Hershman D L, Simonoff P A, Frishman W H, Paston F, Aronson M K
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
J Am Geriatr Soc. 1995 Apr;43(4):356-60. doi: 10.1111/j.1532-5415.1995.tb05807.x.
To characterize medication use in a "well" very old population and relate the quantity and type of medication use to 10-year mortality.
A longitudinal, 10-year, follow-up study involving 488 healthy, community-dwelling volunteers aged 75 to 85 years. The subjects underwent a detailed baseline evaluation and annual assessments that included comprehensive physical exams, laboratory and diagnostic tests, and related interviews. Prescription and nonprescription drug use was determined by self report, confirmation through hospital records, and reports by subjects and significant others.
At study baseline, the mean number of prescription and nonprescription medications used was 2.3 and 1.5, respectively. Female subjects (n = 315), those older than 80 years, or those who reported themselves to be in fair or poor health on initial health self-report were found to show significantly increased use of prescription medications. The most commonly used classes of medications were cardiovascular drugs and analgesics. Subjects who were consuming a greater number of prescription and nonprescription medications did not have higher mortality rates. After correcting for differences in cardiovascular health status between users and nonusers, only digoxin approached significance as an independent predictor of death (P < .08).
This study confirmed that medication use in an ambulatory, old old population is not excessive. The oldest subjects in the cohort consumed more medications than did the younger subjects. Women used more prescription drugs than men. Increased medication use was associated with worse ratings on health self report. Medication use alone, however, was not a predictor of 10-year mortality in this population. Questions are raised about the inappropriate prescription of digoxin in older subjects.
描述“健康”高龄人群的用药情况，并将用药数量和类型与10年死亡率相关联。
一项为期10年的纵向随访研究，涉及488名年龄在75至85岁之间、居住在社区的健康志愿者。研究对象接受了详细的基线评估和年度评估，包括全面的体格检查、实验室和诊断测试以及相关访谈。通过自我报告、医院记录确认以及研究对象及其重要他人的报告来确定处方药和非处方药的使用情况。
在研究基线时，使用的处方药和非处方药的平均数量分别为2.3种和1.5种。发现女性研究对象（n = 315）、年龄大于80岁的研究对象或在初始健康自我报告中称自己健康状况一般或较差的研究对象使用的处方药显著增加。最常用的药物类别是心血管药物和镇痛药。使用较多处方药和非处方药的研究对象死亡率并未更高。在校正使用者和非使用者心血管健康状况的差异后，只有地高辛作为死亡的独立预测因素接近显著水平（P < .08）。
本研究证实，高龄社区人群的用药量并不过多。队列中年龄最大的研究对象比年轻研究对象服用的药物更多。女性使用的处方药比男性多。用药量增加与健康自我报告评分较差有关。然而，仅用药情况并非该人群10年死亡率的预测因素。对于老年研究对象不适当开具地高辛处方的问题也由此提出。
