Polypharmacy, chronic diseases and nutritional markers in community-dwelling older

Abstract

Polypharmacy is a common practice among the elderly, but few studies have evaluated its association with nutritional markers. The aim of this study was to estimate the prevalence of polypharmacy and its association with nutritional markers, chronic diseases, sociodemographic and health variables. This research is part of the Study Elderly/Goiânia, which evaluated 418 elderly community in a cross-sectional design. Polypharmacy was defined as the use of five or more concomitant medications. The following nutritional markers were investigated: BMI, waist circumference, percentage body fat, weight gain and loss, use of diet, daily consumption of fruits, vegetables, skimmed and whole milk. Multivariate analysis was performed using hierarchical Poisson regression, with significance level set at 5%. The prevalence of polypharmacy was 28% (95%CI 23.1 -32.5), with a significant association with feminine gender, age range 75 -79 years, eutrophic nutritional status and obesity, use of diet, poor self-rated health and presence of two, three or more chronic diseases. The high prevalence of polypharmacy and its association with nutritional markers and chronic diseases call the attention for the need of nutritional surveillance and monitoring in the elderly.

Polifarmácia em idosos: um estudo de base populacional

“…The analysis between polypharmacy and sociodemographic characteristics revealed a connection with the female sex 7,8,[14][15][16][17] and the age of 80 years old or older 15,17 . Regardless of the socioeconomic variables, studies found a higher prevalence of polypharmacy in the female sex 7,[14][15][16]23,26,27 ; the potential explanations for this are: women have higher life expectancy in relation to men, and thus deal with chronic processes for a longer period of time; women are more affected by non-fatal health problems and are more aware of their health, reporting more signs and symptoms to health professionals, often resulting in prescriptions 24,25 ; women are responsible for the family and, therefore, are more familiarized with medication and better cared for by public health policies, being subject to medicalization [25][26][27] , corroborating the results from this study. As for the association between polypharmacy and age, the most accepted hypotheses are that it can be associated with the increase in the number/ severity of diseases among the elderly, as well as the wider use of health services by this age group, rather than due to aging.…”

Perfil de idosos submetidos à avaliação geriátrica ampla em serviço de reabilitação

“…As conclusões divergentes sugerem que a polifarmácia tem características regionais (31,32) . O perfil farmaco-epidemiológico da presente pesquisa indica a necessidade de desenvolver práticas de cuidados de saúde para garantir a segurança do paciente, sendo ainda importante considerar o baixo nível educacional dos idosos brasileiros uma vez que este é um dos fatores que interferem na adesão a um tratamento farmacológico, no uso de medicamentos impróprios e na polifarmácia (33) . A prevalência de baixo peso do presente estudo é de 3,1%, sem diferença significativa entre os sexos.…”

Association of Bone Mineral Density with Frailty, Pre-Frailty, and Osteoporosis in Community-Dwelling Elderly: A Prospective Study

“…A cohort study is presented herein, which integrates the Elderly Project/Goiânia [15][16][17] that analyzed several aspects of health conditions of the elderly in community-dwelling settings. The initial sample was constituted of 418 elderly, selected by probabilistic sampling carried out in multiple stages, proportional to the health districts of Goiânia (Midwest Brazil).…”

“…The methodological details on sample calculation and sampling are described in previous publications [15,16].…”