Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, Iowa, USA.
Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
J Am Geriatr Soc. 2023 Jul;71(7):2219-2228. doi: 10.1111/jgs.18305. Epub 2023 Feb 28.
Dietary supplement and complementary and alternative medication (CAM) use can contribute to drug interactions, polypharmacy, nonadherence with prescription medications, and healthcare expenses, whereas evidence supporting benefits of using these products is sparse. There is a lack of current published literature describing the patterns or predictors of their use in community-dwelling older adults.
We performed a cross-sectional analysis of community-dwelling adults from Australia and the US, aged 70 years and older (65 years for US minorities), enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) study. At study enrollment, eligible participants were required to be without concurrent 5-year life-limiting illness and free of documented evidence of cardiovascular disease, dementia, or significant physical disability. During the final study visit, a questionnaire was administered to collect information about supplement/CAM use. Data from 15,729 participants who completed this questionnaire between January 2017 and January 2018 were analyzed. Descriptive statistics were used to report the prevalence and types of products used. Factors associated with use were determined using multivariate regression.
Mean age of respondents was 79.6 years; 56.4% were female, 88.8% were from Australia, 56.5% reported 12 years of education or less, and 98.7% were living at home. Two-thirds (66.2%) of participants reported use of one or more supplement/CAM in the previous month. Products most commonly used included vitamin D (33.8% of participants), fish oil (22.7%), calcium (20.6%), glucosamine (14.8%), and multivitamin (12.9%). Female sex, US residency, higher education, polypharmacy (prescription medications), and frailty (in women) were significantly associated with higher use of supplements/CAMs.
Dietary supplement and CAM use is common among community-dwelling older adults in the United States and Australia. Given the high prevalence of use, collaboration between healthcare providers and older adult patients is important to insure safe and optimal use of these products.
膳食补充剂和补充替代药物(CAM)的使用可能会导致药物相互作用、多种药物治疗、不遵医嘱使用处方药和医疗保健费用增加,而支持使用这些产品的益处的证据却很少。目前缺乏描述社区居住的老年人使用这些产品的模式或预测因素的已发表文献。
我们对澳大利亚和美国的社区居住的成年人进行了一项横断面分析,年龄在 70 岁及以上(美国少数民族为 65 岁),参加了阿司匹林减少老年人事件(ASPREE)研究。在研究入组时,符合条件的参与者必须没有同时患有 5 年生命限制的疾病,并且没有心血管疾病、痴呆或严重身体残疾的记录证据。在最后一次研究访问期间,进行了问卷调查以收集有关补充剂/CAM 使用的信息。分析了 2017 年 1 月至 2018 年 1 月期间完成此问卷的 15729 名参与者的数据。使用描述性统计数据报告使用的产品的流行率和类型。使用多元回归确定与使用相关的因素。
受访者的平均年龄为 79.6 岁;56.4%为女性,88.8%来自澳大利亚,56.5%报告接受了 12 年或以下的教育,98.7%居住在自己家中。三分之二(66.2%)的参与者报告在上个月使用了一种或多种补充剂/CAM。最常使用的产品包括维生素 D(33.8%的参与者)、鱼油(22.7%)、钙(20.6%)、氨基葡萄糖(14.8%)和多种维生素(12.9%)。女性、美国居民、更高的教育程度、多种药物治疗(处方药)和虚弱(女性)与补充剂/CAMs 的更高使用显著相关。
膳食补充剂和 CAM 的使用在澳大利亚和美国的社区居住的老年人中很常见。鉴于使用率高,医疗保健提供者与老年患者之间的合作对于确保这些产品的安全和最佳使用非常重要。