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WEDNESDAY, Nov. 23 (HealthDay News) -- An estimated 100,000 older Americans are hospitalized for adverse drug reactions yearly, and most of those emergencies stem from four common medications, a new study finds.

The four types of medication -- two for diabetes and two blood-thinning agents -- account for two-thirds of those drug-related emergency hospitalizations.

"Of the thousands of medications available to older patients, a small group of blood thinners and diabetes medications caused a high proportion of emergency hospitalizations for adverse drug events among elderly Americans," said lead study author Dr. Daniel Budnitz, director of the U.S. Centers for Disease Control and Prevention's medication safety program.

Medications previously designated "high-risk" were implicated in only 1.2 percent of hospitalizations, the study found.

Working with a nationally representative database, CDC researchers identified more than 5,000 cases of drug-related adverse events that occurred among people aged 65 and older from 2007 to 2009 and used that to make their estimates for the whole population.

Nearly half (48 percent) of the hospitalizations occurred among adults 80 and up, according to the study, published in the Nov. 24 issue of the New England Journal of Medicine. Nearly two-thirds (66 percent) were the result of unintentional overdoses.

The four medications, used alone or together, most often cited:

• The blood thinning medication warfarin (Coumadin, Jantoven), which is used to treat blood clots, was involved in 33 percent of emergency hospitalizations.
• Insulin, used to control blood sugar in diabetes patients, was involved in 14 percent of cases.
• Antiplatelet drugs such as aspirin and clopidogrel (Plavix), which are used to prevent blood clots, were involved in 13 percent of cases.
• Oral hypoglycemic agents -- diabetes medications taken by mouth -- were involved in 11 percent of cases.

With antiplatelet or blood thinning drugs, bleeding was the main problem. For insulin and other diabetes medications, about two-thirds of cases involved changes in mental status such as confusion, loss of consciousness or seizures.

"These are important findings," said Dr. Michael Steinman, an associate professor of medicine in the division of geriatrics at the University of California, San Francisco, who is familiar with the research. "This study highlights a few key issues that are important for doctors and patients to be aware of. The first is that serious adverse reactions to drugs are common among older people, particularly among people over 80. But even those 65 and older are at substantial risk of having an adverse effect from their drugs."

One challenge for doctors and patients is that the medications may be necessary, Budnitz said.

"These are often critical medicines for patients' health," he said. "Patients who are on these medicines should tell all their doctors what they are taking and work together with their doctors and pharmacist to make sure that they are taking these medicines correctly."

Among U.S. adults aged 65 and up, 40 percent take five to nine medications and 18 percent take 10 or more, according to the study authors. Prior research has also found that older adults are nearly seven times more likely than younger people to have an adverse drug event that requires hospitalization. "As most people age, there often are changes in how their kidneys, liver, heart, and other organs work that can make them more susceptible to adverse drug events," Budnitz said.

And though taking lots of pills raises safety issues, in 82 percent of cases the treating physician attributed the overdose to a single drug, Budnitz added.

To reduce risks, Steinman said doctors and patients need to discuss whether the drug is truly necessary. For people with very high blood pressure or blood sugar, "the answer is almost always 'yes,' you should treat it," Steinman said. "But if you have only mildly elevated blood pressure or blood sugar, the benefits of treating it versus the harms start to shift. Do these drugs really provide enough benefit that it's worth taking them?"

Physicians and patients need to consider a person's age, overall health, other medications they take (keep a list including dosages) and patient preference, such as how easy they find it to keep track of blood sugar and dosages, he said.

With anticlotting or blood-thinning agents, stopping them is probably not an option, Steinman said. So patients need to be attuned to any side effects they experience, even if they seem minor. Catching side effects early can prevent more serious problems later on, and doctors may be able to change the medication or lower the dosage, he said.

More information

The American Geriatrics Society Foundation for Health and Aging has more on preventing adverse drug reactions.

MONDAY, Nov. 21 (HealthDay News) -- Among older married Americans, an active sex life is associated with greater happiness with their marriages and with life in general, according to a new study.

The finding is based on an analysis of the responses of 238 married people 65 and older who took part in the 2004 General Social Surveys.

Sexual-activity frequency significantly predicted both overall and marital happiness, and this association remained even after factors such as age, gender, health status and financial satisfaction were taken into account.

Nearly 60 percent of those who had sex more than once a month were very happy with life in general, compared with 40 percent of those who had no sex in the last year. Nearly 80 percent of those who had sex more than once a month were very happy with their marriage, compared with 59 percent of those who had no sex in the last year.

The findings were presented Sunday at the annual meeting of the Gerontological Society of America in Boston.

"This study will help open the lines of communication and spark interest in developing 'outside-the-box' approaches to dealing with resolvable issues that limit or prevent older adults from participating in sexual activity," study author Adrienne Jackson, an assistant professor at Florida Agricultural and Mechanical University, said in a society news release.

"Highlighting the relationship between sex and happiness will help us in developing and organizing specific sexual-health interventions for this growing segment of our population," Jackson added.

To assess frequency of sexual activity, survey participants were asked the following question: "About how many times did you have sex during the last 12 months? By 'sex' we mean vaginal, oral or anal sex."

Participants were also asked the following questions to assess general happiness, and marital happiness, respectively: "Taken all together, how would you say things are these days -- would you say that you are very happy, pretty happy, or not too happy?"; "Taking things all together, how would you describe your marriage? Would you say that your marriage is very happy, pretty happy, or not too happy?"

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute on Aging has more about sexuality in later life.

MONDAY, Nov. 21 (HealthDay News) -- People with early evidence of Alzheimer's disease are more likely to be underweight than people who don't have this type of dementia, a new study suggests.

"Weight loss may be a manifestation of the disease process progressing," said Eric Vidoni, lead author of a study appearing in the Nov. 22 issue of Neurology. "This may be further evidence for body-wide or systemic changes associated with Alzheimer's disease ... and it certainly supports the idea that Alzheimer's disease-related changes could be silently occurring, i.e., a 'preclinical' phase."

The findings may hold implications for diagnosis, prevention or treatment, but these are likely to be years or even decades away.

"A long history of declining weight or BMI (body mass index, a ratio of weight to height) could aid the diagnostic process," said Vidoni, who is assistant director of the University of Kansas Alzheimer's Disease Center in Kansas CityIs.

At this point, though, it's too early "to make body composition part of the diagnostic toolbox," he added.

"If weight loss is part of the disease process, this could suggest, along with the many papers linking metabolic dysfunction with AD, that preventing such dysfunction could reduce the progression of AD," said Ian Murray, an assistant professor of neuroscience and experimental therapeutics at the Texas A&M Health Science Center College of Medicine. "Of course this is, at present, speculative."

Previous studies have found that people who are overweight in middle age or earlier have a higher risk of developing Alzheimer's. And those who are overweight in their later years actually may have a lower risk of Alzheimer's, something known as the "obesity paradox."

Vidoni and his partners looked at PET (positron emission tomography) imaging of the brain and analyzed cerebrospinal fluid for markers of Alzheimer's disease in 506 people. Participants represented a range of cognitive function, some with no memory problems, some with mild cognitive impairment and some with Alzheimer's.

People with evidence of Alzheimer's -- either in brain scans or protein levels in the cerebrospinal fluid -- were more likely to have a lower BMI than those who did not show early evidence of the disease.

And the markers of brain changes for Alzheimer's were most evident in people with normal memory functioning or mild cognitive impairment, although it's not clear yet why this is.

There are a number of theories -- but only theories at this point -- to explain the findings.

One is that the Alzheimer's disease process is affecting the hippocampus, that part of the brain involved in metabolism and appetite.

Or inflammatory processes may be driving both the decreased BMI and the cognitive changes.

More Information

The Alzheimer's Association has more on has more on this condition.

SUNDAY, Nov. 20 (HealthDay News) -- A good night's sleep doesn't seem to improve older adults' memory, according to a new study.

The findings suggest that age-related brain changes, not age-related sleep problems, are responsible for some of the memory problems that can occur in older adults, the researchers said.

The study included 25 younger and 24 older adults who learned how to navigate through a series of 10 "virtual rooms" on a computer screen. Each room had three doors, one of which led to the next virtual room.

The participants had to successfully navigate through all 10 rooms four times in order to prove that they'd learned the task. They then spent 12 hours either awake or asleep before being asked to navigate the rooms again.

Younger adults who had a good night's sleep made fewer mistakes than those who remained awake for 12 hours, but older adults who slept did no better than those who stayed awake.

The study was presented last week at the annual meeting of the Society for Neuroscience, in Washington, D.C.

"Our research suggests that changes in the aging brain, rather than the restorative effects of sleep itself, may underlie some of the memory problems that older adults experience," senior author Rebecca M. Spencer, of the University of Massachusetts, Amherst, said in a university news release.

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute on Aging has more about memory loss.