E-ISSN: 2147-2688
Relationship Between Frailty and Medicine Use and Polypharmacy in People Over Sixty-five Years of Age
PDF
Cite
Share
Request
Original Article
VOLUME: 58 ISSUE: 1
P: 33-41
January 2020

Relationship Between Frailty and Medicine Use and Polypharmacy in People Over Sixty-five Years of Age

Med Bull Haseki 2020;58(1):33-41
DOI: 10.4274/haseki.galenos.2019.5409
Mehmet Arslan 1
Elif Keskin Arslan 2
Esra Meltem Koç 3
Melih Kaan Sözmen 4
Yusuf Cem Kaplan 2
1. İzmir Buca 26 No’lu Aile Sağlığı Merkezi, Aile Hekimliği, İzmir, Türkiye
2. İzmir Katip Çelebi Üniversitesi Tıp Fakültesi, Tıbbi Farmakoloji Anabilim Dalı, İzmir, Türkiye
3. İzmir Katip Çelebi Üniversitesi Tıp Fakültesi, Aile Hekimliği Anabilim Dalı, İzmir, Türkiye
4. İzmir Katip Çelebi Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, İzmir, Türkiye
No information available.
No information available
Received Date: 30.05.2019
Accepted Date: 31.08.2019
Publish Date: 18.02.2020
PDF
Cite
Share
Request

ABSTRACT

Aim:

Frailty has become an important health issue in recent years. The aim of this study was to investigate the relationship between frailty and medicine use and polypharmacy in people over 65 years of age.

Methods:

Patients aged 65 years and over, who were admitted to family medicine outpatient clinics, were included in the study. The Tilburg frailty indicator, timed up and go test and gait speed test were used. Multivariate linear and logistic regression model were conducted.

Results:

Individuals, who used five or more medicines (polypharmacy) daily, constituted 49.1% of all participants. 55.6% of patients on polypharmacy were frail. Gender (β=-0.560, 95% Cl=-0.943-0.177) and the number of chronic diseases (β=1.496, 95% Cl=1.376-1.616) were found to have an effect on the total number of medicines. According to the results of logistic regression analysis on polypharmacy; female gender (aOR=3.4, 95% Cl=1.412-8.639), living alone (single/divorced/widowed) (aOR=2.8, 95% Cl=1.133-7.201) and number of chronic diseases (aOR=6.8, 95% Cl=4.218-11.075) were significantly associated with increased risk of polypharmacy.

Conclusion:

A significant increase in frailty score and reduction in walking speeds were detected in patients aged 65 years and over on polypharmacy. It should be kept in mind that polypharmacy is significantly related with frailty in elderly patients.

References

1Gökçe-Kutsal Y, Bilir N, Önderoğlu L, et al. Yaşlılıkta kaliteli yaşam [Internet]. Hacettepe Üniversitesi Geriatrik Bilimler Araştırma ve Uygulama Merkezi 2007. http://www.gebam.hacettepe.edu.tr/yaslilikta_kaliteli_yasam_son.pdf
2World Health Organization. World Report on Ageing and Health [Internet]. Geneva; 2015. Available from: http://www.who.int/life-course/publications/2015-ageing-report/en/. Accessed May 19, 2017.
3Coelho T, Paúl C, Gobbens RJJ, et al. Determinants of frailty: the added value of assessing medication. Front Aging Neurosci 2015;7:1-8.
4Şahin S, Cankurtaran M. Geriatrik sendromlar. Ege J Med 2010;49:31-7.
5Poudel A, Hubbard RE, Nissen L, et al. Frailty: a key indicator to minimize inappropriate medication in older people. QJM 2013;106:969-75.
6Gelal A. Yaşlılarda Akılcı İlaç Kullanımı. Turkiye Klin J Pharmacol-Special Top 2015;3:57-64.
7Ilhan B, Bahat-Ozturk G. Yaşlı ve Akılcı İlaç Kullanımı. Turkiye Klin J Geriatr-Special Top 2015;1:1-7.
8Herr M, Robine J-M, Pinot J, et al. Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people. Pharmacoepidemiol Drug Saf 2015;24:637-46.
9Yeşil Y, Cankurtaran M, Kuyumcu ME. Polifarmasi. Klin Gelişim Derg 2012;25:18-23.
10Rolland Y, Morley JE. Frailty and polypharmacy. J Nutr Health Aging 2016;20:645-6.
11Schoufour JD, Echteld MA, Bastiaanse LP, Evenhuis HM. The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities. Res Dev Disabil 2015;38:39-47.
12Saum KU, Schöttker B, Meid AD, et al. Is Polypharmacy Associated with Frailty in Older People? Results From the ESTHER Cohort Study. J Am Geriatr Soc 2017;65:e27-32.
13İlaçların Anatomik-Tedavi Edici-Kimyasal Sınıflandırılması (ATC) [Internet]. Available from: http://akgul.bilkent.edu.tr/DPT-BTD/kdep/rapor/KDEP_56_Rapor.pdf. Accessed May 20, 2017.
14Gobbens RJJ, van Assen MALM, Luijkx KG, et al. The Tilburg Frailty Indicator: Psychometric Properties. J Am Med Dir Assoc 2010;11:344-55.
15Arslan M, Koç EM, Sözmen MK. The Turkish Adaptation of The Tilburg Frailty Indicator: a Validity and Reliability Study. Turkish J Geriatr 2018;21:173-83.
16Podsiadlo D, Richardson S. The Timed ”Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons. J Am Geriafrics Soc 1991;39:142-8.
17The Timed Up and Go ( TUG ) Test [Internet]. CDC - Centers for Disease Control and Prevention, National Center for Injury Prevention and Control STEADI - Stopping Elderly Accidents, Deaths and Injuries. Available from: https://www.cdc.gov/steadi/pdf/tug_test-a.pdf. Accessed May 9, 2017.
18Fritz S, Lusardi M. Gait Speed (self selected) [Internet]. Journal of Geriatric Physical Therapy. 2010. Available from: http://geriatrictoolkit.missouri.edu/gaitspeed/Gait-Speed.pdf. Accessed May 9, 2017.
19Rawle MJ, Richards M, Davis D, Kuh D. The prevalence and determinants of polypharmacy at age 69: A British birth cohort study. BMC Geriatr 2018;18:1-12.
20Abolhassani N, Castioni J, Santschi V. Trends and Determinants of Polypharmacy and Potential Drug-Drug Interactions at Discharge From Hospital. J Patient Saf 2018;00:1-8.
21Gnjidic D, Hilmer SN, Blyth FM, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol 2012;65:989-95.
22Yuki A, Otsuka R, Tange C, et al. Polypharmacy is associated with frailty in Japanese community-dwelling older adults. Geriatr Gerontol Int 2018;18:1497-500.
23Saum K-U, Schöttker B, Meid AD, et al. Is Polypharmacy Associated with Frailty in Older People? Results From the ESTHER Cohort Study. J Am Geriatr Soc 2017;65:e27-e32.
24Rawle MJ, Cooper R, Kuh D, Richards M. Associations Between Polypharmacy and Cognitive and Physical Capability: A British Birth Cohort Study. J Am Geriatr Soc 2018;66:916-23.
25George C, Verghese J. Polypharmacy and Gait Performance in Community-dwelling Older Adults. J Am Geriatr Soc 2017;65:2082-7.
26König M, Spira D, Demuth I, Steinhagen-Thiessen E, Norman K. Polypharmacy as a Risk Factor for Clinically Relevant Sarcopenia: Results From the Berlin Aging Study II. Journals Gerontol Ser A 2017;73:117-22.
27Sganga F, Vetrano DL, Volpato S, et al. Physical performance measures and polypharmacy among hospitalized older adults: Results from the crime study. J Nutr Health Aging 2014;18:616-21.
28Efstratopoulos AD, Voyaki SM, Baltas AA, et al. Prevalence, Awareness, Treatment and Control of Hypertension in Hellas, Greece: The Hypertension Study in General Practice in Hellas (HYPERTENSHELL) National Study. Am J Hypertens 2006;19:53-60.
29Pereira KG, Peres MA, Iop D, et al. Polypharmacy among the elderly: a population-based study. Rev Bras Epidemiol 2017;20:335-44.
30de Groot MH, van Campen JPCM, Kosse NM, et al. The Association of Medication-Use and Frailty-Related Factors with Gait Performance in Older Patients. Maetzler W, editor. PLoS One 2016;11:e0149888.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House