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 language | English |
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Pages (from-to) | 251-257 |
Number of pages | 7 |
Journal | International Journal of Clinical Pharmacy |
Volume | 41 |
Issue number | 1 |
Early online date | 29 Nov 2018 |
DOIs | |
Publication status | Published - Feb 2019 |
Bibliographical note
Open via Springer Compact AgreementAcknowledgements
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.
Keywords
- Cognitive impairment
- Emotional impairment
- Observational cohort study
- Older adults
- Physical impairment
- Polypharmacy
- United Kingdom
- RISK
- FRAILTY
- PREVALENCE
- IMPACT
- FRAMEWORK
- HEALTH