Department of Psychiatry and Addiction, Telemark Hospital Trust, Skien, Norway.
Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
Eur Geriatr Med. 2021 Dec;12(6):1213-1220. doi: 10.1007/s41999-021-00511-6. Epub 2021 May 25.
Handgrip strength is an indicator of frailty and longevity in older adults. The association between psychotropic drug use and handgrip strength in older hospitalized patients was investigated in this study.
A total of 488 patients were included in this retrospective cross-sectional study, 333 women and 155 men, from two different cohorts of older (mean age 84 years) hospitalized in-patients. We used multiple linear regression models to explore the association between psychotropic drug use and handgrip strength. We adjusted for factors known to affect handgrip strength: Age, gender, body mass index (BMI) and comorbidity (Charlson comorbidity index).
Both unadjusted and adjusted analyses showed that psychotropic drug use was associated with handgrip strength (β = - 0.183, p < 0.0001). The relationship was of a linear character, with no clear threshold value, but with the greatest reduction in handgrip strength between zero and two psychotropic drugs.
An increasing number of psychotropic drugs were significantly associated with reduced handgrip strength in a linearly pattern. Hence, it is timely to question the guided threshold value of avoidance of three or more psychotropic drugs in older people. Psychotropic drug use should be kept as low as possible in treatment of older patients.
握力是老年人虚弱和长寿的指标。本研究调查了老年住院患者使用精神药物与握力之间的关系。
本回顾性横断面研究纳入了来自两个不同老年住院患者队列的 488 名患者,其中女性 333 名,男性 155 名,平均年龄 84 岁。我们使用多元线性回归模型探讨了精神药物使用与握力之间的关系。我们调整了已知影响握力的因素:年龄、性别、体重指数(BMI)和合并症(Charlson 合并症指数)。
未调整和调整分析均表明,精神药物使用与握力呈负相关(β=-0.183,p<0.0001)。这种关系具有线性特征,没有明显的阈值,但在使用零到两种精神药物时,握力下降最大。
使用的精神药物数量越多,握力下降越明显,呈线性关系。因此,及时质疑老年人避免使用三种或三种以上精神药物的指导阈值是适时的。在治疗老年患者时,应尽可能减少精神药物的使用。