Association between polypharmacy and dementia – A systematic review and metaanalysis

Leelakanok, Nattawut; D’Cunha, Ronilda

doi:10.1080/13607863.2018.1468411

Cited by 53 publications

(40 citation statements)

References 69 publications

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“…Epidemiological study has indicated that approximately half of the elderly adult population is subjected to polypharmacy 5 . Polypharmacy is a critical problem for elderly adults because it decreases medication adherence, 6 and increases both healthcare costs and the risk of adverse drug events, such as falls and fractures, 7 cognitive decline, 8 drug‐induced parkinsonism 9 and potentially inappropriate medicines (PIMs) 10 . Some medications cause side effects that appear to be symptoms of poor oral health, such as dry mouth, 11 oral ulcers 12 and taste disorders 13 .…”

Section: Introductionmentioning

confidence: 99%

Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward

Nakamura

Kitagaki

Ueda

et al. 2020

Geriatrics Gerontology Int

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AimThe oral health status of elderly adults has implications for general health problems. Polypharmacy for elderly adults is associated with an increased risk of potentially inappropriate medicines and many adverse drug events; however, no report has shown that polypharmacy itself is associated with complex oral problems. This study aimed to determine the association between polypharmacy and oral health status in patients admitted to the recovery and rehabilitation ward.MethodsThis cross‐sectional study included 471 patients (age: 81.9 ± 7.7 years, women: n = 346). Oral health status was measured using the Oral Health Assessment Tool and poor oral health status was defined as a score of ≥3. Cases of patients taking six or more medications were defined as polypharmacy. Logistic regression analysis was performed to examine the relationship between polypharmacy and oral health status. Age, sex, body mass index, number of comorbidities, cognitive and motor functions, and potentially inappropriate medicines were set as confounding factors.ResultsUsing the Oral Health Assessment Tool, 51.0% (n = 240) of patients scored ≥3. The prevalence of patients with polypharmacy was 56.9% (n = 268). Polypharmacy was significantly associated with poor oral health status (odds ratio = 1.65, 95% confidence interval = 1.14–2.39, P = 0.007; adjusted odds ratio = 1.65, 95% confidence interval = 1.12–2.43, P = 0.011).ConclusionsThis study showed that polypharmacy was associated with poor oral health status. Focusing on the number of medications may be helpful in detecting oral problems. Geriatr Gerontol Int 2021; 21: 66–70.

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Section: Introductionmentioning

confidence: 99%

Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward

Nakamura

Kitagaki

Ueda

et al. 2020

Geriatrics Gerontology Int

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“…These studies have revealed various complications due to polypharmacy, such as adverse drug events, 4,5 falls 7,11 and increased mortality. 12,13 However, to our knowledge, few studies have predicted the length of hospitalization using patient characteristics and medical history. In the current study, polypharmacy at admission was identified as a predictor of prolonged hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy at admission prolongs length of hospitalization in gastrointestinal surgery patients

Abe

Kakamu

Kumagai

et al. 2020

Geriatrics Gerontology Int

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Aim: Polypharmacy in elderly people is a social issue and has been reported to cause not only drug adverse events, but also falls, dysfunction and cognitive decline. Those events may trigger prolonged length of hospitalization. Therefore, the aim of this study was to investigate whether polypharmacy has a prolonging effect on hospitalization. Methods: The study subjects were 584 patients in a university hospital in Japan who had been admitted for hepatectomy, pancreaticoduodenectomy, gastrectomy or colectomy, and to whom clinical pathways had been applied. In this study, polypharmacy was defined as taking five or more regular oral medications, and prolonged hospitalization was defined as hospitalization longer than that determined by the clinical pathway. Multiple logistic regression analysis was performed to investigate whether polypharmacy affects the length of hospitalization. Results: The subjects were 348 males and 236 females, mean ± SD age of 65.8 ± 12.9 years. Among all subjects, 228 (39.0%) were receiving polypharmacy at admission, and the number of patients with prolonged hospitalization was 262 (44.9%). Multiple logistic regression analysis revealed that the following variables were significantly associated with prolonged hospitalization; polypharmacy (odds ratio = 1.532; 95% confidence interval = 1.010-2.327), age 50-59; 2.971 (1.216-7.7758), age 60-69; 2.405 (1.059-5.909), organ pancreas; 0.298 (0.122-0.708), operation time ≥386 min; 2.050 (1.233-3.432), intraoperative bleeding volume ≥401 mL; 2.440 (1.489-4.038), postoperative delirium; 2.395 (1.240-4.734), postoperative infection; 10.715 (4.270-33.059). Conclusion: The current study revealed that polypharmacy at admission was an independent factor for prolonged hospitalization. In future, measures against polypharmacy are required, collaborating with outpatient clinics, family doctors and dispensing pharmacies.

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“…Although we are not aware of any studies that have identified an association between polypharmacy and AD severity, there have been some recent studies showing that polypharmacy is a risk factor for dementia. 33,34 Other studies have also correlated polypharmacy with prescription of PIMs 1 and occurrence of PIIs. 3 Presence of these factors is associated with increased mortality among elderly people.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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BACKGROUND: Improving knowledge and establishing strategies and policies for better patient safety are worldwide priorities. OBJECTIVE: To evaluate drug safety among elderly people with Alzheimer's disease (AD). DESIGN AND SETTING: Cross-sectional study among elderly people within the National AD Assistance Protocol (PCDTDA/MS) who were living in the municipality of Araraquara, Brazil, in 2017. METHODS: Through interviews conducted with relatives/caregivers of elderly people with diagnoses of AD, the following variables were evaluated: comorbidities, drug therapy used, use of potentially inappropriate medications for the elderly (PIMs), presence of potentially inappropriate interactions (PIIs) and medication regimen complexity index. Factors associated with AD severity were also evaluated. Multivariate and simple logistic regressions were applied. RESULTS: 143 elderly people enrolled in PCDTDA/MS were analyzed. The majority were women (67.1%); assisted only through the public healthcare system (75.5%); polymedicated (57.4%); using at least one PIM (63.6%); presenting at least one PII (63.6%); and under drug therapy of low to medium complexity (92.2%). No semi-annual monitoring of the effectiveness of PCDTDA/MS drugs was identified. The proportion using AD drug therapy at daily doses differing from those recommended by the World Health Organization was 75.6%. However, these doses were not associated with drug risk. CONCLUSION: The data from this study raise the hypothesis that use of polypharmacy might show a correlation with severity of AD. The drug safety risk may be associated with comorbidities of the metabolic syndrome, anxiety and off-label use of PIMs, such as risperidone and quetiapine, and benzodiazepines (i.e. clonazepam and flunitrazepam). Risk factors associated with drug therapy among elderly people with Alzheimer's disease: a cross-sectional study | ORIGINAL ARTICLE

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Association between polypharmacy and dementia – A systematic review and metaanalysis

Cited by 53 publications

References 69 publications

Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward

Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward

Polypharmacy at admission prolongs length of hospitalization in gastrointestinal surgery patients

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

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