Influência da renda na associação entre disfunção cognitiva e polifarmácia: Projeto Bambuí

Abstract

OBJECTIVE:To evaluate the prevalence of polypharmacy and the infl uence of income on the association between medication use and cognitive impairment among elderly people. METHODS:Out of the 1,606 baseline members of the Bambuí cohort of elderly people, which started in 1997, 1,554 took part in the study. The MiniMental State Examination was applied to all the participants. The association between cognitive impairment and polypharmacy was tested by means of multivariate ordinal regression, performed for the whole population and for each of the income strata. RESULTS:The prevalence of polypharmacy (two or more medications consumed) was 70.4% and the number of medications used presented an independent negative association with cognitive impairment (OR=0.72; 95% CI: 0.55;0.95). When this was stratifi ed according to personal income (<2 minimum monthly salaries versus > 2 minimum monthly salaries), a negative association was observed between medication use and cognitive impairment among elderly people with lower income (OR=0.64; 95% CI: 0.48;0.86), but not among those with higher income (OR=1.74; 95% CI: 0.81;3.74). CONCLUSIONS:With regard to the association between cognitive impairment and number of medications consumed, the results indicate social inequality in the use of medications. It is possible that these elderly people are not consuming the medicines needed for appropriate treatment of their health problems.

Factors associated with beliefs about adherence to non-pharmacological treatment of patients with heart failure

“…The cognitive dysfunction is prevalent among the elderly (19) and may be responsible for non-adherence rates, especially when changes related to treatment are frequent (11,20) . The findings point to the importance of developing strategies to minimize forgetfulness, which may contribute to the reduction of barriers to control of weight and edema.…”

Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

“…In the elderly population, the risks associated with consumption of medications compete with the expected benefits, due to the physiological changes proper to aging, including the decrease in muscle mass and body water, with effects on the pharmacodynamics and pharmacokinetics of medications. Thus, unwanted effects (adverse effects and drug-drug interactions) are more likely to occur 4 .The prevalence of polypharmacy is high in the elderly 5,6,7 , and is one of the strongest predictors of health problems associated with use of medications 4 . Polypharmacy is defined as the use of multiple medications, a basically quantita-ARTIGO ARTICLE Loyola Filho AI et al…”

“…The prevalence of polypharmacy is high in the elderly 5,6,7 , and is one of the strongest predictors of health problems associated with use of medications 4 . Polypharmacy is defined as the use of multiple medications, a basically quantita-tive concept, which does not take the pertinence of their utilization into account 8 .…”

“…Polypharmacy is defined as the use of multiple medications, a basically quantita-tive concept, which does not take the pertinence of their utilization into account 8 . The characteristics most consistently associated with polypharmacy are female gender, more advanced age, chronic illness, and greater utilization of health services 6,7,9 . Increasing polypharmacy has been observed in elderly populations in high-income countries 10,11 .…”

Fatores associados ao uso de psicofármacos em idosos asilados

“…Esse achado é compatível com outros estudos 18,20 , que relataram que o controle comportamental (medicamentoso ou não) encontra-se entre as principais preocupações da equipe de profi ssionais vinculada a ILPI, em que os internados se encontram em estágios mais avança-dos e de difícil manejo do quadro demencial 26 . Apesar de, na análise bivariada, o menor número de medicamentos ter sido correlato ao uso de neurolépticos (o que poderia ser justificado pela possibilidade terapêutica nesse estágio da doença restringir-se aos distúrbios comportamentais 27 ), essa relação não foi observada na regressão logística.…”