High-risk prescribing and incidence of frailty among older community-dwelling men

Date

2012

Authors

Gnjidic, Donijela
Hilmer, Sarah
Blyth, Fiona
Naganathan, Vasin
Cumming, Robert
Handelsman, D
McLachlan, Andrew
Abernethy, D
Banks, Emily
Le Couteur, D

Journal Title

Journal ISSN

Volume Title

Publisher

Nature Publishing Group

Abstract

Evidence about the association between treatment with high-risk medicines and frailty in older individuals is limited. We investigated the relationship between high-risk prescribing and frailty at baseline, as well as 2-year incident frailty, in 1,662 men 70 years of age. High-risk prescribing was defined as polypharmacy (5 medicines), hyperpolypharmacy (10 medicines), and by the Drug Burden Index (DBI), a dose-normalized measure of anticholinergic and sedative medicines. At baseline, frail participants had adjusted odds ratios (ORs) of 2.55 (95% confidence interval, CI: 1.69-3.84) for polypharmacy, 5.80 (95% CI: 2.90-11.61) for hyperpolypharmacy, and 2.33 (95% CI: 1.58-3.45) for DBI exposure, as compared with robust participants. Of the 1,242 men who were robust at baseline, 6.2% developed frailty over two years. Adjusted ORs of incident frailty were 2.45 (95% CI: 1.42-4.23) for polypharmacy, 2.50 (95% CI: 0.76-8.26) for hyperpolypharmacy, and 2.14 (95% CI: 1.25-3.64) for DBI exposure. High-risk prescribing may contribute to frailty in community-dwelling older men.

Description

Keywords

Keywords: acetylsalicylic acid; allopurinol; amlodipine; atenolol; atorvastatin; clopidogrel; furosemide; irbesartan; metformin; omeprazole; paracetamol; perindopril; ramipril; sedative agent; simvastatin; warfarin; aged; anticholinergic effect; article; follow up;

Citation

Source

Clinical Pharmacology and Therapeutics

Type

Journal article

Book Title

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Restricted until

2037-12-31