Loyola Filho Antônio I de, Uchoa Elizabeth, Firmo Josélia O A, Lima-Costa Maria Fernanda
Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rev Saude Publica. 2008 Feb;42(1):89-99. doi: 10.1590/s0034-89102008000100012.
To evaluate the prevalence of polypharmacy and the influence of income on the association between medication use and cognitive impairment among elderly people.
Out of the 1,606 baseline members of the Bambuí cohort of elderly people, which started in 1997, 1,554 took part in the study. The Mini-Mental State Examination was applied to all the participants. The association between cognitive impairment and polypharmacy was tested by means of multivariate ordinal regression, performed for the whole population and for each of the income strata.
The prevalence of polypharmacy (two or more medications consumed) was 70.4% and the number of medications used presented an independent negative association with cognitive impairment (OR=0.72; 95% CI: 0.55;0.95). When this was stratified according to personal income (<2 minimum monthly salaries versus >or= 2 minimum monthly salaries), a negative association was observed between medication use and cognitive impairment among elderly people with lower income (OR=0.64; 95% CI: 0.48;0.86), but not among those with higher income (OR=1.74; 95% CI: 0.81;3.74).
With regard to the association between cognitive impairment and number of medications consumed, the results indicate social inequality in the use of medications. It is possible that these elderly people are not consuming the medicines needed for appropriate treatment of their health problems.
评估老年人多重用药的患病率以及收入对用药与认知障碍之间关联的影响。
在1997年启动的Bambuí老年队列研究的1606名基线成员中，有1554人参与了本研究。对所有参与者进行简易精神状态检查表测试。通过多变量有序回归对认知障碍与多重用药之间的关联进行检验，分别针对总体人群以及每个收入阶层进行分析。
多重用药（服用两种或更多药物）的患病率为70.4%，用药数量与认知障碍呈独立负相关（比值比=0.72；95%置信区间：0.55；0.95）。按个人收入分层（月最低工资<2倍与月最低工资≥2倍）后，低收入老年人的用药与认知障碍之间存在负相关（比值比=0.64；95%置信区间：0.48；0.86），而高收入老年人则不存在这种相关性（比值比=1.74；95%置信区间：0.81；3.74）。
关于认知障碍与用药数量之间的关联，结果表明在用药方面存在社会不平等。这些老年人可能没有服用针对其健康问题进行适当治疗所需的药物。
