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Nocebo phenomena may be enhanced in aging: Implications for clinical practice
E Kravvariti1, M Kotsani2, D D Mitsikostas3
1Postgraduate Medical Studies in the Physiology of Aging and Geriatric Syndromes, National and Kapodistrian University of Athens' Medical School, Athens, Greece.
Maturitas
|December 14, 2020
Summary
Nocebo effects, negative health outcomes from expectations, significantly impact older adults, leading to trial dropout and medication non-adherence. Research is needed to understand and mitigate these effects in geriatric populations.
Area of Science:
- Geriatric Medicine
- Psychosomatic Medicine
- Clinical Pharmacology
Background:
- Nocebo effects are unfavorable health outcomes stemming from negative expectations, not direct pharmacological actions.
- These effects contribute to clinical trial dropout and medication non-adherence, particularly in older adults.
- Factors like anxiety, chronic pain, and poor patient-physician communication can increase nocebo susceptibility in the elderly.
Purpose of the Study:
- To highlight the significance of nocebo effects in older adults.
- To identify factors contributing to nocebo susceptibility in geriatric patients.
- To underscore challenges in researching nocebo effects within this demographic.
Main Methods:
- This study is a review and synthesis of existing literature on nocebo effects in older adults.
- It analyzes factors influencing nocebo susceptibility in the geriatric population.
- It discusses barriers to current research in this area.
Main Results:
- Older adults exhibit heightened susceptibility to nocebo effects due to various age-related factors.
- Specific conditions like depression, anxiety, and chronic pain exacerbate nocebo responses.
- Strained patient-physician communication and use of generic medications are identified as contributing elements.
Conclusions:
- Nocebo effects pose a significant challenge in geriatric care, impacting treatment adherence and clinical trial validity.
- Further research is crucial to develop effective strategies for managing nocebo responses in older individuals.
- Overcoming research limitations, such as under-representation and lack of validated tools, is essential for advancing this field.
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