Evolution of medication use in Jerusalem elders: Results from the Jerusalem Longitudinal Study.

Background: While overall rates of medication use have been increasing over time, less is known about how medication use changes within individuals as they age.
Objective: The aim of this study was to evaluate changes in medication use and predictors of medication accrual among community-dwelling elders followed for a 7-year period, from age 70 +/- 1 years to age 77 +/- 1 years.
Methods: The study was a community-based, longitudinal, cohort study. The study group consisted of 280 patients from the Jerusalem Longitudinal Study, a population-based sample of Jerusalem residents born in 1920-1 who underwent extensive evaluation in 1990-1 and again in 1997-8. The main outcome measure of the study was the change in the total number of medications taken between baseline and follow-up. Medication use was assessed by home interviews.
Results: Half of the sample were men. Medication use more than doubled over the 7-year study period, from a mean of 2.0 to 5.3 medications per patient (p < 0.001), and 57 patients (20%) increased their total drug use by six or more medications. Vitamins, minerals and cardiovascular medications were the most commonly prescribed medications at follow-up, and accounted for approximately half of the total increase in medication use. On multivariable logistic regression analyses, decline in self-rated health was the strongest predictor of above-median increases in medication use (odds ratio [OR] 3.2; 95% CI 1.8, 6.2). The only nonclinical predictor of above-median increases in medication use was good social engagement at baseline (OR 1.8; 95% CI 1.1, 3.1).
Conclusion: Medication use in Jerusalem elders grew rapidly over the 1990s, more than doubling in volume over a 7-year period. While health status was the factor most strongly predictive of the degree of change, the magnitude of increase for elders as a whole suggests major changes in prescribing practices over this interval.