Gnjidic Danijela, Le Couteur David G, Abernethy Darrell R, Hilmer Sarah N
Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, AustraliaSydney Medical School, University of Sydney, New South Wales, AustraliaCentre for Education and Research on Ageing, Concord Hospital, Concord, New South Wales, AustraliaOffice of Clinical Pharmacology, Food and Drug Administration, Silver Spring, USA.
J Clin Pharmacol. 2012 Feb;52(2):258-65. doi: 10.1177/0091270010395591.
The objectives of this study were to determine whether Drug Burden Index (DBI), a measure of individuals' exposure to anticholinergic and sedative drugs, and Beers criteria, an explicit measure of potentially inappropriate drug use, are associated with function in older adults living in low-level care facilities; and to compare DBI with Beers criteria as a predictor of function in older people. The study population consisted of 115 residents living in low-level care facilities in Sydney, Australia. Data on demographics, drugs, and comorbidities were collected. Outcomes included objective measures of physical function Short Performance Physical Battery (SPPB) and grip strength. In total, 50 (44%) participants were exposed to DBI drugs, 51 (44%) participants received at least 1 Beers criteria drug, and 30 (26%) were exposed to both. After adjusting for confounders, for every unit increase in DBI, the SPPB score decreased by 1.3 (P = .04). DBI was not associated with weaker grip strength. Beers criteria were not associated with any of the outcomes. In older adults living in self-care retirement villages, DBI was associated with impairments in physical functioning. Exposure to Beers criteria drugs was common; however, Beers criteria did not predict functional outcomes in this population of older adults.
本研究的目的是确定药物负担指数（DBI，一种衡量个体对抗胆碱能药物和镇静药物暴露程度的指标）以及Beers标准（一种明确衡量潜在不适当药物使用的指标）是否与生活在低级别护理机构中的老年人的功能相关；并比较DBI与Beers标准作为老年人功能预测指标的情况。研究人群包括居住在澳大利亚悉尼低级别护理机构中的115名居民。收集了有关人口统计学、药物和合并症的数据。结局指标包括身体功能的客观测量指标简短体能状况量表（SPPB）和握力。总共有50名（44%）参与者暴露于DBI药物，51名（44%）参与者至少服用了1种符合Beers标准的药物，30名（26%）同时暴露于这两种药物。在对混杂因素进行调整后，DBI每增加一个单位，SPPB评分下降1.3（P = .04）。DBI与较弱的握力无关。Beers标准与任何结局均无关。在居住于自理退休村的老年人中，DBI与身体功能障碍相关。暴露于符合Beers标准的药物很常见；然而，Beers标准并不能预测该老年人群体的功能结局。
