Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Geriatr Gerontol Int. 2019 Aug;19(8):730-735. doi: 10.1111/ggi.13688. Epub 2019 May 20.
Polypharmacy has been reported to be associated with poor outcomes, including falls and frailty, in older populations. Past studies have found that slower walking speed is a good predictor of progression to frank dementia in mild cognitive impairment (MCI). Some studies of the general population reported that polypharmacy was associated with slower gait speed; however, it remains to be elucidated whether polypharmacy affects gait speed even in individuals with MCI, who already have some deterioration in gait compared with cognitively preserved individuals. The current study explored the association between the number of medications and gait speed in older adults with MCI who have a Clinical Dementia Rating score of 0.5.
A total of 128 individuals with MCI were included in the present study. The participants were divided into three groups according to the number of medications they were taking: up to four medications was non-polypharmacy; five to nine medications was polypharmacy; and ≥10 medications was hyperpolypharmacy. The background characteristics were compared by analysis of variance for numerical numbers, and by χ analysis for categorical factors. Multiple regression and logistic analysis were applied to investigate the association between gait speed and polypharmacy status or number of medications.
Gait speed was significantly negatively associated with hyperpolypharmacy status and the number of medications. Slow gait speed (<1 m/s) was also significantly associated with polypharmacy status and the number of medications.
We found that polypharmacy was associated with slow gait speed in older adults with MCI. Geriatr Gerontol Int 2019; 19: 730-735.
已有报道称,在老年人中,多种药物治疗与不良结局相关,包括跌倒和虚弱。过去的研究发现,步行速度较慢是轻度认知障碍(MCI)进展为痴呆的良好预测指标。一些普通人群的研究报告称,多种药物治疗与较慢的步速相关;然而,在 MCI 患者中,多种药物治疗是否会影响步速,仍有待阐明,这些患者的步态已经比认知正常的个体有所恶化。本研究探讨了 MCI 老年人中药物种类与步态速度之间的关系,这些老年人的临床痴呆评定量表(CDR)得分为 0.5。
本研究共纳入 128 名 MCI 患者。根据服用药物的种类,将参与者分为三组:服用药物不超过 4 种为非多种药物治疗;服用药物 5-9 种为多种药物治疗;服用药物≥10 种为超多种药物治疗。通过方差分析比较数值的背景特征,通过卡方分析比较分类因素。应用多元回归和逻辑回归分析探讨步态速度与多种药物治疗状态或药物种类之间的关系。
步态速度与超多种药物治疗状态和药物种类呈显著负相关。较慢的步速(<1m/s)也与多种药物治疗状态和药物种类显著相关。
我们发现,多种药物治疗与 MCI 老年人的缓慢步态速度相关。老年医学与老年病学杂志 2019;19:730-735。