Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil.
J Am Med Dir Assoc. 2010 Sep;11(7):519-22. doi: 10.1016/j.jamda.2009.12.001. Epub 2010 Jun 30.
To analyze the association between use of psychoactive drugs and functional decline among noninstitutionalized dependent elderly people.
Cross-sectional study.
A total of 161 community-dwelling elderly people with functional dependence.
The data were analyzed using logistic regression with adjustment for age models. The independent variables were the following: use of psychoactive drugs (antidepressants, anticonvulsants, anxiolytics, antipsychotics, or sedatives), cognitive decline (Mini-Mental State Examination score<20), and daytime sleepiness. The dependent variables were the following: dependence relating to activities of daily living (ADLs) and dependence relating to instrumental activities of daily living (IADLs).
Data on 131 individuals of mean age 77.5 years were analyzed. Psychoactive drugs were used by 33.6%. Age-adjusted univariate analysis showed associations between psychoactive drug use and both ADLs and IADLs. However, in multivariate analysis, only ADLs showed a significant association with psychoactive drug use, independent of cognitive decline and daytime sleepiness (OR=2.67; 95% CI: 1.04-6.85; P=.04).
There is a greater risk of impairment of ADLs among noninstitutionalized elderly people using psychoactive drugs. These results indicate the need for rational use of medication groups among this population with greater risk of functional impairment.
分析使用精神活性药物与非住院依赖老年人功能下降之间的关联。
横断面研究。
共 161 名居住在社区且依赖功能的老年人。
使用逻辑回归分析调整年龄模型对数据进行分析。自变量为：使用精神活性药物（抗抑郁药、抗惊厥药、抗焦虑药、抗精神病药或镇静剂）、认知能力下降（简易精神状态检查评分<20）和日间嗜睡。因变量为：日常生活活动（ADL）依赖和工具性日常生活活动（IADL）依赖。
分析了 131 名平均年龄为 77.5 岁的个体的数据。33.6%的人使用了精神活性药物。年龄调整的单因素分析显示，精神活性药物的使用与 ADL 和 IADL 均相关。然而，在多变量分析中，只有 ADL 与精神活性药物的使用显著相关，与认知能力下降和日间嗜睡无关（OR=2.67；95%CI：1.04-6.85；P=.04）。
使用精神活性药物的非住院老年人日常生活活动受损的风险更高。这些结果表明，在功能受损风险较高的人群中，需要合理使用药物。
