Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability

Cheng, Chih Ming; Chang, Wen Han; Chiu, Yu‐Chuan; Sun, Yu; Lee, Huey Jane; Tang, Li; Wang, Pei Ning; Chiu, Ming Jang; Yang, Cheng; Tsai, Shih Jen; Tsai, Chia Fen

doi:10.4088/jcp.17m12043

Cited by 26 publications

(18 citation statements)

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“…Previous studies have assessed the association between polypharmacy and dementia in community-dwelling older adults [2] and found that community-dwelling elderly people who met the criteria for polypharmacy had an average MMSE score that was 0.51 points below that of elderly people who did not meet the criteria for polypharmacy [11]; the difference in MMSE score was greater in our newly diagnosed PD cohort. We speculate that polypharmacy may exhibit a greater effect on the cognitive function of patients with newly diagnosed PD, compared to community-dwelling elderly people, for the following reasons.…”

Section: Discussionmentioning

confidence: 87%

Polypharmacy Associated with Cognitive Decline in Newly Diagnosed Parkinson’s Disease: A Cross-Sectional Study

Ishii

Mochizuki

Sakai

et al. 2019

Dement Geriatr Cogn Disord Extra

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Aims: Polypharmacy is well known to affect cognitive function in community-dwelling older adults. However, the effect of polypharmacy on cognitive function in patients with newly diagnosed Parkinson's disease remains unknown. Here, we evaluated the association between polypharmacy and cognitive function in patients with newly diagnosed Parkinson's disease. Methods: This cross-sectional study enrolled 131 consecutive hospitalized patients with newly diagnosed Parkinson's disease. Cognitive function was evaluated with the Mini-Mental State Examination and analyzed between groups of patients with or without polypharmacy. Comparisons were adjusted for confounders by performing inverse probability weighting with propensity scores. Results: After inverse probability weighting, patients in the polypharmacy group had a significantly lower Mini-Mental State Examination score than patients in the nonpolypharmacy group (26.2 vs. 27.7, p = 0.001). Conclusion: Polypharmacy was associated with cognitive decline in patients with newly diagnosed Parkinson's disease. This finding suggests that medication reduction might serve as a promising intervention to prevent the development of dementia in patients with early Parkinson's disease. Further prospective studies are needed to determine whether medication reduction improves cognitive function in patients with newly diagnosed Parkinson's disease.

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Section: Discussionmentioning

confidence: 87%

Polypharmacy Associated with Cognitive Decline in Newly Diagnosed Parkinson’s Disease: A Cross-Sectional Study

Ishii

Mochizuki

Sakai

et al. 2019

Dement Geriatr Cogn Disord Extra

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“…Although polypharmacy is associated with cognitive decline and memory loss [14,15,25,26], minimal information exists on how polypharmacy contributes to memory loss in AA older adults. While some cross-sectional and longitudinal studies have suggested that polypharmacy may be a risk factor for cognitive changes in the general population [14,15,25,26], we still need to explore the same association in economically challenged AA older adults. If polypharmacy is also responsible for some of the cognitive decline of AA older adults with multimorbidity, then prevention of inappropriate polypharmacy becomes a core strategy to prevent the cognitive/memory decline of this population.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

et al. 2020

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Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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“…Furthermore, one could argue that polypharmacy is simply a marker of medical comorbidities or medical complexity. However, in studies examining polypharmacy and outcomes such as gait velocity, MCI, and dementia, the associations with polypharmacy remain significant after adjustments for medical comorbidities. This suggests that medical comorbidities may only partially explain the impact of polypharmacy, but in the case of this study, it is unclear if medical comorbidities play a greater role in MCR than in other predementia syndromes such as MCI.…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between polypharmacy and other dementia syndromes such as MCI has been reported. In a large population‐based study, Cheng and colleagues reported that polypharmacy was associated with a 1.7‐fold increased odds of MCI diagnosis and a 2.3‐fold increased odds of dementia even after adjusting for medical comorbidities. Chen and colleagues reported a prevalence of polypharmacy in MCI of 58.9% for those who remained stable and 67% among MCI participants who progressed to dementia …”

Section: Discussionmentioning

confidence: 99%

Motoric Cognitive Risk Syndrome in Polypharmacy

George

2020

J American Geriatrics Society

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OBJECTIVES: Risk factors for motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by slow gait and cognitive complaints, have been identified, but few are reversible. Polypharmacy is a potentially reversible risk factor for cognitive decline, but the relationship between MCR and polypharmacy has not been examined. Our aim was to compare the epidemiology of MCR and polypharmacy. DESIGN: Cross-sectional. SETTING: Community-based Health and Retirement Study cohort. PARTICIPANTS: A total of 1119 adults 65 years and older (mean age = 74.7 AE 7.0 y; 59% female). MEASUREMENTS: Polypharmacy is defined as the use of five or more regularly scheduled medications. MCR is defined as cognitive complaints and slow gait in an individual without dementia. RESULTS: The prevalence of MCR among 417 participants with polypharmacy was 10%; it was 6% among 702 participants without polypharmacy. The odds of meeting MCR criteria in those with polypharmacy was 1.8 (confidence interval = 1.0-3.0; P = .035) compared with those without polypharmacy, even after adjusting for high-risk medication use. CONCLUSION: Our results show the coexistence of MCR and polypharmacy in older adults, suggesting a potentially modifiable risk factor for dementia.

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Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability

Cited by 26 publications

References 0 publications

Polypharmacy Associated with Cognitive Decline in Newly Diagnosed Parkinson’s Disease: A Cross-Sectional Study

Polypharmacy Associated with Cognitive Decline in Newly Diagnosed Parkinson’s Disease: A Cross-Sectional Study

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Motoric Cognitive Risk Syndrome in Polypharmacy

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