Aim To synthesise current study findings on the diseases and the corresponding medications that are potentially associated with polypharmacy in community‐dwelling older adults. Background Polypharmacy is receiving increased attention as a potential problem for the older population. Although several scientific investigations have studied polypharmacy, most of them were carried out in long‐term care facilities or mixed settings rather than in community settings solely. Methods This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). Relevant studies published in the English language in peer‐reviewed journals were identified from searches of seven electronic databases for the period of January 2000 through December 2019. Inclusion criteria were: (1) Participants were older adults aged 65 years and older; (2) Polypharmacy was defined by medication count; (3) Medication classes associated with polypharmacy were revealed; (4) Studies were conducted in outpatient care or community settings. The Joanna Briggs Institute critical appraisal checklists for cross‐sectional studies and for cohort studies were used to assess the methodological quality. Results Ten studies were considered having appropriate and acceptable quality to be reviewed, comprising nine cross‐sectional studies and one cohort study. Polypharmacy was most defined as concurrently using five or more medications. Polypharmacy prevalence ranged between 7%–45%. Older age, comorbidity, poor self‐perceived health status, limitations in physical activity, history of falls, depression, and pain were positively associated with polypharmacy. The most prevalent medication taken by older adults with polypharmacy was cardiovascular drugs. Conclusions The prevalence of polypharmacy in older adults varying widely may be due to geographical locations, clinical practice guidelines, and polypharmacy definition used. Relevance to Clinical Practice Validated measurements to investigate medications associated with polypharmacy are required. How polypharmacy develops over time needs to be investigated in longitudinal studies in order to formulate strategies for reducing polypharmacy.

Context Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations. Objective The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults. Data Sources Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design. Data Extraction Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Data Analysis Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78–0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity. Conclusions An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered. Systematic Review Registration PROSPERO registration no. CRD 42020169195.

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Older adults are at high risk of developing chronic pain, recognized as pain that persists or recurs for more than 3 months (American Chronic Pain Association [ACPA], 2019;Treede et al., 2015). Chronic pain in older adults is often associated with an increased incidence of adverse outcomes such as physical disability, anxiety, depression, suicide, a lower quality of life, and sleep impairment (Mills et al., 2019). Distinct from acute pain, which is of short duration and is expected to stop once the underlying cause is treated, appropriate chronic pain management is extremely important for older adults because older adults affected by chronic pain are likely to suffer from limited daily activities and they may focus their attention on their pain all the time (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018). However, evidence-based guidelines for chronic pain management in older adults are lacking because previous studies tend to focus more on younger adults.