Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
Department of Pharmacy Practice, West Coast University School of Pharmacy, Los Angeles, CA 91606, USA.
Int J Environ Res Public Health. 2019 Jun 20;16(12):2181. doi: 10.3390/ijerph16122181.
Despite high prevalence of obesity and polypharmacy among African American (AA) older adults, little information exists on the associations between the two in this population. This study explored the association between obesity and polypharmacy among AA older adults who were residing in poor urban areas of South Los Angeles. We also investigated role of gender as the moderator and multimorbidity as the mediator of this association. In a community-based study in South Los Angeles, 308 AA older adults (age ≥ 55 years) were entered into this study. From this number, 112 (36.4%) were AA men and 196 (63.6%) were AA women. Polypharmacy (taking 5+ medications) was the dependent variable, obesity was the independent variable, gender was the moderator, and multimorbidity (number of chronic medical conditions) was the mediator. Age, educational attainment, financial difficulty (difficulty paying bills, etc.), income, marital status, self-rated health (SRH), and depression were the covariates. Logistic regressions were used for data analyses. In the absence of multimorbidity in the model, obesity was associated with higher odds of polypharmacy in the pooled sample. This association was not significant when we controlled for multimorbidity, suggesting that multimorbidity mediates the obesity-polypharmacy link. We found significant association between obesity and polypharmacy in AA women not AA men, suggesting that gender moderates such association. AA older women with obesity are at a higher risk of polypharmacy, an association which is mainly due to multimorbidity. There is a need for screening for inappropriate polypharmacy in AA older women with obesity and associated multimorbidity.
尽管非裔美国人（AA）老年人群体中肥胖症和多种药物治疗的患病率很高，但关于这两个人群之间的关联的信息却很少。本研究探讨了居住在南洛杉矶贫困城市地区的 AA 老年人群体中肥胖症和多种药物治疗之间的关联。我们还研究了性别作为这种关联的调节者和多种疾病作为这种关联的中介的作用。在南洛杉矶的一项基于社区的研究中，有 308 名 AA 老年成年人（年龄≥55 岁）参与了这项研究。在这个数字中，有 112 名（36.4%）是 AA 男性，196 名（63.6%）是 AA 女性。多种药物治疗（服用 5 种以上药物）是因变量，肥胖症是自变量，性别是调节变量，多种疾病（慢性疾病数量）是中介变量。年龄、教育程度、经济困难（难以支付账单等）、收入、婚姻状况、自我评估健康状况（SRH）和抑郁是协变量。逻辑回归用于数据分析。在模型中不存在多种疾病的情况下，肥胖症与合并样本中多种药物治疗的可能性更高相关。当我们控制多种疾病时，这种关联并不显著，表明多种疾病中介了肥胖症与多种药物治疗之间的联系。我们发现，在 AA 女性中，肥胖症与多种药物治疗之间存在显著关联，但在 AA 男性中则没有，这表明性别调节了这种关联。患有肥胖症的 AA 老年女性更有可能接受多种药物治疗，这种关联主要是由于多种疾病引起的。需要对患有肥胖症和相关多种疾病的 AA 老年女性进行不适当的多种药物治疗筛查。
