Polypharmacy Is Associated With Higher Frailty Risk in Older People: An 8-Year Longitudinal Cohort Study

Nicola Veronese, Christoph Mueller, Nicola Veronese, Jonathan Huntley, Jacopo Demurtas, Stefania Maggi, Brendon Stubbs, Marianna Noale, Marco Solmi, Alberto Pilotto, Gaetano Crepaldi, Alberto Vaona

Risultato della ricerca: Articlepeer review

65 Citazioni (Scopus)

Abstract

Objective To investigate whether polypharmacy is associated with a higher incidence of frailty in a large cohort of North Americans during 8 years of follow-up. Design Longitudinal study, follow-up of 8 years. Participants A total of 4402 individuals at high risk or having knee osteoarthritis free from frailty at baseline. Measurements Details regarding medication prescription were captured and categorized as 0–3, 4–6, and ≥7. Frailty was defined using the Study of Osteoporotic Fracture index as the presence of ≥2 out of (1) weight loss ≥5% between baseline and the subsequent follow-up visit; (2) inability to do 5 chair stands; and (3) low energy level according to the Study of Osteoporotic Fracture definition. Cox's regression models calculating a hazard ratio (HR) with 95% confidence intervals (CIs), adjusted for potential confounders, were undertaken. Results During the 8-year follow-up, from 4402 participants at baseline, 361 became frail. Compared with participants taking 0–3 medications, the incidence of frailty was approximately double in those taking 4–6 medications and 6 times higher in people taking ≥7 medications. After adjusting for 11 potential baseline confounders, participants using 4–6 medications had a higher risk of frailty of 55% (HR = 1.55; 95% CI 1.22–1.96; P <.0001), whereas those using more than 7 drugs were at approximately 147% (HR = 2.47; 95% CI 1.78–3.43; P <.0001). Each additional drug used at the baseline increased the risk of frailty at the follow-up of 11% (HR = 1.11; 95% CI 1.07–1.15; P <.0001). Conclusions Polypharmacy is associated with a higher incidence of frailty over 8-year follow-up period. Our data suggest evidence of a dose response relationship. Future research is required to confirm our findings and explore underlying mechanisms. © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Lingua originaleEnglish
pagine (da-a)624-628
Numero di pagine5
RivistaJournal of the American Medical Directors Association
Volume18
Stato di pubblicazionePublished - 2017

All Science Journal Classification (ASJC) codes

  • ???subjectarea.asjc.2900.2900???
  • Health Policy
  • Geriatrics and Gerontology

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