The relationship between number of medications and weight loss or impaired balance in older adults
The relationship between number of medications and weight loss or impaired balance in older adults
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DOI：
10.1111/j.1532-5415.2004.52467.x
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发表时间：
2004-10-01
影响因子：
6.3
通讯作者：
Tinetti, ME
中科院分区：
文献类型：
--
作者：
Agostini, JV;Han, L;Tinetti, ME
目的：检验累积药物暴露与两种常见的药物不良反应表现：体重减轻和平衡受损的风险之间的关系。设计：横断面和纵向队列。设置：康涅狄格州城市社区。参与者：885名72岁及以上的社区居民。测量：体重减轻(大于或等于10磅)和平衡，由四种平衡测量组成。结果：参与者服用2.2%+/-1.9%药物的平均+/-标准差(范围0-15)。在调整了年龄、抑郁症状、认知障碍、视力和听力障碍、慢性病数量和前一年住院次数后，服用一到两种药物的调整后的减肥优势比(OR)为1.48(95%可信区间=0.85-2.59)，服用三到四种药物的调整后的减肥优势比(OR)为1.96(95%CI=1.08-3.54)，服用五种或五种以上药物的调整后的OR为2.78(95%CI=1.38-5.60)。平衡受损的调整OR值分别为1.44(95%CI=0.94~2.19)、1.72(95%CI=1.09~2.71)和1.80(95%CI=1.02~3.19)。临床医生应该考虑整体药物使用的不良影响，而不仅仅是个别药物对特定疾病的益处或风险。
Objectives: To examine the relationship between cumulative medication exposure and risk of two common manifestations of adverse drug effects: weight loss and impaired balance.Design: Cross-sectional and longitudinal cohort.Setting: Urban Connecticut community.Participants: Eight hundred eighty-five community-dwelling residents aged 72 and older.Measurements: Weight loss (greater than or equal to10 pounds) and balance, a composite of four balance measures.Results: Participants took a mean+/-standard deviation of 2.2+/-1.9 medications (range 0-15). After adjustment for age, depressive symptoms, cognitive impairment, vision and hearing impairments, number of chronic diseases, and number of hospitalizations in the previous year, the adjusted odds ratio (OR) for weight loss was 1.48 (95% confidence interval (CI)=0.85-2.59) for those taking one to two medications, 1.96 (95% CI=1.08-3.54) for three to four medications, and 2.78 (95% CI=1.38-5.60) for five or more medications. For impaired balance, adjusted ORs were 1.44 (95% CI=0.94-2.19), 1.72 (95% CI=1.09-2.71), and 1.80 (95% CI=1.02-3.19), respectively.Conclusion: A greater number of medications were associated with increased risk of adverse drug outcomes, after extensive adjustment for chronic illness. Clinicians should consider the adverse effects of total drug use and not merely the benefits or risks of individual medications for specific diseases.