Polypharmacy is a geriatric syndrome defined variously as the use of potentially inappropriate drugs and/or the concurrent use of multiple medications including prescription and over-the-counter drugs. An association has been shown between polypharmacy and physical health, increased morbidity and increased mortality. However, there is little information regarding the association between polypharmacy and physical disease, personality trait and mental health problems in elderly. The aim of this study was to investigate potential predictive psychosocial factors related to polypharmacy in elderly Thai people. The study analysed the secondary data from the Depressive Disorders, Anxiety Disorders, Suicide Risk and Associated Factors Among Elderly Thai People Program (DAS Study) which was funded by National Research Council of Thailand and conducted between January 2012 and April 2013. Demographic and baseline clinical characteristics including sex, age, education, living alone or with others, access to health care privilege and monthly income were described. The number of medication, physical diseases and mental health problems (i.e. depression, anxiety, and personality trait of neuroticism) were analyzed using descriptive statistics, chi-square and proportional odds logistic regression. The 803 participants consumed an average of 2.13 prescribed medicines daily (SD 1.46, median = 2). The largest group used 3 medications (18.6%). Predictors found to be associated with polypharmacy in the logistic regression model included hypertension (OR = 1.985, 95% CI = 1.420–2.775), anxiety disorder (OR = 4.402, 95% CI = 2.630–7.367), number of diseases (OR = 2.140, 95% CI = 1.874–2.445), depressive disorder (OR = 1.470, 95% CI = 1.080–2.001), diabetes mellitus (OR = 1.864, 95% CI = 1.122–3.098) and dyslipidemia (OR = 0.511, 95%CI = 0.325–0.803). The prevalence of polypharmacy among Thai elderly was relatively high compared to other related studies. Several aspects should be taken into consideration before starting an additional medication in elderly patients. In addition to the number of physical disease that leads to polypharmacy, general practitioners should be aware of anxiety, depression, and personality trait of neuroticism that may be related to polypharmacy. Early detection for such condition as well as non-pharmacological intervention could be one way to help reduce polypharmacy in the elderly.

Objective: Age-associated decline in central cholinergic activity makes older adults susceptible to harmful effects of anticholinergics (ACs). Evidence exists of an association between effects of AC medications on cognition. This retrospective cohort study examines how ACs affect cognition among older adults with Alzheimer’s disease (AD) who received acetylcholine esterase inhibitors (AChEIs) over the course of 12 months. Results: A total of 133 (80% women, mean age 78.38 years, SD 7.4) were recruited. No difference in sex, age and comorbid diseases was observed between participants who took ACs, benzodiazepines (BZDs) and AChEIs. The most common prescribed ACs was quetiapine, being used for behavioral and psychological symptoms (BPSD). Multilevel analysis showed that the change of mental state examination scores were significantly predicted in the group using ACs (t (169), − 2.52, p = .020) but not with the groups using BZD (t (162), 0.84, p = .440). Evidence showed that older adults with Alzheimer’s disease and exposed to ACs exhibited lower global cognitive scores than those without AC exposure. Using ACs could be a trade-off between controlling BPSD and aggravating cognitive impairment. Highlighting the awareness of the potential anticholinergic effect is important and may be the best policy.

Background: Infertility can affect a couple’s mental health and marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and their relationships with other factors. Methods: This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The actor–partner interdependence model (APIM) was used for dyadic analysis. Results: The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = 0.039). Conclusions: Like other populations, depression in infertile couples seems to be associated with aggression, extraversion and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of the sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration.

(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions.

What is known and Objective Delirium is more common and life‐threatening among the elderly. Currently, no other medications, including antipsychotics, have been approved for delirium. The number of practice guidelines recommends antipsychotics to be the first option among selected patients. This study aimed to identify the type of drug‐related problems (DRPs) concerning antipsychotics use among elderly patients with delirium. Methods A retrospective observational study was conducted by collecting data from 2013 to 2016 in Maharaj Nakorn Chiang Mai Hospital, Thailand. Inpatients who were 60 years and over, diagnosed with delirium by ICD‐10 diseases coding F05.X and treated with antipsychotics for delirium were included. A modified version of the American Society of Hospital Pharmacists classification criteria (mASHP‐delirium) was used. Results and discussion A total of 379 patients were enrolled. Mean daily dose of haloperidol (oral) was 1.06 ± 1.33 mg, haloperidol (intramuscular) 2.71 ± 1.88 mg, haloperidol (intravenous; IV) 3.42 ± 1.97 mg, risperidone was 0.71 ± 0.52 mg, and quetiapine was 19.26 ± 15.63 mg. Among all, 427 events were classified as DRPs. The most common DRPs included inappropriate duration, dose, route of administration or dosage form accounting for the 416 events (97.4%), followed by actual adverse drug reactions (extrapyramidal symptoms; EPS), 6 events (1.4%) and potential drug‐drug interactions for 5 events (1.2%). Of those 416 events, 200 events (48.1%) antipsychotics were continued after discharge and continued for more than 10 days. Dosage exceeding initial dose or maximum daily dose accounted for 179 events (43.0%). Other DRPs such as inappropriate route haloperidol IV and receiving the extended‐release dosage form of quetiapine involve 26 (6.3%) and 11 (2.6%) events, respectively. What is new and Conclusion To the best of our knowledge, this is the first study using mASHP‐delirium to identify DRPs of antipsychotics in treating delirium among elderly patients. Several DRPs were found that might lead to severe adverse drug reactions, particularly EPS and QTc interval prolongation. However, all DRPs could be prevented by developing antipsychotic setting protocols and specialty consulting systems to communicate among healthcare providers caring for vulnerable groups of patients. In addition, a prospective pharmacist intervention is required.

Despite the growing number of older adults engaging in voluntary migration, there is a lack of knowledge about their psychological well-being in cross-cultural contexts. This cross-sectional study investigated factors associated with psychological well-being among older Chinese migrants residing in Chiang Mai, Thailand. Between December 2024 and February 2025, 204 Chinese migrants aged 60 and above who had resided in Chiang Mai for at least six months participated in a survey in Chinese. The survey measured sociodemographic and psychosocial factors including perceived health, income, marital status, number of co-residing family members, social support, acculturative stress, sense of mastery, and loneliness. Multiple regression analysis showed that gender (female) (p = 0.006), better perceived health status (p = 0.021), higher income (p = 0.007), more co-residing family members (p = 0.037), a greater sense of mastery (p = 0.009), and lower levels of loneliness (p < 0.001) were each independently associated with better psychological well-being. In contrast, neither general family support nor acculturative stress was a statistically significant predictor. These findings highlight the significant roles of financial security, family co-residence, personal empowerment, and social connectedness in shaping overall well-being. Strategies to improve psychological well-being in this population should focus on strengthening emotional connectedness, supporting the development of meaningful family and social relationships, and supporting economic stability.