High-risk prescribing and incidence of frailty among older community-dwelling men.
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.
Department of Clinical Pharmacology, Royal North Shore Hospital, Sydney, Australia. danijela.gnjidic@sydney.edu.au
D
D
Gnjidic
S N
SN
Hilmer
F M
FM
Blyth
V
V
Naganathan
R G
RG
Cumming
D J
DJ
Handelsman
A J
AJ
McLachlan
D R
DR
Abernethy
E
E
Banks
D G
DG
Le Couteur
D000368:Aged; D000369:Aged, 80 and over; D004363:Drug Utilization; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D019338:Polypharmacy; D055553:Prescription Drugs; D012111:Residence Characteristics; D012307:Risk Factors
D055553:Prescription Drugs