University of Ljubljana, Faculty of Pharmacy, Askerceva cesta 7, 1000, Ljubljana, Slovenia.
BMC Geriatr. 2021 Jan 7;21(1):25. doi: 10.1186/s12877-020-01969-y.
Understanding potentially modifiable factors that influence the risk of frailty is a key concern for the management of this urgent contemporary public health challenge. This study evaluates the association between the use of various medications or alcohol and the incidence of frailty among older adults.
This study was a retrospective cohort study on older adults (≥ 65 years) using data from the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE survey, 28 countries). Medication use was measured as taking several different groups of medications. Alcohol use was assessed with SHARE questions corresponding to AUDIT-C. The outcome measure was the incidence of frailty after two years, defined by frailty index (FI) and frailty phenotype (FP). A multiple logistic regression model was used to evaluate the association with adjustment for several potential confounding factors.
Of the 14,665 FI-population participants, 1800 (12.3%) developed frailty within two years. Of the 8133 FP-population participants, 2798 (34.4%) developed pre-frailty and 247 (3.0%) developed frailty within two years of baseline. After adjustment for potential confounding variables, non-hazardous alcohol use (adjusted OR; 95% CI for the FI-population: 0.68; 0.60-0.77) and hazardous alcohol use (0.80; 0.68-0.93) are associated with lower incidence of frailty compared to no alcohol use. The odds of frailty are increased when taking medications; the largest effect size was observed in older adults taking medication for chronic bronchitis (adjusted OR; 95% CI for the FI-population: 2.45; 1.87-3.22), joint pain and other pain medication (2.26; 2.00-2.54), medication for coronary and other heart disease (1.72; 1.52-1.96), medication for diabetes (1.69; 1.46-1.96), and medication for anxiety, depression and sleep problems (1.56; 1.33-1.84). Additionally, the risk of frailty was increased with stroke, Parkinson's disease and dementia.
Taking certain groups of medication was associated with increased incidence of frailty and pre-frailty, which might be due to either medication use or the underlying disease. Alcohol use was associated with a lower risk of pre-frailty and frailty compared to no alcohol use, which might be due to reverse causality or residual confounding. There was no significant interaction effect between medication groups and alcohol use on frailty incidence.
了解影响虚弱风险的潜在可改变因素是管理这一紧迫当代公共卫生挑战的关键。本研究评估了老年人中各种药物或酒精使用与虚弱发生之间的关联。
这是一项基于欧洲健康老龄化和退休纵向调查（SHARE 调查，28 个国家）数据的老年人群（≥65 岁）回顾性队列研究。药物使用被衡量为服用几组不同的药物。酒精使用通过与 AUDIT-C 对应的 SHARE 问题进行评估。结果测量是两年后虚弱的发生率，通过虚弱指数（FI）和虚弱表型（FP）来定义。使用多因素逻辑回归模型评估与调整多种潜在混杂因素相关的关联。
在 FI 人群的 14665 名参与者中，1800 名（12.3%）在两年内发生虚弱。在 FP 人群的 8133 名参与者中，2798 名（34.4%）出现衰弱前期，247 名（3.0%）出现衰弱。在调整潜在混杂变量后，非危害性饮酒（FI 人群的调整比值比；95%CI：0.68；0.60-0.77）和危害性饮酒（0.80；0.68-0.93）与虚弱发生率降低相关。与不饮酒相比，服用药物会增加衰弱的几率；最大的效应大小见于服用慢性支气管炎药物（FI 人群的调整比值比；95%CI：2.45；1.87-3.22）、关节疼痛和其他疼痛药物（2.26；2.00-2.54）、用于治疗冠心病和其他心脏病的药物（1.72；1.52-1.96）、用于治疗糖尿病的药物（1.69；1.46-1.96）和用于治疗焦虑、抑郁和睡眠问题的药物（1.56；1.33-1.84）。此外，中风、帕金森病和痴呆与虚弱风险增加相关。
服用某些药物组与衰弱和衰弱前期的发生率增加相关，这可能是由于药物使用或潜在疾病。与不饮酒相比，酒精使用与衰弱前期和衰弱的风险降低相关，这可能是由于反向因果关系或残余混杂。药物组与酒精使用之间对虚弱发生率的交互作用无显著影响。
