High-Risk Prescribing and Incidence of Frailty Among Older Community-Dwelling Men
High-Risk Prescribing and Incidence of Frailty Among Older Community-Dwelling Men
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DOI：
10.1038/clpt.2011.258
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发表时间：
2012-03-01
影响因子：
6.7
通讯作者：
Le Couteur, D. G.
中科院分区：
文献类型：
--
作者：
Gnjidic, D.;Hilmer, S. N.;Le Couteur, D. G.
关于高风险药物治疗与老年人虚弱之间的关联的证据有限。我们在1,662名≥ 70岁的男性中调查了高风险处方与基线虚弱以及2年事件虚弱之间的关系。高风险处方被定义为多种药物（>= 5种药物），超多种药物（>= 10种药物），并通过药物负担指数（DBI），抗胆碱能和镇静药物的剂量标准化措施。在基线时，与健康受试者相比，体弱受试者的多种药物治疗的校正比值比（OR）为2.55（95%置信区间，CI：1.69-3.84），过度多种药物治疗的OR为5.80（95% CI：2.90-11.61），DBI暴露的OR为2.33（95% CI：1.58-3.45）。在1,242名基线时健壮的男性中，6.2%在两年内发展为虚弱。多种药物治疗组、过度多种药物治疗组和DBI暴露组的脆弱事件校正OR分别为2.45（95% CI：1.42-4.23）、2.50（95% CI：0.76-8.26）和2.14（95% CI：1.25-3.64）。高风险处方可能会导致社区居住的老年男性虚弱。
Evidence about the association between treatment with high-risk medicines and frailty in older individuals is limited. We investigated the relationship between high-risk prescribing and frailty at baseline, as well as 2-year incident frailty, in 1,662 men >= 70 years of age. High-risk prescribing was defined as polypharmacy (>= 5 medicines), hyperpolypharmacy (>= 10 medicines), and by the Drug Burden Index (DBI), a dose-normalized measure of anticholinergic and sedative medicines. At baseline, frail participants had adjusted odds ratios (ORs) of 2.55 (95% confidence interval, Cl: 1.69-3.84) for polypharmacy, 5.80 (95% Cl: 2.90-11.61) for hyperpolypharmacy, and 2.33 (95% Cl: 1.58-3.45) for DBI exposure, as compared with robust participants. Of the 1,242 men who were robust at baseline, 6.2% developed frailty over two years. Adjusted ORs of incident frailty were 2.45 (95% Cl: 1.42-4.23) for polypharmacy, 2.50 (95% Cl: 0.76-8.26) for hyperpolypharmacy, and 2.14 (95% Cl: 1.25-3.64) for DBI exposure. High-risk prescribing may contribute to frailty in community-dwelling older men.