title: Potentially inappropriate medications: predictor for mortality in a cohort of community-dwelling older adults.
abstract: OBJECTIVE
  The objective of this study was to investigate whether the potentially inappropriate medication (PIM) use is a predictor for mortality in a community-based population of older adults.
  
  
  METHODS
  A cohort study was performed between January 1, 1997, and December 31, 2011, based on data from a representative sample of the population aged 60 years or older living in Bambuí, Brazil. Univariate and multivariate analyses of the association between the variable of interest (use of PIM or pharmacological groups of PIM) and mortality were based on the extended Cox model for proportional hazards. The extended model was adopted to include the measurement of the exposure of interest throughout the follow-up period and not only at baseline. Adjustment variables included sociodemographic characteristics, health status, and use of health care services and medications. A level of significance of 5% was adopted for all analyses.
  
  
  RESULTS
  The prevalence of PIM use was 56.0% (95%CI 53.4-58.6). After multiple adjustments, the risk of death among users of at least one PIM was 44% higher (HR = 1.44; 95%CI 1.21 to 1.71) than among those who did not use any PIM. Among the PIM groups analyzed, antipsychotics were the most strongly associated with mortality (HR = 2.33; 95%CI 1.72 to 3.17).
  
  
  CONCLUSIONS
  The study revealed a high prevalence of PIM use among the community-based aged population. It also identified PIM use as a predictor for mortality in this group of individuals. This indicates the need for selection of safer drug therapy alternatives in this patient group.
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil. marianamgn@yahoo.com.br.|Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, 31275-060, Brazil. marianamgn@yahoo.com.br.
authors.forename: Mariana Martins Gonzaga
authors.initials: MM
authors.lastname: do Nascimento
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil.
authors.forename: Juliana Vaz de Melo
authors.initials: JV
authors.lastname: Mambrini
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil.
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lima-Costa
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil.
authors.forename: Josélia Oliveira Araújo
authors.initials: JO
authors.lastname: Firmo
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil.
authors.forename: Sérgio William Viana
authors.initials: SW
authors.lastname: Peixoto
authors.affiliation: Center for Studies on Aging and Public Health (NESPE), René Rachou Research Center (CPqRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil.|Department of Applied Nursing, Nursing School, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
authors.forename: Antônio Ignácio
authors.initials: AI
authors.lastname: de Loyola Filho
mesh_terms: D000368:Aged; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067561:Potentially Inappropriate Medication List
keywords: Aged; Beers criteria; Cohort studies; Inappropriate prescribing; Mortality; Potentially inappropriate medication