Risk factors associated with drug therapy among elderly people with Alzheimer’s disease: a cross-sectional study

Forgerini, Marcela; Herdeiro, María Teresa; Galduróz, José Carlos Fernandes; Mastroianni, Patrícia de Carvalho

doi:10.1590/1516-3180.2019.0461.r2.19022020

Cited by 8 publications

(8 citation statements)

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“…Therefore, in the scope of patient safety, the most effective strategy is the monitoring and control of comorbidities considered to be risk factors to COVID-19 infection (7). Nevertheless, adequate management of comorbidities can be impaired in the elderly due to the aging process and the presence of multimorbidity (11) and polymedication (12), which may favor the prescription of potentially inappropriate medications (13), the occurrence of drug interactions (14), and adherence issues (15).…”

Section: Introductionmentioning

confidence: 99%

Drug interactions for elderly with respiratory disorders and times of COVID-19: a systematic scoping review

Forgerini

Schiavo

Lucchetta

et al. 2020

Vitae

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Background: The elderly people have high morbimortality associated with respiratory disorders, in addition to the presence of other safety risk factors, such as the use of potentially inappropriate medication and the occurrence of drug interactions. Objective: Considering the current pandemic scenario, it was intended to identify explicit criteria-based tools that reported drug interactions between potentially inappropriate medication and respiratory system disorders and possibly worse prognosis of COVID-19 infection. Methods: A systematic scoping review was conducted until February 2020. Study characteristics of explicit criteria-based tools, and potentially inappropriate medication, drug interactions, and therapeutic management, were extracted. Results: Nineteen explicit criteria-based tools were included. Nineteen drug interactions and 17 potentially inappropriate medications with concerns for three respiratory disorders (asthma, chronic pulmonary obstructive disease, and respiratory failure) were identified. The most frequent pharmacological classes reported were benzodiazepines and beta-blockers. For clinical management, the tools recommend using cardioselective beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II type I receptor blockers, and benzodiazepines with a short or intermediate half-life. Conclusion: Considering the increased risk of COVID-19 infection in the elderly, drug interactions and the use of potentially inappropriate medication associated with the occurrence of adverse drug events in the respiratory system may also worsening COVID-19 infection in patients with uncontrolled respiratory disorders. Thus, it is essential to assess drug therapy in use, to identify safety risks, and monitor the elderly in general and those with a worse prognosis concerning COVID-19, promoting patient safety.

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Section: Introductionmentioning

confidence: 99%

Drug interactions for elderly with respiratory disorders and times of COVID-19: a systematic scoping review

Forgerini

Schiavo

Lucchetta

et al. 2020

Vitae

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“…This physical-cognitive deterioration produced by the high intake of medication could expose older people to a greater extent to Alzheimer's disease in the future. Moreover, one study hypothesized that polypharmacy could be related to the severity of Alzheimer's [48], but not to Alzheimer's onset. Therefore, to the best of our knowledge, our study results suggest that high daily drug intake may be a novel risk factor for the onset of AD.…”

Section: Discussionmentioning

confidence: 99%

Falls and Sleep Disorders in Spanish Alzheimer’s Disease in Nursing Homes: An Observational Study

Cámara-Calmaestra,

Martínez-Amat,

Aibar-Almazán

et al. 2023

Healthcare

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Objective: The main objective of this study was to establish a relationship between the number of falls and sleep problems experienced by patients with Alzheimer’s disease. Materials and Methods: This was a cross-sectional study. A total of 114 Spanish aged people with Alzheimer’s disease institutionalized in nursing homes and 80 independent Spanish aged people without neurodegenerative diseases living at home were enrolled in this study and completed in-person interviews and digital questionnaires. Results: The mean age was 78.98 ± 8.59 years. Sleep disorders were related to continuous stress (p = 0.001; OR = 4.729) and a high frequency of falls (p = 0.001; OR = 2.145), while predictor variables associated with falls in patients with Alzheimer’s disease were continuous medical visits (β = 0.319, p < 0.001), family history of dementia (β = 0.212; p = 0.014), and sleep disorders (β = 0.235; p = 0.007). Second, the analysis showed that moderate physical activity (p = 0.001; OR = 0.147), continuous medical visits (p < 0.001; OR = 0.621), and high level of study (p = 0.011; OR = 0.334) were protective factors against Alzheimer’s, while older age (p = 0.035; OR = 1.087), type II Diabetes Mellitus (p = 0.042; OR = 3.973), number of falls (p = 0.021; OR = 1.409), and daily drug intake (p = 0.001; OR = 1.437) were risk factors for Alzheimer’s. Conclusions: Sleep disturbances are related to stress and falls in a sample of 114 Spanish AD aged people institutionalized in nursing homes, and the falls they experience are related to ongoing medical visits, a history of dementia, and sleep disturbances. Therefore, a bidirectional relationship was established between falls and sleep disorders in these patients. Moreover, this study showed that a greater frequency of falls and high daily drug intake could constitute novel risk factors for Alzheimer’s disease, in addition to already known factors, such as age and type II Diabetes Mellitus, while being physically active and a high level of studies are protective factors against Alzheimer’s disease.

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“…Of all included studies, 53 studies reported the prevalence of PIM (Zuckerman et al, 2005;Raivio et al, 2006;Holmes et al, 2008; Frontiers in Pharmacology frontiersin.org Frontiers in Pharmacology frontiersin.org conducted in South America (Forgerini et al, 2020;Ferreira et al, 2021), and the rest of the studies conducted in Oceania (Somers et al, 2010;Bosboom et al, 2012;Cross et al, 2016;Bala et al, 2019;Eshetie et al, 2019b;Brimelow et al, 2019;Eshetie et al, 2020;Eshetie et al, 2020;Ruangritchankul et al, 2020;Thapaliya et al, 2021) (n = 10), North America (Zuckerman et al, 2005;Holmes et al, 2008;Chan et al, 2009;Lau et al, 2010;Tjia et al, 2010;Lau et al, 2011;Thorpe et al, 2012;Koyama et al, 2013;Tjia et al, 2014;Hanlon et al, 2015;Ramsey et al, 2017;Growdon et al, 2021;Vickers et al, 2021;Bae-Shaaw et al, 2023;Ryskina et al, 2023) (n = 15), and Asia (Chuang et al, 2017;Nguyen et al, 2018;Chao et al, 2022;Yoon et al, 2022;Zhao et al, 2022) (n = 5). Table 1 presents the characteristics of the included studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Clague et al, 2017;Kanagaratnam et al, 2017;Oesterhus et al, 2017;Kristensen et al, 2018;Nguyen et al, 2018;Kristensen et al, 2019;Soysal et al, 2019;Forgerini et al, 2020;Rausch and Hoffmann, 2020;Ruangritchankul et al, 2020;Ferreira et al, 2021;Gareri et al, 2021;Growdon et al, 2021;Jaramillo-Hidalgo et al, 2021;Thapaliya et al, 2021;Vickers et al, 2021;Chao et al, 2022;Delgado et al, 2022;Riedl et al, 2022;Zhao et al, 2022). The sample size ranged from 34 to 259,291, comprising a total of 658,431 study subjects.…”

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confidence: 99%

Global prevalence of polypharmacy and potentially inappropriate medication in older patients with dementia: a systematic review and meta-analysis

Zhao,

Chen,

et al. 2023

Front. Pharmacol.

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Background: Older patients with dementia always need multiple drugs due to comorbidities and cognitive impairment, further complicating drug treatment and increasing the risk of potentially inappropriate medication. The objective of our study is to estimate the global prevalence of polypharmacy and potentially inappropriate medication (PIM) and explore the factors of PIM for older patients with dementia.Methods: We searched PubMed, Embase (Ovid), and Web of Science databases to identify eligible studies from inception to 16 June 2023. We conducted a meta-analysis for observational studies reporting the prevalence of potentially inappropriate medication and polypharmacy in older patients with dementia using a random-effect model. The factors associated with PIM were meta-analyzed.Results: Overall, 62 eligible studies were included, of which 53 studies reported the prevalence of PIM and 28 studies reported the prevalence of polypharmacy. The pooled estimate of PIM and polypharmacy was 43% (95% CI 38–48) and 62% (95% CI 52–71), respectively. Sixteen studies referred to factors associated with PIM use, and 15 factors were further pooled. Polypharmacy (2.83, 95% CI 1.80–4.44), diabetes (1.31, 95% CI 1.04–1.65), heart failure (1.17, 95% CI 1.00–1.37), depression (1.45, 95% CI 1.14–1.88), history of cancer (1.20, 95% CI 1.09–1.32), hypertension (1.46, 95% CI 1.05–2.03), ischemic heart disease (1.55, 95% CI 0.77–3.12), any cardiovascular disease (1.11, 95% CI 1.06–1.17), vascular dementia (1.09, 95% CI 1.03–1.16), chronic obstructive pulmonary disease (1.39, 95% CI 1.13–1.72), and psychosis (1.91, 95% CI 1.04–3.53) are positively associated with PIM use.Conclusion: PIM and polypharmacy were highly prevalent in older patients with dementia. Among different regions, the pooled estimate of PIM use and polypharmacy varied widely. Increasing PIM in older patients with dementia was closely associated with polypharmacy. For other comorbidities such as heart failure and diabetes, prescribing should be cautioned.

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Risk factors associated with drug therapy among elderly people with Alzheimer’s disease: a cross-sectional study

Cited by 8 publications

References 51 publications

Drug interactions for elderly with respiratory disorders and times of COVID-19: a systematic scoping review

Drug interactions for elderly with respiratory disorders and times of COVID-19: a systematic scoping review

Falls and Sleep Disorders in Spanish Alzheimer’s Disease in Nursing Homes: An Observational Study

Global prevalence of polypharmacy and potentially inappropriate medication in older patients with dementia: a systematic review and meta-analysis

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