Abstract
Background/Objectives
To investigate if polypharmacy modifies the association between frailty and health
outcomes in older adults.
Design
Ongoing cohort study.
Setting
Albacete City, Spain.
Participants
A total for 773 participants, 457 women (59.1%), over age 70 years from the FRADEA
Study.
Measurements
Frailty phenotype, polypharmacy considered as the chronic use of 5 or more drugs,
and comorbidity were collected at the baseline visit. Participants were categorized
in 6 groups according to frailty and polypharmacy, and were followed up for 5.5 years
(mean 1057 days, range 1-2007). Mortality or incident disability in basic activities
of daily living was considered the main outcome variable. Hospitalization and visits
to the emergency department were also recorded. The adjusted association between combined
frailty status and polypharmacy with outcome variables was analyzed.
Results
The mean age of study population was 78.5 years. In this population, we identified
a 15.3% (n = 118) of frail with polypharmacy, 3.4% (n = 26) of frail without polypharmacy,
35.3% (n = 273) of prefrail with polypharmacy, 20.3% (n = 157) of prefrail without
polypharmacy, 10.3% (n = 80) of nonfrail with polypharmacy, and 15.4% (n = 119) of
nonfrail participants without polypharmacy. Participants with frailty and polypharmacy
had a higher adjusted risk of mortality or incident disability [odds ratio (OR) 5.3;
95% confidence interval (CI) 2.3–12.5] and hospitalization (OR 2.3; 95% CI 1.2–4.4),
compared with those without frailty and polypharmacy. Frail and prefrail participants
with polypharmacy had a higher adjusted mortality risk compared with the nonfrail
without polypharmacy, hazard ratio 5.8 (95% CI 1.9–17.5) and hazard ratio 3.1 (95%
CI 1.1–9.1), respectively.
Conclusions
Polypharmacy is associated with mortality, incident disability, hospitalization, and
emergency department visits in frail and prefrail older adults, but not in nonfrail
adults. Polypharmacy should be monitored in these patient subgroups to optimize health
outcomes.
Keywords
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Article info
Publication history
Published online: September 09, 2017
Footnotes
This work was supported by CIBERFES, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, España. Ayuda cofinanciada por el Fondo Europeo de Desarrollo Regional FEDER Una Manera de hacer Europa.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
