Faculty of Education, Kochi University, Kochi City, Japan.
Section of the NILS-LSA, National Center for Geriatrics and Gerontology, Morioka, Japan.
Geriatr Gerontol Int. 2018 Oct;18(10):1497-1500. doi: 10.1111/ggi.13507. Epub 2018 Aug 30.
The association between polypharmacy and the development of frailty is unknown. The present study assessed the longitudinal relationship between polypharmacy and frailty risk in Japanese community-dwelling older adults.
Participants included 299 non-frail older Japanese adults aged 65-81 years who participated in both baseline and follow-up examinations of a longitudinal study of aging (mean duration 6.2 years). At baseline examination, all prescribed and non-prescribed medications used during the previous 2 weeks were confirmed and coded by physicians. Frailty was diagnosed according to frailty criteria, and included shrinking, exhaustion, low activity, low grip strength and low gait speed. The relationship between frailty and the number of medications was assessed using multiple logistic regression analysis. The logistic regression model was used to control for potential confounders, including age at baseline, sex, body fat, total physical activity, education, employment, current smoking and number of comorbidities.
The percentage of participants who developed frailty during follow up was 5.1% in those taking five or fewer medications, and 22.5% in those taking six or more medications. The fully adjusted odds ratio for frailty among participants taking six or more medications was 5.55 (95% confidence interval 2.17-14.22).
Polypharmacy appears to be a significant risk factor for the development of frailty in older Japanese adults. Geriatr Gerontol Int 2018; 18: 1497-1500.
目前尚不清楚多种药物治疗与衰弱发生之间的关系。本研究评估了日本社区居住的老年人群中多种药物治疗与衰弱风险之间的纵向关系。
参与者包括 299 名年龄在 65-81 岁之间、无虚弱的日本老年人，他们参加了一项老龄化纵向研究的基线和随访检查（平均随访时间为 6.2 年）。在基线检查时，由医生确认并编码所有在过去 2 周内使用的处方药和非处方药。根据衰弱标准诊断衰弱，包括消瘦、疲惫、活动减少、握力降低和步速降低。使用多因素逻辑回归分析评估衰弱与用药数量之间的关系。逻辑回归模型用于控制潜在的混杂因素，包括基线时的年龄、性别、体脂、总体力活动、教育程度、就业状况、当前吸烟状况和合并症数量。
在随访期间，服用五种或五种以下药物的参与者中有 5.1%发展为衰弱，而服用六种或六种以上药物的参与者中有 22.5%发展为衰弱。服用六种或六种以上药物的参与者发生衰弱的调整后比值比为 5.55（95%置信区间 2.17-14.22）。
多种药物治疗似乎是日本老年人群衰弱发生的一个重要危险因素。老年医学与老年病学国际 2018; 18: 1497-1500。
