The association between polypharmacy and late life deficits in cognitive, physical and emotional capability

a cohort study

Mina Khezrian (Corresponding Author), Christopher J. McNeil, Phyo K. Myint, Alison D. Murray

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Abstract

Background Polypharmacy is a growing health concern for older adults and is associated with poorer clinical outcome. Objective This study aim is to investigate the association between polypharmacy and impairment in cognitive, physical and emotional capability controlling for the confounding effect of co-morbidities. Setting The Aberdeen 1936 Birth Cohort from 1999 to 2004. Method Recruited were 498 dementia free participants around 64 years old and recruited into wave one. Linear regression and structural equation models were used. Models were adjusted for the effect of age, gender, childhood IQ, education and Body Mass Index. A triad of impairment was defined as a composite measure of impairment in cognitive, physical and emotional function. Main outcome measure The relationships between polypharmacy, co-morbidity and triad of impairment. Results The prevalence of polypharmacy was 12.3% in this relatively healthy sample. Polypharmacy was significantly associated with increased impairment in cognitive, physical and emotional ability (β = 3.6, p = 0.003) after controlling for the effect of comorbidities and other confounding variables. As expected, higher childhood IQ and educational achievement had protective effects against impairment while higher comorbidity score and Body Mass Index were associated with increased impairment in this population. Conclusions The independent association of polypharmacy and reduced cognitive, physical and emotional capability makes this a promising target for predicting and potentially reducing the risk of impairment and associated healthcare costs in older adults. Longitudinal studies are required to investigate the underlying mechanisms for the observed relationships further.
Original languageEnglish
Pages (from-to)251-257
Number of pages7
JournalInternational Journal of Clinical Pharmacy
Volume41
Issue number1
Early online date29 Nov 2018
DOIs
Publication statusPublished - Feb 2019

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Polypharmacy
Cohort Studies
Linear regression
Education
Health
Comorbidity
Composite materials
Body Mass Index
Morbidity
Costs
Educational Status
Aptitude
Confounding Factors (Epidemiology)
Structural Models
Health Care Costs
Longitudinal Studies
Dementia
Linear Models
Outcome Assessment (Health Care)
Parturition

Keywords

  • Cognitive impairment
  • Emotional impairment
  • Observational cohort study
  • Older adults
  • Physical impairment
  • Polypharmacy
  • United Kingdom
  • RISK
  • FRAILTY
  • PREVALENCE
  • IMPACT
  • FRAMEWORK
  • HEALTH

Cite this

@article{87241dfc021c4a03966db272d358346f,
title = "The association between polypharmacy and late life deficits in cognitive, physical and emotional capability: a cohort study",
abstract = "Background Polypharmacy is a growing health concern for older adults and is associated with poorer clinical outcome. Objective This study aim is to investigate the association between polypharmacy and impairment in cognitive, physical and emotional capability controlling for the confounding effect of co-morbidities. Setting The Aberdeen 1936 Birth Cohort from 1999 to 2004. Method Recruited were 498 dementia free participants around 64 years old and recruited into wave one. Linear regression and structural equation models were used. Models were adjusted for the effect of age, gender, childhood IQ, education and Body Mass Index. A triad of impairment was defined as a composite measure of impairment in cognitive, physical and emotional function. Main outcome measure The relationships between polypharmacy, co-morbidity and triad of impairment. Results The prevalence of polypharmacy was 12.3{\%} in this relatively healthy sample. Polypharmacy was significantly associated with increased impairment in cognitive, physical and emotional ability (β = 3.6, p = 0.003) after controlling for the effect of comorbidities and other confounding variables. As expected, higher childhood IQ and educational achievement had protective effects against impairment while higher comorbidity score and Body Mass Index were associated with increased impairment in this population. Conclusions The independent association of polypharmacy and reduced cognitive, physical and emotional capability makes this a promising target for predicting and potentially reducing the risk of impairment and associated healthcare costs in older adults. Longitudinal studies are required to investigate the underlying mechanisms for the observed relationships further.",
keywords = "Cognitive impairment, Emotional impairment, Observational cohort study, Older adults, Physical impairment, Polypharmacy, United Kingdom, RISK, FRAILTY, PREVALENCE, IMPACT, FRAMEWORK, HEALTH",
author = "Mina Khezrian and McNeil, {Christopher J.} and Myint, {Phyo K.} and Murray, {Alison D.}",
note = "Open via Springer Compact Agreement Acknowledgements We thank the participants of the Aberdeen Birth Cohort of 1936. Funding ABC1936 was funded (1999–2009) by Biotechnology and Biological Sciences Research Council, Scottish Health Department, Wellcome Trust, Medical Research Council, Alzheimer Research UK, Alzheimer Society and University of Aberdeen Development Trust. This work was supported by the Roland Sutton Academic Trust, Morningfield Association and the Rabin Ezra Scholarship Trust, which provides salary cost and consumables to MK.",
year = "2019",
month = "2",
doi = "10.1007/s11096-018-0761-2",
language = "English",
volume = "41",
pages = "251--257",
journal = "International Journal of Clinical Pharmacy",
issn = "2210-7703",
publisher = "Springer Netherlands",
number = "1",

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TY - JOUR

T1 - The association between polypharmacy and late life deficits in cognitive, physical and emotional capability

T2 - a cohort study

AU - Khezrian, Mina

AU - McNeil, Christopher J.

AU - Myint, Phyo K.

AU - Murray, Alison D.

N1 - Open via Springer Compact Agreement Acknowledgements We thank the participants of the Aberdeen Birth Cohort of 1936. Funding ABC1936 was funded (1999–2009) by Biotechnology and Biological Sciences Research Council, Scottish Health Department, Wellcome Trust, Medical Research Council, Alzheimer Research UK, Alzheimer Society and University of Aberdeen Development Trust. This work was supported by the Roland Sutton Academic Trust, Morningfield Association and the Rabin Ezra Scholarship Trust, which provides salary cost and consumables to MK.

PY - 2019/2

Y1 - 2019/2

N2 - Background Polypharmacy is a growing health concern for older adults and is associated with poorer clinical outcome. Objective This study aim is to investigate the association between polypharmacy and impairment in cognitive, physical and emotional capability controlling for the confounding effect of co-morbidities. Setting The Aberdeen 1936 Birth Cohort from 1999 to 2004. Method Recruited were 498 dementia free participants around 64 years old and recruited into wave one. Linear regression and structural equation models were used. Models were adjusted for the effect of age, gender, childhood IQ, education and Body Mass Index. A triad of impairment was defined as a composite measure of impairment in cognitive, physical and emotional function. Main outcome measure The relationships between polypharmacy, co-morbidity and triad of impairment. Results The prevalence of polypharmacy was 12.3% in this relatively healthy sample. Polypharmacy was significantly associated with increased impairment in cognitive, physical and emotional ability (β = 3.6, p = 0.003) after controlling for the effect of comorbidities and other confounding variables. As expected, higher childhood IQ and educational achievement had protective effects against impairment while higher comorbidity score and Body Mass Index were associated with increased impairment in this population. Conclusions The independent association of polypharmacy and reduced cognitive, physical and emotional capability makes this a promising target for predicting and potentially reducing the risk of impairment and associated healthcare costs in older adults. Longitudinal studies are required to investigate the underlying mechanisms for the observed relationships further.

AB - Background Polypharmacy is a growing health concern for older adults and is associated with poorer clinical outcome. Objective This study aim is to investigate the association between polypharmacy and impairment in cognitive, physical and emotional capability controlling for the confounding effect of co-morbidities. Setting The Aberdeen 1936 Birth Cohort from 1999 to 2004. Method Recruited were 498 dementia free participants around 64 years old and recruited into wave one. Linear regression and structural equation models were used. Models were adjusted for the effect of age, gender, childhood IQ, education and Body Mass Index. A triad of impairment was defined as a composite measure of impairment in cognitive, physical and emotional function. Main outcome measure The relationships between polypharmacy, co-morbidity and triad of impairment. Results The prevalence of polypharmacy was 12.3% in this relatively healthy sample. Polypharmacy was significantly associated with increased impairment in cognitive, physical and emotional ability (β = 3.6, p = 0.003) after controlling for the effect of comorbidities and other confounding variables. As expected, higher childhood IQ and educational achievement had protective effects against impairment while higher comorbidity score and Body Mass Index were associated with increased impairment in this population. Conclusions The independent association of polypharmacy and reduced cognitive, physical and emotional capability makes this a promising target for predicting and potentially reducing the risk of impairment and associated healthcare costs in older adults. Longitudinal studies are required to investigate the underlying mechanisms for the observed relationships further.

KW - Cognitive impairment

KW - Emotional impairment

KW - Observational cohort study

KW - Older adults

KW - Physical impairment

KW - Polypharmacy

KW - United Kingdom

KW - RISK

KW - FRAILTY

KW - PREVALENCE

KW - IMPACT

KW - FRAMEWORK

KW - HEALTH

UR - http://www.mendeley.com/research/association-between-polypharmacy-late-life-deficits-cognitive-physical-emotional-capability-cohort-s

U2 - 10.1007/s11096-018-0761-2

DO - 10.1007/s11096-018-0761-2

M3 - Article

VL - 41

SP - 251

EP - 257

JO - International Journal of Clinical Pharmacy

JF - International Journal of Clinical Pharmacy

SN - 2210-7703

IS - 1

ER -