Patients with ME are at increased risk for severe exacerbation despite more intensive maintenance anti-inflammatory treatment. Persistent irreversible airflow limitation and complications of chronic sinusitis and/or NSAIDs intolerance are characteristics to this subpopulation.

Reminder devices reportedly improve medication adherence in the elderly patients with mild dementia; however, the efficacy of such devices remains unexplored. Therefore, a 3-month before and after study with convenience sampling was conducted to determine the efficacy of a medication reminder device used by 18 participants (aged 81.2 ± 6.2 years) with Clinical Dementia Rating scores of 0.5 or 1. At the onset of device use, examiners visited the users’ homes to ensure that they and their caregivers understood how to use the device. Caregivers monitored its use during the first week. Values of the self-administration medication rate during 1 week for 13 (72.2%) users showed improvement at 3 months. This result revealed that reminder devices can improve medication adherence in the elderly patients with mild cognitive impairment. Further study is needed to assess the magnitude of this improvement and to enhance its support for users with mild cognitive impairment.

This article describes four older adults with Alzheimer's disease and comorbidities who used an automatic medication dispenser (AMD) to continue pharmacotherapy for these chronic diseases and who remained at home living either alone or with an older spouse. The AMDs were used for 3 to 4.5 years. The patients scored at least 21 on the Mini-Mental State Examination, and their dosing regimen involved taking the medication once or twice per day throughout this period. The caregivers filled the devices with medications once every 1 to 2 weeks and continuously monitored the patients' conditions nearly every day. Additionally, one caregiver changed how the device is used to accommodate a participant's conditions. As a result of using the device, medication adherence remained good, and caregiver burden was reduced. The results indicate that an AMD can be used as a long-term medication management tool for some older adults with dementia when caregivers provide continued support, as described above. Further research is needed to clarify the necessary conditions for using an AMD and to identify benefits for older adults with dementia to use AMDs to take medication on a long-term basis.

The urinary COMP assay with mAb 14G4 is useful for discriminating horses with osteoarthritis. The higher COMP levels in urine from such horses would be indicative of enhanced proteolytic activity, in addition to the increased COMP levels in the diseased joints.

ObjectiveHome safety assessment and intervention is a key component in the management of fall risk in elderly people. However, a standardised assessment for home safety has not yet been established in Japan. We developed a Japanese version of the Westmead Home Safety Assessment by partially modifying the original version according to house structures and lifestyles in Japan and examined its inter-rater reliability and content validity.MethodsJapanese elderly in the community who had fear of falls were recruited to investigate the reliability of the Japanese version of the Westmead Home Safety Assessment. Two occupational therapists simultaneously visited a participant’s home to perform the Japanese version of the Westmead Home Safety Assessment independently. Further, an expert panel of 18 occupational therapists evaluated the relevance of each item of the Japanese version of the Westmead Home Safety Assessment.ResultsFifty elderly people (aged 78.2 ± 7.1 years) participated in this reliability study. The most frequent hazards were identified as internal steps/stairs, seating, bathroom, bath, and external steps/stairs. Forty-nine items (69%) in the Japanese version of the Westmead Home Safety Assessment were rated to have fair to good (0.40 < κ < 0.75) or excellent (κ ≥ 0.75) reliability as well as excellent validity (item content validity ≥0.78). These items were concerned with basic activities of daily living and some simple instrumental activities of daily living. The scale content validity was 0.78 ± 0.16 but was not excellent (scale content validity index <0.90).ConclusionsThis study suggested that 49 items in the Japanese version of the Westmead Home Safety Assessment were appropriate for home safety assessment for Japanese elderly. Further research is necessary to improve the reliability and validity of the present version of the Japanese version of the Westmead Home Safety Assessment for this population.