Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population
Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population
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DOI：
10.1002/pds.2116
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发表时间：
2011-05-01
影响因子：
2.6
通讯作者：
Hartikainen, Sirpa
中科院分区：
文献类型：
--
作者：
Jyrkka, Johanna;Enlund, Hannes;Hartikainen, Sirpa
目的探讨复方药物与老年人营养状况、功能和认知能力的关系。方法：这是一项前瞻性队列研究，来自以人群为基础的老年医学多学科策略（GeMS）研究的294名幸存者，2004年至2007年每年随访一次。参与者是芬兰库奥皮奥的公民，基线年龄为75岁及以上。多药状态分为非多药（0-5种药物）、多药（6-9种药物）和过度多药（10+种药物）。采用线性混合模型方法分析多药治疗对短形式微量营养评估（MNA-SF）、日常生活工具活动（IADL）和微量精神状态检查（MMSE）评分的影响。结果与非多药组相比，过量多药组营养状况（p = 0.001）、功能能力（p < 0.001）和认知能力（p < 0.001）下降。年龄、机构生活、自我报告的健康状况不佳和测量时间也与三项结果测量有关。在过量多药组中，营养不良或有营养不良风险的比例从31%增加到50%，日常工作有困难的比例从48%增加到74%，认知功能受损的比例从36%增加到54%。混合模型分析显示，多药状态不能预测MNA-SF、IADL和MMSE评分在三年时间内的进展。结论过量服用多种药物与老年人营养状况、功能和认知能力下降有关。然而，在三年的时间里，营养、身体功能和认知的变化不能通过多药状态来预测。版权所有：John Wiley & Sons， Ltd。
Purpose To determine the association of polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons.Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-polypharmacy (0-5 drugs), polypharmacy (6-9 drugs) and excessive polypharmacy (10+drugs). A linear mixed model approach was used for analysis the impact of polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores.Results Excessive polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the followup. The mixed model analysis revealed that polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time.Conclusions Excessive polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by polypharmacy status. Copyright (C) 2011 John Wiley & Sons, Ltd.