title: Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people.
abstract: OBJECTIVE
  To assess the prevalence of polypharmacy and frailty, to examine their association, and to establish their independent and combined effects on mortality in a sample of French old people.
  
  
  METHODS
  This is a cross-sectional population study of people aged 70 years and over. A total of 2350 respondents were interviewed at home in 2008-2010. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility, in the absence of difficulties in basic activities of daily living. Mortality data were documented after a mean follow-up period of 2.6 years.
  
  
  RESULTS
  Mean age of the population was 83.3 +/- 7.5 years, with 59.4% of women. Prevalence of frailty was 17.0%. Polypharmacy (5-9 drugs) was reported in 53.6% of the population, and excessive polypharmacy (10 drugs or more) in 13.8%. After adjustment for socio-demographic and health variables, polypharmacy and excessive polypharmacy were associated with frailty with odds ratio 1.77 [1.20-2.61] and 4.47 [2.37-8.42], respectively. Frailty (hazard ratio [HR] 2.56 [1.63-4.04]) and excessive polypharmacy (HR 1.83 [1.28-2.62]) were independent predictors of mortality. Compared with non-frail people without polypharmacy, frail people with excessive polypharmacy were six times more likely to die during the follow-up period (HR 6.30 [3.09-12.84]).
  
  
  CONCLUSIONS
  By showing the independent and combined effects of polypharmacy and frailty on mortality risk, this study should reinforce the awareness of clinicians with regard to these factors, rather prevalent in old people.
authors: INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, U1168, Villejuif, France.|UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.
authors: Marie
authors: M
authors: Herr
authors: INSERM U988 et U1198, EPHE, Paris & Montpellier, France.
authors: Jean-Marie
authors: JM
authors: Robine
authors: INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, U1168, Villejuif, France.|UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.
authors: Juliette
authors: J
authors: Pinot
authors: AG2R La Mondiale, Direction des Etudes, Prévoyance Individuelle et IARD, Paris, France.
authors: Jean-Jacques
authors: JJ
authors: Arvieu
authors: INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, U1168, Villejuif, France.|UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France.
authors: Joël
authors: J
authors: Ankri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D019338:Polypharmacy; D015995:Prevalence
keywords: aged; drugs; frailty; pharmacoepidemiology; polypharmacy; survival