Journal article
The association of allopurinol with persistent physical disability and frailty in a large community based older cohort
Journal of the American Geriatrics Society (JAGS), Vol.71(9), pp.2798-2809
09/2023
DOI: 10.1111/jgs.18395
PMCID: PMC10524392
PMID: 37158186
Abstract
The protective effects of allopurinol on physical function in older adults are not well understood, despite its potential to improve functional gains and reduce sarcopenia. This study aims to determine the association between allopurinol, persistent physical disability, and frailty in older gout patients.
This analysis used data from a randomized trial in an older cohort, ASPirin in Reducing Events in the Elderly (ASPREE). ASPREE recruited 19,114 participants aged ≥65 years without prior cardiovascular events, dementia, or independence-limiting physical disability at trial enrolment. This analysis examined the association of baseline and time-varying allopurinol use with persistent physical disability and new-onset frailty in participants with gout at baseline (self-report or use of any anti-gout medications). Frailty was measured using the Fried frailty phenotype (score ≥3/5) and a deficit accumulation frailty index (FI) (score >0.21/1.0). Multivariable Cox proportional-hazards models were used for main analyses.
This analysis included 1155 gout participants, with 630 taking allopurinol at baseline and 525 not. During a median follow-up of 5.7 years, 113 new allopurinol users were identified. Compared with nonusers, baseline allopurinol use was associated with a significant risk reduction of persistent physical disability (Adjusted HR 0.46, 95% CI 0.23-0.92, p = 0.03). The strength of the association was modestly attenuated in the time-varying analysis (Adjusted HR 0.56, 0.29-1.08, p = 0.08). No significant associations with frailty measures were observed for either baseline allopurinol use (Fried frailty: Adjusted HR 0.83, 0.62-1.12; FI: Adjusted HR 0.96, 0.74-1.24) or time-varying allopurinol use (Fried frailty: Adjusted HR 0.92, 0.69-1.24; FI: Adjusted HR 1.02, 0.78-1.33).
Allopurinol use in older adults with gout is associated with a reduced risk of persistent physical disability but not associated with risk of frailty.
Details
- Title: Subtitle
- The association of allopurinol with persistent physical disability and frailty in a large community based older cohort
- Creators
- Zhen Zhou - University of TasmaniaJoanne Ryan - Monash UniversityMark R Nelson - University of TasmaniaRobyn L Woods - Monash UniversitySuzanne G Orchard - Monash UniversityChao Zhu - Monash UniversityJulia F M Gilmartin-Thomas - Australian Institute for Musculoskeletal ScienceMichelle A Fravel - University of IowaAlice J Owen - Monash UniversityAnne M Murray - Berman Center for Outcomes and Clinical ResearchSara E Espinoza - South Texas Veterans Health Care SystemMichael E Ernst - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.71(9), pp.2798-2809
- DOI
- 10.1111/jgs.18395
- PMID
- 37158186
- PMCID
- PMC10524392
- NLM abbreviation
- J Am Geriatr Soc
- eISSN
- 1532-5415
- Grant note
- U19AG062682 / NIA NIH HHS U01AG029824 / NIA NIH HHS
- Language
- English
- Electronic publication date
- 05/09/2023
- Date published
- 09/2023
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984406605402771
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