Nishijima Chiharu, Harada Kenji, Kurita Satoshi, Morikawa Masanori, Fujii Kazuya, Kakita Daisuke, Shimada Hiroyuki
Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan.
Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan; School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW 2052, Australia; UNSW Ageing Futures Institute, University of New South Wales, Sydney, NSW 2052, Australia; Neuroscience Research Australia, Sydney, Australia.
Maturitas. 2025 Feb;193:108184. doi: 10.1016/j.maturitas.2024.108184. Epub 2024 Dec 25.
This study examined the association between polypharmacy and incident disability across the dietary variety score (DVS) strata among community-dwelling older adults.
A prospective cohort study with community-dwelling adults aged ≥65 in Aichi, Japan.
Polypharmacy was defined as ≥5 concomitant prescription drugs per day. Participants were classified as having non-polypharmacy or polypharmacy and a lower, moderate, or high DVS. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) with 95 % confidence intervals (CIs) for incident disability among the polypharmacy groups after adjusting for potentially confounding variables.
The analysis included 5254 older adults (55.7 % female; average age 74.0 ± 5.5 years) with a mean follow-up time of 34.7 ± 5.9 months. Among them, 4842 remained disability-free, while 412 (7.8 %) developed a disability during follow-up. The potential confounder-adjusted disability HR for participants in the polypharmacy group was 1.37 (CI: 1.07-1.75; p = 0.011). In the stratified analyses, polypharmacy in the lower DVS group was significantly associated with higher HRs for incident disability (1.62 [1.11-2.37; p = 0.013]), and no significant association between polypharmacy and incident disability was observed in the higher DVS group (1.12 [0.74-1.71; p = 0.590]).
Polypharmacy was positively associated with disability incidence, with a more pronounced effect in participants with a lower DVS. Polypharmacy patients may have different reasons for not being able to have a higher variety diet from non-polypharmacy people.
本研究探讨了社区居住的老年人中，多重用药与不同饮食多样性评分（DVS）分层下的新发残疾之间的关联。
一项针对日本爱知县年龄≥65岁的社区居住成年人的前瞻性队列研究。
多重用药定义为每天服用≥5种处方药。参与者被分为非多重用药组或多重用药组，以及低、中、高饮食多样性评分组。在调整潜在混杂变量后，使用Cox比例风险回归模型估计多重用药组中发生残疾的风险比（HRs）及其95%置信区间（CIs）。
分析纳入了5254名老年人（女性占55.7%；平均年龄74.0±5.5岁），平均随访时间为34.7±5.9个月。其中，4842人仍无残疾，而412人（7.8%）在随访期间出现了残疾。多重用药组参与者经潜在混杂因素调整后的残疾风险比为1.37（CI：1.07 - 1.75；p = 0.011）。在分层分析中，低饮食多样性评分组中的多重用药与新发残疾的较高风险比显著相关（1.62 [1.11 - 2.37；p = 0.013]），而在高饮食多样性评分组中未观察到多重用药与新发残疾之间的显著关联（1.12 [0.74 - 1.71；p = 0.590]）。
多重用药与残疾发生率呈正相关，在饮食多样性评分较低的参与者中影响更为明显。多重用药患者可能有不同于非多重用药者无法摄入更多样化饮食的原因。
