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多药治疗与智利老年人的虚弱、营养风险和慢性病有关:PIEI-ES 研究述评。

Polypharmacy Is Associated with Frailty, Nutritional Risk and Chronic Disease in Chilean Older Adults: Remarks from PIEI-ES Study.

机构信息

Thrombosis Research Center, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Interdisciplinary Center on Aging, Universidad de Talca, Talca, Chile.

Thematic Task Force on Healthy Aging, CUECH Research Network, Viña Del Mar, Chile.

出版信息

Clin Interv Aging. 2020 Jun 29;15:1013-1022. doi: 10.2147/CIA.S247444. eCollection 2020.

Abstract

AIM

To analyze the relationship between polypharmacy and variables as frailty and other chronic comorbidities in Chilean older adults.

DESIGN

Cross-sectional study.

PARTICIPANTS

One thousand two hundred and five older adults aged 65 and older.

METHODS

The presence or absence of frailty syndrome was determined according to Fried criteria. Data collection was made through questionnaires conducted by an interview.

RESULTS

The prevalence of polypharmacy was 37.59%. The prevalence of hyperpolypharmacy was 2%. Increased prevalence of frailty was demonstrated regarding the progression of the state of polypharmacy. When analyzing the contribution of frailty respect polypharmacy condition, frail state, nutritional risk and obesity are founded as a factor associated with polypharmacy. Regarding chronic disease, hypertension (OR: 8.039, p<0.0001), type 2 diabetes (OR: 4.001, p<0.0001) and respiratory diseases (OR: 2.930, p<0.0001) were associated to polypharmacy. It was found a strong and significant positive correlation between polypharmacy prevalence and frailty score (polypharmacy condition, Spearman R: 0.89, p=0.033; hyperpolypharmacy condition, Spearman R: 0.94, p=0.016). When analyzing the contribution of the polypharmacy to the presence of frailty, polypharmacy condition (OR: 1.510, p<0.05), cognitive impairment (OR: 3.887, p<0.001), obesity (OR: 1.560, p<0.01) and nutritional risk (OR: 2.590, p<0.001) are associated to frailty.

CONCLUSION

Frailty and chronic conditions as nutritional risk, obesity, hypertension, type 2 diabetes and respiratory disease are an important risk factor for the development of polypharmacy in Chilean older adults. Likewise, polypharmacy condition was observed to be a risk factor for frailty, demonstrating the bidirectional relationship between both conditions. Frailty syndrome evaluation in Chilean older adults could be an important alternative for polypharmacy prevention.

摘要

目的

分析智利老年人中药物滥用与脆弱和其他慢性合并症等变量之间的关系。

设计

横断面研究。

参与者

1205 名 65 岁及以上的老年人。

方法

根据弗莱德标准确定是否存在衰弱综合征。通过访谈进行的问卷调查收集数据。

结果

药物滥用的患病率为 37.59%。超高药物滥用的患病率为 2%。随着药物滥用状态的进展,衰弱的患病率增加。在分析脆弱状态对药物滥用状况的影响时,发现衰弱状态、营养风险和肥胖是与药物滥用相关的因素。在分析慢性病与药物滥用的关系时,发现高血压(OR:8.039,p<0.0001)、2 型糖尿病(OR:4.001,p<0.0001)和呼吸系统疾病(OR:2.930,p<0.0001)与药物滥用相关。药物滥用的患病率与衰弱评分之间存在强烈且显著的正相关(药物滥用状况,斯皮尔曼 R:0.89,p=0.033;超高药物滥用状况,斯皮尔曼 R:0.94,p=0.016)。在分析药物滥用对衰弱的影响时,发现药物滥用状况(OR:1.510,p<0.05)、认知障碍(OR:3.887,p<0.001)、肥胖(OR:1.560,p<0.01)和营养风险(OR:2.590,p<0.001)与衰弱相关。

结论

脆弱和慢性病(如营养风险、肥胖、高血压、2 型糖尿病和呼吸系统疾病)是智利老年人药物滥用发生的重要危险因素。同样,药物滥用状况也是衰弱的危险因素,这表明这两种情况之间存在双向关系。在智利老年人中评估衰弱综合征可能是预防药物滥用的重要替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd3b/7334011/dc45b5ec89b6/CIA-15-1013-g0001.jpg

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