International Medical University, Jalan Jalil Perkasa, Bukit Jalil, Kuala Lumpur, Malaysia.
Neuroepidemiology. 2017;49(1-2):82-90. doi: 10.1159/000480433. Epub 2017 Sep 12.
BACKGROUND/AIMS: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes.
The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score. Medication appropriateness was assessed using the Medication Appropriateness Index (MAI) and 2015 Beers' criteria for Potentially Inappropriate Medication (PIM).
CNS medications constituted about 16% of the total, with an average of 0.8 ± 1.1 medications per resident, which reduced to 0.5 ± 0.8 medications after 3 months. Frailty (154/202) and polypharmacy (90/202) were highly prevalent in study subjects. Subjects on CNS medications had significantly higher GFI score (7.1 vs. 5.9; p = 0.031), polypharmacy (57.8 vs. 35.3%; p = 0.002), number of PIMs (0.9 vs. 0.2; p = 0.001), and mean summed MAI score (3.6 vs. 2.6; p = 0.015) than subjects not on CNS medications. Medication number was also significantly correlated with GFI (r = 0.194; p = 0.006) and KATZ (r = 0.141; p = 0.046) scores.
Frailty and polypharmacy were highly prevalent among aged care home subjects taking CNS medications. These findings support the notion that periodic regular medication review should improve the overall use of medications in elderly patients.
背景/目的：老年人和在养老院中的机构化生活与使用影响中枢神经系统（CNS）的风险药物的增加有关。本研究评估了马来西亚养老院居民的药物使用情况和适当性；并评估了居民的虚弱程度。
本研究的对象包括马来西亚半岛郊区 17 家养老院的 202 名老年人（≥65 岁）。使用 Groningen 虚弱指标（GFI）评分测量虚弱程度，使用 Katz 日常生活活动评分（KATZ）测量日常生活活动的独立性。使用药物适当性指数（MAI）和 2015 年 Beers 标准评估潜在不适当药物（PIM）。
CNS 药物占总药物的 16%左右，每位居民平均使用 0.8±1.1 种药物，3 个月后减少至 0.5±0.8 种药物。研究对象中虚弱（154/202）和多药治疗（90/202）的发生率很高。使用 CNS 药物的患者 GFI 评分（7.1 比 5.9；p=0.031）、多药治疗（57.8 比 35.3；p=0.002）、PIM 数量（0.9 比 0.2；p=0.001）和平均 MAI 评分（3.6 比 2.6；p=0.015）均显著更高。药物数量与 GFI（r=0.194；p=0.006）和 KATZ（r=0.141；p=0.046）评分显著相关。
使用 CNS 药物的养老院居民中虚弱和多药治疗的发生率很高。这些发现支持定期进行常规药物审查的观点，这将改善老年患者的整体用药情况。
