Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy.
J Alzheimers Dis. 2019;71(3):889-897. doi: 10.3233/JAD-190284.
BACKGROUND: With multimorbidity increasing among older people, polypharmacy and the use of potentially inappropriate medications (PIMs) are assuming a prominent role in the life of the geriatric population. OBJECTIVE: To investigate the association of polypharmacy and PIM use with a wide range of factors in older people with mild cognitive impairment (MCI) to mild dementia. METHODS: The study population comprised 160 outpatients with a Clinical Dementia Rating of 0.5-1 and a Mini-Mental State Examination score of 20-30. Patients were classified as receiving polypharmacy when they took ≥5 different medications at the same time. PIMs were identified using the STOPP-J criteria. Cognitive, neuropsychological, nutritional, and physical function tests were performed and body measurements taken. Quality of life (QOL) was assessed using both components of the EQ-5D scale, the index score and the visual analogue scale (QOL VAS). A comorbidity index was calculated for all participants. RESULTS: PIM use was significantly associated with lower scores on the verbal fluency (initial letters) test and QOL index. Participants receiving polypharmacy showed an increased likelihood of worse frailty status and lower QOL VAS score. The number of medications was significantly associated with a worse frailty status. CONCLUSION: In a geriatric population with MCI to mild dementia, PIM use was associated with lower verbal fluency (initial letters) score and lower QOL, while the presence of polypharmacy was correlated with a worse frailty status and lower QOL. The number of medicines, instead, was correlated with a worse frailty status only.
背景:随着老年人多病共存的增加,多种药物治疗和潜在不适当药物的使用(PIMs)在老年人群的生活中占据了重要地位。
目的:调查多种药物治疗和 PIM 使用与轻度认知障碍(MCI)至轻度痴呆的老年人的多种因素之间的关联。
方法:研究人群包括 160 名临床痴呆评定量表(CDR)为 0.5-1 分和简易精神状态检查(MMSE)评分为 20-30 分的门诊患者。当患者同时服用≥5 种不同药物时,将其归类为接受多种药物治疗。使用 STOPP-J 标准识别 PIMs。进行认知、神经心理学、营养和身体功能测试,并进行身体测量。使用 EQ-5D 量表的两个组成部分(QOL 指数和视觉模拟量表(QOL VAS))评估生活质量(QOL)。为所有参与者计算了共病指数。
结果:PIM 使用与言语流畅性(初始字母)测试和 QOL 指数得分较低显著相关。接受多种药物治疗的患者更有可能出现虚弱状态恶化和 QOL VAS 评分降低。药物数量与更差的虚弱状态显著相关。
结论:在 MCI 至轻度痴呆的老年人群中,PIM 使用与言语流畅性(初始字母)评分和较低的 QOL 相关,而同时存在多种药物治疗与更差的虚弱状态和较低的 QOL 相关。然而,药物数量仅与更差的虚弱状态相关。
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