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Is Polypharmacy Associated with Frailty in Older People? Results From the ESTHER Cohort Study.
- Source :
- Journal of the American Geriatrics Society; Feb2017, Vol. 65 Issue 2, pe27-e32, 6p, 3 Charts
- Publication Year :
- 2017
-
Abstract
- Objectives To investigate the relationship between polypharmacy and frailty. Design Longitudinal, observational cohort study. Setting Saarland, Germany. Participants 3,058 community-dwelling adults aged between 57 and 84 years. Measurements Frailty was assessed according to the frailty phenotype, described by Fried et al. Polypharmacy and hyperpolypharmacy were defined as the concomitant use of five or more and 10 or more drugs, respectively. We assessed associations between polypharmacy and prevalent and incident frailty within 3 years of follow-up by logistic regression models controlled for multiple potential confounders including comorbidity. Additionally, cubic splines were used to assess dose-response associations. Results Polypharmacy was reported in 39.1% (n = 1,194), and hyperpolypharmacy in 8.9% (n = 273) of participants. Prevalent frailty was present in 271 (8.9%) participants; 186 (9.3%) of 1,998 non-frail participants with follow-up data became frail within 3 years. After adjustment, polypharmacy and hyperpolypharmacy were associated with prevalent frailty with adjusted odds ratios (95% confidence interval) of 2.30 (1.60-3.31) and 4.97 (2.97-8.32), respectively. Polypharmacy (odds ratio ( OR) 1.51 (1.05-2.16)) and hyperpolypharmacy ( OR 1.90 (1.10-3.28)) were also independent predictors of incident frailty. Furthermore, there was a moderate exposure-response relationship between the number of medicines and prevalent as well as incident frailty. Conclusion Our study showed that polypharmacy is associated with frailty. Further research should address the potential benefit of reducing of inappropriate polypharmacy and better pharmacotherapeutic management for preventing medication-associated frailty. [ABSTRACT FROM AUTHOR]
- Subjects :
- POLYPHARMACY
FRAIL elderly
MEDICATION therapy management
OLDER people
COHORT analysis
DRUG side effects
PHARMACOKINETICS
MUSCLE strength
MEDICAL care
DRUG utilization
GERIATRIC assessment
ANALYSIS of variance
CHI-squared test
CONFIDENCE intervals
STATISTICAL correlation
DIAGNOSIS
DRUGS
NONPRESCRIPTION drugs
GAIT in humans
GRIP strength
LIFE skills
LONGITUDINAL method
SCIENTIFIC observation
QUESTIONNAIRES
RESEARCH funding
SCALE analysis (Psychology)
PHENOTYPES
COMORBIDITY
LOGISTIC regression analysis
SOCIOECONOMIC factors
BODY mass index
INDEPENDENT living
CROSS-sectional method
SEVERITY of illness index
PHYSICAL activity
DATA analysis software
DESCRIPTIVE statistics
ODDS ratio
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 65
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 121289449
- Full Text :
- https://doi.org/10.1111/jgs.14718