Effects of Introducing Core Competencies; and Caregivers

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