title: Drug burden index and beers criteria: impact on functional outcomes in older people living in self-care retirement villages.
abstract: The objectives of this study were to determine whether Drug Burden Index (DBI), a measure of individuals' exposure to anticholinergic and sedative drugs, and Beers criteria, an explicit measure of potentially inappropriate drug use, are associated with function in older adults living in low-level care facilities; and to compare DBI with Beers criteria as a predictor of function in older people. The study population consisted of 115 residents living in low-level care facilities in Sydney, Australia. Data on demographics, drugs, and comorbidities were collected. Outcomes included objective measures of physical function Short Performance Physical Battery (SPPB) and grip strength. In total, 50 (44%) participants were exposed to DBI drugs, 51 (44%) participants received at least 1 Beers criteria drug, and 30 (26%) were exposed to both. After adjusting for confounders, for every unit increase in DBI, the SPPB score decreased by 1.3 (P = .04). DBI was not associated with weaker grip strength. Beers criteria were not associated with any of the outcomes. In older adults living in self-care retirement villages, DBI was associated with impairments in physical functioning. Exposure to Beers criteria drugs was common; however, Beers criteria did not predict functional outcomes in this population of older adults.
authors.affiliation: Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, AustraliaSydney Medical School, University of Sydney, New South Wales, AustraliaCentre for Education and Research on Ageing, Concord Hospital, Concord, New South Wales, AustraliaOffice of Clinical Pharmacology, Food and Drug Administration, Silver Spring, USA.
authors.forename: Danijela
authors.initials: D
authors.lastname: Gnjidic
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Abernethy
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Hilmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D009483:Neuropsychological Tests; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012179:Retirement; D012648:Self Care
chemical_list: D018680:Cholinergic Antagonists; D006993:Hypnotics and Sedatives