Polypharmacy in a Belgian cohort of community-dwelling oldest old (80+).
OBJECTIVE
Polypharmacy is highly prevalent among older people (65+), but little is known on the medication use of the oldest old (80+). This study explores the medication use of the Belgian community-dwelling oldest old in relation to their demographic, clinical and functional characteristics.


METHODS
Baseline data was used from the BELFRAIL study; a prospective, observational population-based cohort of Belgian community-dwelling patients (80+). General practitioners recorded clinical problems and medications. Medications were coded by the Anatomic Therapeutic Chemical classification.


RESULTS
Participants' (n = 503) mean age was 84.4 years (range 80-102) and 61.2% was female. Median chronic medication use was 5 (range 0-16). Polypharmacy (≥5 medications) was high (57.7%), with excessive polypharmacy (≥10 medications) in 9.1%. Most commonly used medication group were antithrombotics, but also benzodiazepines and antidepressants were frequently consumed. Demographics related to polypharmacy (univariate analysis) were female gender, low education and moderate alcohol use. Age, care dependency and cognitive impairment showed no association with polypharmacy. In multivariate analysis, the predominant association with polypharmacy was found for multimorbidity (OR 1.78, 95% CI 1.5-2.1), followed by depression (OR 3.7, 95% CI 4.4-9.7) and physical activity (OR 0.8, 95% CI 0.7-0.9).


CONCLUSIONS
Polypharmacy was high among Belgian community-dwelling oldest old (80+). Determinants of polypharmacy were interrelated, but dominated by multimorbidity. On top of the burden of multimorbidity, polypharmacy was independently associated with less physical activity, and with depressive symptoms.
a Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology , Ghent University , Ghent , Belgium.
Maarten
M
Wauters
a Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology , Ghent University , Ghent , Belgium.
Monique
M
Elseviers
b Louvain Drug Research Institute , Université catholique de Louvain, Cliniques universitaires Saint-luc , Brussels , Belgium.|c Department of Public and Primary Health Care , Catholic University of Leuven , Leuven , Belgium.
Bert
B
Vaes
b Louvain Drug Research Institute , Université catholique de Louvain, Cliniques universitaires Saint-luc , Brussels , Belgium.|c Department of Public and Primary Health Care , Catholic University of Leuven , Leuven , Belgium.
Jan
J
Degryse
b Louvain Drug Research Institute , Université catholique de Louvain, Cliniques universitaires Saint-luc , Brussels , Belgium.
Olivia
O
Dalleur
a Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology , Ghent University , Ghent , Belgium.
Robert
R
Vander Stichele
a Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology , Ghent University , Ghent , Belgium.
Luc
L
Van Bortel
a Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology , Ghent University , Ghent , Belgium.
Majda
M
Azermai
D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019338:Polypharmacy; D011446:Prospective Studies
Drug utilisation; aged, 80 and over; comorbidity; polypharmacy; primary health care