Chong Rui Qi, Gelissen Ingrid, Chaar Betty, Penm Jonathan, Cheung Janet My, Harnett Joanna E
The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, New South Wales, Australia.
Explor Res Clin Soc Pharm. 2021 Sep 3;3:100067. doi: 10.1016/j.rcsop.2021.100067. eCollection 2021 Sep.
Chronic health conditions and polypharmacy are common among the older population and associated with increased risks of adverse events, medicine-interactions, geriatric syndromes, falls and mortality. Poor nutrition is also common in older people. Causal associations between medication use and older people's nutrient status is seldom discussed.
The objectives of this review were to summarise the literature reporting associations between medicines commonly prescribed to older adults and nutrient deficiencies, and to discuss the clinical implications and management.
Medicine information resources ( = 5) were searched for information about nutrient deficiencies associated with common medicines used by older people and listed within the top 50 medicines prescribed by volume on the Australian Pharmaceutical Benefits Scheme. This was followed by a search for clinical studies published on PubMed from inception to April 2020. Data was extracted, tabulated and summarised with clinical information relevant to pharmacists and clinicians involved in the care of older people taking medicines.
A total of 23 clinical studies were identified reporting medicine-induced nutrient deficiencies in older adults. Vitamin B12, sodium, magnesium were identified as the 3 main nutrients susceptible to deficiency by medicines used to treat cardiovascular disease, neurological conditions, gastrointestinal conditions, and diabetes. The coenzyme CoQ10 was depleted by statins.Conclusion: Certain medicines commonly prescribed to older adults are associated with nutrient deficiencies that may be clinically significant. Given the high prevalence of comorbidities and polypharmacy it is possible that some of these individual drug-induced nutrient deficiencies are compounded, warranting both clinical and research attention.
慢性健康状况和多种药物联合使用在老年人群中很常见，且与不良事件、药物相互作用、老年综合征、跌倒及死亡风险增加相关。营养不良在老年人中也很常见。药物使用与老年人营养状况之间的因果关联很少被讨论。
本综述的目的是总结报告老年人常用药物与营养缺乏之间关联的文献，并讨论其临床意义及管理方法。
检索了5个药物信息资源，以获取与老年人常用且在澳大利亚药品福利计划中按处方量排名前50的药物相关的营养缺乏信息。随后在PubMed上检索从创刊至2020年4月发表的临床研究。提取数据，制成表格，并与参与照顾服药老年人的药剂师和临床医生的临床信息一起进行总结。
共确定了23项临床研究，报告了老年人药物引起的营养缺乏。维生素B12、钠、镁被确定为治疗心血管疾病、神经系统疾病、胃肠道疾病和糖尿病的药物易导致缺乏的3种主要营养素。辅酶Q10会被他汀类药物消耗。
老年人常用的某些药物与可能具有临床意义的营养缺乏有关。鉴于合并症和多种药物联合使用的高患病率，这些个体药物引起的营养缺乏中的一些可能会叠加，值得临床和研究关注。
