Journal article
Multiple Chronic Conditions and Polypharmacy in Cognitively Unimpaired Older Adults are Associated with Subsequent Cognitive Decline: Results from the National Alzheimer's Coordinating Center Data
Archives of gerontology and geriatrics, Vol.134, 105846
07/2025
DOI: 10.1016/j.archger.2025.105846
PMCID: PMC12178129
PMID: 40220663
Abstract
•Older adults commonly have multiple chronic conditions and/or polypharmacy.•Individuals who have multiple chronic conditions or polypharmacy have reduced cognitive function than those without these conditions.•A higher number of chronic conditions is associated with a greater decline in semantic ability/language and executive function,•A higher number of medications is linked to a greater decline in attention/working memory, semantic ability/language, and executive function.
Prior cross-sectional studies revealed that multiple chronic conditions (MCC) and polypharmacy are associated with cognitive impairment. The purpose of this study was to determine whether the number of chronic conditions and the number of medications are associated with longitudinal changes in cognition (memory, attention/working memory, semantic ability/language, processing speed, executive function). We analyzed data from 5,671 individuals (age 71.4 ± 9.3, 68% female) from the National Alzheimer's Coordinating Center database who were cognitively unimpaired at baseline and had 3 or more subsequent visits. 57% had more than two chronic conditions, and 44% were taking 5 or more medications at baseline. At baseline, we observed that individuals with MCC had lower memory, attention/working memory, semantic ability/language, processing speed, and executive function performance than those without MCC. Using mixed-effect modeling approaches, we found that having a higher number of chronic conditions was associated with greater decline in semantic ability/language and executive function, and having a higher number of medications was associated with greater decline in attention/working memory, semantic ability/language, and executive function. The findings suggest that healthcare professionals and service providers should be conscious of the fact that patients dealing with MCC and those on multiple medications are vulnerable and require careful monitoring. Future studies are warranted using more comprehensive multimorbidity data and advanced analytic approaches, and prospective, controlled trials are warranted to test whether managing MCC and reducing the number of unnecessary medications or certain medications can prevent decline.
Details
- Title: Subtitle
- Multiple Chronic Conditions and Polypharmacy in Cognitively Unimpaired Older Adults are Associated with Subsequent Cognitive Decline: Results from the National Alzheimer's Coordinating Center Data
- Creators
- Chooza Moon - University of Iowa College of NursingMeina Zhang - University of IowaBoxiang Wang - University of Iowa, Statistics and Actuarial ScienceSue Gardner - University of IowaJoel Geerling - University of Iowa, Iowa Neuroscience InstituteKarin Hoth - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Archives of gerontology and geriatrics, Vol.134, 105846
- DOI
- 10.1016/j.archger.2025.105846
- PMID
- 40220663
- PMCID
- PMC12178129
- NLM abbreviation
- Arch Gerontol Geriatr
- ISSN
- 0167-4943
- eISSN
- 1872-6976
- Publisher
- Elsevier B.V
- Grant note
- NIA-funded ADRCs: P30 AG062429, P30 AG066468, P30 AG062421, P30 AG066509, P30 AG066514, P30 AG066530, P30 AG066507, P30 AG066444, P30 AG066518, P30 AG066512, P30 AG066462, P30 AG072979, P30 AG072972, P30 AG072976, P30 AG072975, P30 AG072977, P30 AG066519, P30 AG062677, P30 AG079280, P30 AG062422, P30 AG066511, P30 AG072946, P30 AG062715, P30 AG072973, P30 AG066506, P30 AG066508, P30 AG066515, P30 AG072947, P30 AG072931, P30 AG066546, P30 AG086401, P30 AG086404, P20 AG068082, P30 AG072958, P30 AG072959 NIA/NIH: U24 AG072122
The NACC database is funded by NIA/NIH Grant U24 AG072122. NACC data are contributed by the NIA-funded ADRCs: P30 AG062429 (PI James Brewer, MD, PhD) , P30 AG066468 (PI Oscar Lopez, MD) , P30 AG062421 (PI Bradley Hyman, MD, PhD) , P30 AG066509 (PI Thomas Grabowski, MD) , P30 AG066514 (PI Mary Sano, PhD) , P30 AG066530 (PI Helena Chui, MD) , P30 AG066507 (PI Marilyn Albert, PhD) , P30 AG066444 (PI David Holtzman, MD) , P30 AG066518 (PI Lisa Silbert, MD, MCR) , P30 AG066512 (PI Thomas Wisniewski, MD) , P30 AG066462 (PI Scott Small, MD) , P30 AG072979 (PI David Wolk, MD) , P30 AG072972 (PI Charles DeCarli, MD) , P30 AG072976 (PI Andrew Saykin, PsyD) , P30 AG072975 (PI Julie A. Schneider, MD, MS) , P30 AG072978 (PI Ann McKee, MD) , P30 AG072977 (PI Robert Vassar, PhD) , P30 AG066519 (PI Frank LaFerla, PhD) , P30 AG062677 (PI Ronald Petersen, MD, PhD) , P30 AG079280 (PI Jessica Langbaum, PhD) , P30 AG062422 (PI Gil Rabinovici, MD) , P30 AG066511 (PI Allan Levey, MD, PhD) , P30 AG072946 (PI Linda Van Eldik, PhD) , P30 AG062715 (PI Sanjay Asthana, MD, FRCP) , P30 AG072973 (PI Russell Swerdlow, MD) , P30 AG066506 (PI Glenn Smith, PhD, ABPP) , P30 AG066508 (PI Ste-phen Strittmatter, MD, PhD) , P30 AG066515 (PI Victor Henderson, MD, MS) , P30 AG072947 (PI Suzanne Craft, PhD) , P30 AG072931 (PI Henry Paulson, MD, PhD) , P30 AG066546 (PI Sudha Seshadri, MD) , P30 AG086401 (PI Erik Roberson, MD, PhD) , P30 AG086404 (PI Gary Rosenberg, MD) , P20 AG068082 (PI Angela Jefferson, PhD) , P30 AG072958 (PI Heather Whitson, MD) , P30 AG072959 (PI James Lev-erenz, MD) .
- Language
- English
- Electronic publication date
- 03/29/2025
- Date published
- 07/2025
- Academic Unit
- Statistics and Actuarial Science; Neurology; Psychiatry; Iowa Neuroscience Institute; Nursing
- Record Identifier
- 9984808534702771
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