Journal article
The association between polypharmacy, frailty and disability-free survival in community-dwelling healthy older individuals
Archives of gerontology and geriatrics, Vol.101, pp.104694-104694
07/2022
DOI: 10.1016/j.archger.2022.104694
PMCID: PMC9437977
PMID: 35349875
Abstract
•Polypharmacy and frailty are two common geriatric conditions.•Polypharmacy is significantly associated with pre-frailty and frailty.•Polypharmacy-exposed frailty increases the risk of reduced disability-free survival.•Addressing polypharmacy could ameliorate the impact of frailty on disability-free survival.
Polypharmacy and frailty are two common geriatric conditions. In community-dwelling healthy older adults, we examined whether polypharmacy is associated with frailty and affects disability-free survival (DFS), assessed as a composite of death, dementia, or persistent physical disability.
We included 19,114 participants (median age 74.0 years, IQR: 6.1 years) from ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial. Frailty was assessed by a modified Fried phenotype and a deficit accumulation Frailty Index (FI). Polypharmacy was defined as concomitant use of five or more prescription medications. Multinomial logistic regression was used to examine the cross-sectional association between polypharmacy and frailty at base line, and Cox regression to determine the effect of polypharmacy and frailty on DFS over five years.
Individuals with polypharmacy (vs. <5 medications) were 55% more likely to be pre-frail (Relative Risk Ratio or RRR: 1.55; 95%Confidence Interval or CI:1.44, 1.68) and three times more likely to be frail (RRR: 3.34; 95%CI:2.64, 4.22) according to Fried phenotype. Frailty alone was associated with double risk of the composite outcome (Hazard ratio or HR: 2.16; 95%CI: 1.56, 2.99), but frail individuals using polypharmacy had a four-fold risk (HR: 4.24; 95%CI: 3.28, 5.47). Effect sizes were larger when frailty was assessed using the FI.
Polypharmacy was significantly associated with pre-frailty and frailty at baseline. Polypharmacy-exposed frailty increased the risk of reducing disability-free survival among older adults. Addressing polypharmacy in older people could ameliorate the impact of frailty on individuals’ functional status, cognition and survival.
[Display omitted]
Details
- Title: Subtitle
- The association between polypharmacy, frailty and disability-free survival in community-dwelling healthy older individuals
- Creators
- A R M Saifuddin Ekram - Monash UniversityRobyn L. Woods - Monash UniversityJoanne Ryan - Monash UniversitySara E. Espinoza - South Texas Veterans Health Care SystemJulia F.M. Gilmartin-Thomas - Monash UniversityRaj C. Shah - Rush UniversityRaaj Mehta - Massachusetts General HospitalBharati Kochar - Massachusetts General HospitalJudy A. Lowthian - Monash UniversityJessica Lockery - Monash UniversitySuzanne Orchard - Monash UniversityMark Nelson - University of TasmaniaMichelle A. Fravel - University of IowaDanny Liew - Monash UniversityMichael E. Ernst - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Archives of gerontology and geriatrics, Vol.101, pp.104694-104694
- DOI
- 10.1016/j.archger.2022.104694
- PMID
- 35349875
- PMCID
- PMC9437977
- NLM abbreviation
- Arch Gerontol Geriatr
- ISSN
- 0167-4943
- eISSN
- 1872-6976
- Publisher
- Elsevier B.V
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/501100000925, name: National Health and Medical Research Council
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297340302771
Metrics
31 Record Views