Midão Luís, Brochado Pedro, Almada Marta, Duarte Mafalda, Paúl Constança, Costa Elísio
UCIBIO REQUIMTE, Faculty of Pharmacy, Porto4Ageing, University of Porto, 4050-313 Porto, Portugal.
Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal.
Int J Environ Res Public Health. 2021 Mar 30;18(7):3580. doi: 10.3390/ijerph18073580.
European population ageing is associated with frailty, a complex geriatric syndrome, and polypharmacy, both resulting in adverse health outcomes. In this study we aimed to evaluate the impact of frailty and polypharmacy, on mortality rates, within 30 months, using a cohort of SHARE participants aged 65 years old or more. Frailty was assessed using a version of Fried's phenotype criteria operationalized to SHARE while polypharmacy was defined as taking five or more drugs per day. We found a prevalence of 40.4% non-frail, 47.3% pre-frail and 12.3% frail participants. Moreover, a prevalence of polypharmacy of 31.3% was observed, being 3 three times more prevalent in frail individuals and two times in pre-frail individuals, when compared with non-frail. Individuals with both conditions had shown higher mortality rates. Comparing with non-polymedicated non-frail individuals all the other conditions are more prone to die within 30 months. Polymedicated older and male participants exhibited also higher mortality rates. This work shows polypharmacy and frailty to be associated with a higher risk of all-cause of mortality and highlights the need to decrease 'unnecessary' polypharmacy to reduce drug-related issues and also the need to assess frailty early to prevent avoidable adverse outcomes.
欧洲人口老龄化与衰弱（一种复杂的老年综合征）和多重用药有关，这两者都会导致不良健康后果。在本研究中，我们旨在利用一组65岁及以上的健康、退休和老龄化欧洲地区健康研究（SHARE）参与者，评估衰弱和多重用药在30个月内对死亡率的影响。衰弱采用针对SHARE实施的弗里德表型标准版本进行评估，而多重用药定义为每天服用五种或更多药物。我们发现，非衰弱参与者的患病率为40.4%，衰弱前期参与者为47.3%，衰弱参与者为12.3%。此外，观察到多重用药的患病率为31.3%，与非衰弱个体相比，衰弱个体的患病率高出三倍，衰弱前期个体高出两倍。同时患有这两种情况的个体死亡率更高。与未多重用药的非衰弱个体相比，所有其他情况在30个月内死亡的可能性更大。多重用药的老年男性参与者死亡率也更高。这项研究表明，多重用药和衰弱与全因死亡率风险较高有关，并强调需要减少“不必要的”多重用药以减少药物相关问题，还需要尽早评估衰弱以预防可避免的不良后果。
