Polypharmacy in a Belgian cohort of community-dwelling oldest old (80+)
Polypharmacy in a Belgian cohort of community-dwelling oldest old (80+)
复制标题
比利时社区最年长老年人群（80 岁）的多重用药
作者：
Maarten Wauters;M. Elseviers;B. Vaes;J. Degryse;O. Dalleur;R. Vander Stichele;L. V. Van Bortel;M. Azermai
摘要目的：多种药物在老年人（65岁以上）中非常普遍，但对最年长的老年人（80岁以上）的药物使用知之甚少。本研究探讨了药物使用的比利时社区居住的最古老的老人在其人口统计学，临床和功能特征。研究方法：基线数据来自BELFRAIL研究;一项前瞻性、观察性、基于人群的比利时社区居民患者队列（80+）。全科医生记录临床问题和药物。根据解剖学治疗化学分类对药物进行编码。结果：参与者（n = 503）的平均年龄为84.4岁（范围80-102），61.2%为女性。中位慢性药物使用为5（范围0-16）。多药（≥5种药物）比例较高（57.7%），过度多药（≥10种药物）比例为9.1%。最常用的药物组是抗血栓药，但也经常服用苯二氮卓类和抗抑郁药。与多种药物相关的人口统计学（单变量分析）为女性、低教育程度和中度饮酒。年龄、护理依赖和认知障碍与多种药物治疗无关。在多变量分析中，发现与多种药物治疗的主要相关性为多吗啡（OR 1.78，95%CI 1.5-2.1），其次是抑郁（OR 3.7，95%CI 4.4-9.7）和体力活动（OR 0.8，95%CI 0.7-0.9）。结论：比利时社区居住的最年长的老人（80岁以上）中，多种药物的比例很高。多药治疗的决定因素是相互关联的，但多药治疗占主导地位。在多重抑郁症的负担之上，多种药物治疗与较少的体力活动和抑郁症状独立相关。
Abstract Objectives: 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.
DOI：
10.1016/j.jamda.2013.03.013
发表时间：
2013-10
影响因子：
7.6
作者：
Morandi A;Bellelli G;Vasilevskis EE;Turco R;Guerini F;Torpilliesi T;Speciale S;Emiliani V;Gentile S;Schnelle J;Trabucchi M
通讯作者：
Trabucchi M
DOI：
10.1001/jama.1993.03500180078038
发表时间：
1993-05
期刊：
JAMA
影响因子：
--
作者：
R. Crum;J. Anthony;S. Bassett;M. Folstein
通讯作者：
R. Crum;J. Anthony;S. Bassett;M. Folstein