Research Article
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Year 2023, Volume: 5 Issue: 2, 255 - 61, 15.05.2023
https://doi.org/10.37990/medr.1183707

Abstract

References

  • Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021 Jun;12(3):443–52.
  • Löffler C, Drewelow E, Paschka SD, Frankenstein M, Eger J, Jatsch L, et al. Optimizing polypharmacy among elderly hospital patients with chronic diseases--study protocol of the cluster randomized controlled POLITE-RCT trial. Implement Sci. 2014 Oct;9:151.
  • Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review. Expert Opin Drug Saf. 2018 Dec;17(12):1185–96.
  • Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract. 2017 Jun;18(1):70.
  • Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017 Oct;17(1):230.
  • Rieckert A, Trampisch US, Klaaßen-Mielke R, Drewelow E, Esmail A, Johansson T, et al. Polypharmacy in older patients with chronic diseases: a cross-sectional analysis of factors associated with excessive polypharmacy. BMC Fam Pract. 2018 Jul;19(1):113.
  • Petrovic M, De Paepe P, Van Bortel L. Pharmacotherapy of depression in old age. Acta Clin Belg. 2005;60(3):150–6.
  • Fried TR, O’Leary J, Towle V, Goldstein MK, Trentalange M, Martin DK. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review. J Am Geriatr Soc. 2014 Dec;62(12):2261–72.
  • Wyka J, Biernat J, Kiedik D. Nutritional determination of the health status in Polish elderly people from an urban environment. J Nutr Health Aging. 2010 Jan;14(1):67–71.
  • Rozzini R, Sleiman I, Maggi S, Noale M, Trabucchi M. Gender differences and health status in old and very old patients. J Am Med Dir Assoc. 2009 Oct;10(8):554–8.
  • Pana A, Sourtzi P, Kalokairinou A, Velonaki VS. Sarcopenia and polypharmacy among older adults: A scoping review of the literature. Arch Gerontol Geriatr. 2022;98:104520.
  • Kose E, Toyoshima M, Okazoe S, Oka R, Shiratsuchi Y, Hayashi H. The relationship between polypharmacy and recovery of activities of daily living among convalescent stroke patients: a propensity score-matched analysis. Eur Geriatr Med. 2017;8(3):250–5.
  • Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62.
  • Sganga F, Vetrano DL, Volpato S, Cherubini A, Ruggiero C, Corsonello A, et al. Physical performance measures and polypharmacy among hospitalized older adults: results from the CRIME study. J Nutr Health Aging. 2014;18(6):616–21.
  • Jyrkkä J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. 2011 May;20(5):514–22.
  • Rawle 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 May;66(5):916–23.
  • Eyigor S, Kutsal YG, Toraman F, Durmus B, Gokkaya KO, Aydeniz A, et al. Polypharmacy, Physical and Nutritional Status, and Depression in the Elderly: Do Polypharmacy Deserve Some Credits in These Problems? Exp Aging Res. 2021;47(1):79–91.
  • Alexopoulos GS. Depression in the elderly. Lancet (London, England). 2005 Jun;365(9475):1961–70.
  • Yuruyen M, Yavuzer H, Demirdag F, Kara Z, Cengiz M, Yavuzer S, et al. Is depression a predictive factor for polypharmacy in elderly? Klin Psikofarmakol Bülteni-Bulletin Clin Psychopharmacol. 2016;26(4):374–81.
  • DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000 Jul;160(14):2101–7.
  • Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Res Rev. 2019 Aug;53:100903.
  • Katsimpris A, Linseisen J, Meisinger C, Volaklis K. The Association Between Polypharmacy and Physical Function in Older Adults: a Systematic Review. J Gen Intern Med. 2019 Sep;34(9):1865–73.
  • Junius-Walker U, Theile G, Hummers-Pradier E. Prevalence and predictors of polypharmacy among older primary care patients in Germany. Fam Pract. 2007 Feb;24(1):14–9.
  • Kuzuya M, Masuda Y, Hirakawa Y, Iwata M, Enoki H, Hasegawa J, et al. Underuse of medications for chronic diseases in the oldest of community-dwelling older frail Japanese. J Am Geriatr Soc. 2006 Apr;54(4):598–605.
  • Dwyer LL, Han B, Woodwell DA, Rechtsteiner EA. Polypharmacy in nursing home residents in the United States: results of the 2004 National Nursing Home Survey. Am J Geriatr Pharmacother. 2010 Feb;8(1):63–72.
  • Chen Y, Hicks A, While AE. Depression and related factors in older people in China: a systematic review. Rev Clin Gerontol. 2012;22(1):52–67.
  • Alamo C, López-Muñoz F, García-García P, García-Ramos S. Risk-benefit analysis of antidepressant drug treatment in the elderly. Psychogeriatrics. 2014 Dec;14(4):261–8.
  • Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003 Mar;58(3):249–65.
  • Jyrkkä J, Mursu J, Enlund H, Lönnroos E. Polypharmacy and nutritional status in elderly people. Curr Opin Clin Nutr Metab Care. 2012 Jan;15(1):1–6.
  • Agostini J V, Han L, Tinetti ME. The relationship between number of medications and weight loss or impaired balance in older adults. J Am Geriatr Soc. 2004 Oct;52(10):1719–23.
  • Pickering G. Frail elderly, nutritional status and drugs. Arch Gerontol Geriatr. 2004;38(2):174–80.
  • Veehof LJ, Stewart RE, Meyboom-de Jong B, Haaijer-Ruskamp FM. Adverse drug reactions and polypharmacy in the elderly in general practice. Eur J Clin Pharmacol. 1999 Sep;55(7):533–6.
  • Bytzer P. Dyspepsia as an adverse effect of drugs. Best Pract Res Clin Gastroenterol. 2010 Apr;24(2):109–20.
  • Matsumoto A, Yoshimura Y, Wakabayashi H, Kose E, Nagano F, Bise T, et al. Deprescribing Leads to Improved Energy Intake among Hospitalized Older Sarcopenic Adults with Polypharmacy after Stroke. Nutrients. 2022 Jan;14(3).
  • Riker GI, Setter SM. Polypharmacy in older adults at home: what it is and what to do about it--implications for home healthcare and hospice. Home Healthc Nurse. 2012 Sep;30(8):474–7.
  • König 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. J Gerontol A Biol Sci Med Sci. 2017 Dec;73(1):117–22.
  • Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011 May;12(4):249–56.

Polypharmacy in the Elderly: A Double-Edged Sword

Year 2023, Volume: 5 Issue: 2, 255 - 61, 15.05.2023
https://doi.org/10.37990/medr.1183707

Abstract

Aim: Polypharmacy is a very important geriatric syndrome related to critical health conditions. The purpose of this study is to research the association of polypharmacy with comprehensive geriatric assessment’s (CGA) various parameters which are indicators of health and life quality in older individuals.
Material and Methods: 515 older adults admitted to a university hospital were included in this cross-sectional study. Along with CGA, European Quality of Life (EQ-5D) was performed on the participants. Geriatric Depression Scale (GDS) was used to evaluate depressive symptoms. Daily living activities were assessed by using Lawton & Brody index of Instrumental Activities of Daily Living (IADL) and Katz Index of Activities of Daily Living (ADL). The Full Mini-Nutritional Assessment (MNA) questionnaire was performed to evaluate nutritional status.
Results: The participants’ mean age was 72.2±6.3 years and 58.6% of them were female. 242 participants using 5 or more drugs were included in the polypharmacy group. The polypharmacy group had lower IADL, MNA, EQ-5D, Hand Grip Strength (HGS), and gait speed scores and higher GDS scores compared to those without polypharmacy. According to the correlation analysis results, the number of the medications had a moderate positive correlation with GDS scores and a moderate negative correlation with EQ-5D and MNA.
Conclusion: As the number of medications increases; patients tend to have depression, malnutrition, and a decline in functional status. Polypharmacy also impairs the quality of life. We should address polypharmacy as a crucial health problem, optimize the number of medications and thereby make the health condition better.

References

  • Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021 Jun;12(3):443–52.
  • Löffler C, Drewelow E, Paschka SD, Frankenstein M, Eger J, Jatsch L, et al. Optimizing polypharmacy among elderly hospital patients with chronic diseases--study protocol of the cluster randomized controlled POLITE-RCT trial. Implement Sci. 2014 Oct;9:151.
  • Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review. Expert Opin Drug Saf. 2018 Dec;17(12):1185–96.
  • Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract. 2017 Jun;18(1):70.
  • Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017 Oct;17(1):230.
  • Rieckert A, Trampisch US, Klaaßen-Mielke R, Drewelow E, Esmail A, Johansson T, et al. Polypharmacy in older patients with chronic diseases: a cross-sectional analysis of factors associated with excessive polypharmacy. BMC Fam Pract. 2018 Jul;19(1):113.
  • Petrovic M, De Paepe P, Van Bortel L. Pharmacotherapy of depression in old age. Acta Clin Belg. 2005;60(3):150–6.
  • Fried TR, O’Leary J, Towle V, Goldstein MK, Trentalange M, Martin DK. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review. J Am Geriatr Soc. 2014 Dec;62(12):2261–72.
  • Wyka J, Biernat J, Kiedik D. Nutritional determination of the health status in Polish elderly people from an urban environment. J Nutr Health Aging. 2010 Jan;14(1):67–71.
  • Rozzini R, Sleiman I, Maggi S, Noale M, Trabucchi M. Gender differences and health status in old and very old patients. J Am Med Dir Assoc. 2009 Oct;10(8):554–8.
  • Pana A, Sourtzi P, Kalokairinou A, Velonaki VS. Sarcopenia and polypharmacy among older adults: A scoping review of the literature. Arch Gerontol Geriatr. 2022;98:104520.
  • Kose E, Toyoshima M, Okazoe S, Oka R, Shiratsuchi Y, Hayashi H. The relationship between polypharmacy and recovery of activities of daily living among convalescent stroke patients: a propensity score-matched analysis. Eur Geriatr Med. 2017;8(3):250–5.
  • Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62.
  • Sganga F, Vetrano DL, Volpato S, Cherubini A, Ruggiero C, Corsonello A, et al. Physical performance measures and polypharmacy among hospitalized older adults: results from the CRIME study. J Nutr Health Aging. 2014;18(6):616–21.
  • Jyrkkä J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. 2011 May;20(5):514–22.
  • Rawle 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 May;66(5):916–23.
  • Eyigor S, Kutsal YG, Toraman F, Durmus B, Gokkaya KO, Aydeniz A, et al. Polypharmacy, Physical and Nutritional Status, and Depression in the Elderly: Do Polypharmacy Deserve Some Credits in These Problems? Exp Aging Res. 2021;47(1):79–91.
  • Alexopoulos GS. Depression in the elderly. Lancet (London, England). 2005 Jun;365(9475):1961–70.
  • Yuruyen M, Yavuzer H, Demirdag F, Kara Z, Cengiz M, Yavuzer S, et al. Is depression a predictive factor for polypharmacy in elderly? Klin Psikofarmakol Bülteni-Bulletin Clin Psychopharmacol. 2016;26(4):374–81.
  • DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000 Jul;160(14):2101–7.
  • Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Res Rev. 2019 Aug;53:100903.
  • Katsimpris A, Linseisen J, Meisinger C, Volaklis K. The Association Between Polypharmacy and Physical Function in Older Adults: a Systematic Review. J Gen Intern Med. 2019 Sep;34(9):1865–73.
  • Junius-Walker U, Theile G, Hummers-Pradier E. Prevalence and predictors of polypharmacy among older primary care patients in Germany. Fam Pract. 2007 Feb;24(1):14–9.
  • Kuzuya M, Masuda Y, Hirakawa Y, Iwata M, Enoki H, Hasegawa J, et al. Underuse of medications for chronic diseases in the oldest of community-dwelling older frail Japanese. J Am Geriatr Soc. 2006 Apr;54(4):598–605.
  • Dwyer LL, Han B, Woodwell DA, Rechtsteiner EA. Polypharmacy in nursing home residents in the United States: results of the 2004 National Nursing Home Survey. Am J Geriatr Pharmacother. 2010 Feb;8(1):63–72.
  • Chen Y, Hicks A, While AE. Depression and related factors in older people in China: a systematic review. Rev Clin Gerontol. 2012;22(1):52–67.
  • Alamo C, López-Muñoz F, García-García P, García-Ramos S. Risk-benefit analysis of antidepressant drug treatment in the elderly. Psychogeriatrics. 2014 Dec;14(4):261–8.
  • Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003 Mar;58(3):249–65.
  • Jyrkkä J, Mursu J, Enlund H, Lönnroos E. Polypharmacy and nutritional status in elderly people. Curr Opin Clin Nutr Metab Care. 2012 Jan;15(1):1–6.
  • Agostini J V, Han L, Tinetti ME. The relationship between number of medications and weight loss or impaired balance in older adults. J Am Geriatr Soc. 2004 Oct;52(10):1719–23.
  • Pickering G. Frail elderly, nutritional status and drugs. Arch Gerontol Geriatr. 2004;38(2):174–80.
  • Veehof LJ, Stewart RE, Meyboom-de Jong B, Haaijer-Ruskamp FM. Adverse drug reactions and polypharmacy in the elderly in general practice. Eur J Clin Pharmacol. 1999 Sep;55(7):533–6.
  • Bytzer P. Dyspepsia as an adverse effect of drugs. Best Pract Res Clin Gastroenterol. 2010 Apr;24(2):109–20.
  • Matsumoto A, Yoshimura Y, Wakabayashi H, Kose E, Nagano F, Bise T, et al. Deprescribing Leads to Improved Energy Intake among Hospitalized Older Sarcopenic Adults with Polypharmacy after Stroke. Nutrients. 2022 Jan;14(3).
  • Riker GI, Setter SM. Polypharmacy in older adults at home: what it is and what to do about it--implications for home healthcare and hospice. Home Healthc Nurse. 2012 Sep;30(8):474–7.
  • König 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. J Gerontol A Biol Sci Med Sci. 2017 Dec;73(1):117–22.
  • Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011 May;12(4):249–56.
There are 37 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Ercüment Öztürk 0000-0003-4850-7567

Sencer Ganidağlı 0000-0001-9470-9544

Zeynel Abidin Öztürk 0000-0002-1717-2824

Early Pub Date May 15, 2023
Publication Date May 15, 2023
Acceptance Date November 14, 2022
Published in Issue Year 2023 Volume: 5 Issue: 2

Cite

AMA Öztürk E, Ganidağlı S, Öztürk ZA. Polypharmacy in the Elderly: A Double-Edged Sword. Med Records. May 2023;5(2):255-61. doi:10.37990/medr.1183707

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Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

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