Polypharmacy trajectories among older women with and without dementia: A longitudinal cohort study

Thapaliya, Kailash; Harris, Melissa L.; Byles, Julie

doi:10.1016/j.rcsop.2021.100053

Cited by 7 publications

(13 citation statements)

References 57 publications

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“…Notably, female sex, polypharmacy, and multiple comorbidities are known risk factors of dementia progression [ 46 , 55 , 56 ]. This might imply the risk of dementia progression in female patients using five or more medications to treat multiple concomitant diseases might be attributed to DPIM usages [ 57 , 58 ]. Future studies are warranted for effective medication management including medication reconciliation and deprescribing to prevent rapid progression of dementia as well as to reduce potential harms caused by PIMs in elderly patients with dementia in the real-world setting.…”

Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medication Use in Patients with Dementia

Yoon

Kim

Kwack

et al. 2022

IJERPH

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The objective of this study was to characterize the epidemiology of using potentially inappropriate medications associated with dementia exacerbation (DPIMs) in elderly outpatients with dementia. Electronic medical records were retrospectively reviewed for geriatric patients with dementia who were prescribed at least one medication in 2016 at a tertiary, university-affiliated hospital. The 2015 Beers criteria were used to define DPIMs. Logistic regression was performed to identify factors associated with prescribing DPIMs in patients with dementia. Among 2100 patients included in our study, 987 (47.0%) patients were prescribed at least one DPIM. Benzodiazepines were the most frequently prescribed DPIM followed by anticholinergics, histamine H2-receptor blockers, and zolpidem. The risk of prescribing DPIMs was significantly increased in female patients (odds ratio (OR) 1.355) with polypharmacy (OR 5.146) and multiple comorbidities (OR 1.129) (p < 0.05 for all). Coexistence of Parkinson’s disease (OR 1.799), mood disorder (OR 1.373), or schizophrenia (OR 4.116) in patients with dementia further increased the likelihood of receiving DPIMs. In conclusion, DPIMs were commonly used in elderly patients with dementia in Korea with benzodiazepines most frequently prescribed followed by anticholinergics. Female patients using polypharmacy with multiple comorbidities should be closely monitored to minimize unnecessary DPIM use and, ultimately, DPIM-related harms.

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Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medication Use in Patients with Dementia

Yoon

Kim

Kwack

et al. 2022

IJERPH

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“…A cross-sectional study of older adults in Denmark indicated that 62.6% of PLWD had polypharmacy in 2014 ( 8 ). While, a prospective cohort study of women with dementia in Australia showed that the prevalence of polypharmacy increased from 57.7% in 2003 to 71.2% in 2014 ( 5 ). The increasing comorbidity and long-term treatments may contribute to the rising prevalence of polypharmacy among PLWD ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is essential to deprescribe inappropriate medications among PLWD with polypharmacy. Medication review (e.g., the implementation of a routine medication management review system in Australia) and increasing the awareness of potentially inappropriate medicine use in the older population (e.g., the introduction of the red-yellow-green list, a list of potentially inappropriate medications tailored toward use, in Denmark) could be helpful to slow or even reverse such increasing trends ( 5 - 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…Interview questions included socio-demographic characteristics and health status. Detailed descriptions of the data, sampling methods and quality control procedures have been reported elsewhere (4). In this analysis, we used waves 6-8 of SHARE, because of the available information on the medications.…”

mentioning

confidence: 99%

“…There is no single agreed definition of polypharmacy ( 1 ). Respondents were coded as having polypharmacy (=yes) if they took at least five medications ( 5 - 6 ).…”

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confidence: 99%

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Polypharmacy Among People Living with Dementia — Israel and 24 Countries in European Union, 2015–2019

Chen

Zhang

2022

China CDC Weekly

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What is already known about this topic?With a growing number of people living with dementia (PLWD), the practice of taking multiple medications to manage symptoms or comorbidities, i.e., polypharmacy, among PLWD has become a global health challenge. What is added by this report?In 2015-2019, polypharmacy for PLWD varied substantially among 25 studied countries, with approximately 1 in 5 Estonian PLWD and 4 in 5 Cypriot PLWD having polypharmacy. In addition, Switzerland, Poland, Austria, and the Czech Republic have experienced a significantly increasing trend in polypharmacy for PLWD. What are the implications for public health practice?Countries should pay special attention to polypharmacy and make efforts to control polypharmacy among PLWD, especially in countries where the trend of polypharmacy among PLWD has been increasing. China CDC Weekly Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 4 / No. 45 1007 * Marital status means married, cohabiting or civil partnership. † Proxy means proxy report. Abbreviation: NA=not applicable; SD=standard deviations.

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Data‐driven lifestyle patterns and risk of dementia in older Australian women

Dingle,

Bowe,

Bujtor

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONMany lifestyle factors have been associated with dementia, but there is limited evidence of how these group together. The aim of this study was to examine the clustering of lifestyle behaviors and associations with dementia.METHODSThis population‐based study included 9947 older Australian women. Latent class analysis was employed to identify distinct lifestyle classes, and Cox proportional hazard regression compared these with incident dementia over 17 years.RESULTSThree classes were identified: (1) “highly social and non‐smokers” (54.9%), (2) “highly social, smokers, and drinkers” (25.1%), and (3) “inactive and low socializers” (20.0%). Women in Class 3 exhibited a higher risk of dementia compared to both Class 1 (hazard ratio [HR] = 1.19, 95% confidence interval [CI]: 1.08 to 1.30) and Class 2 (HR = 1.12, 95% CI: 1.00 to 1.25).DISCUSSIONA lifestyle pattern characterized by physical inactivity and low social engagement may be particularly detrimental for dementia risk in older women and should be prioritized in preventive strategies.Highlights Latent class analysis was employed to identify distinct lifestyle clusters. Three lifestyle‐related clusters were differentially associated with dementia risk. Inactive and low socializers exhibited the greatest risk of dementia. Targeting physical inactivity and low social engagement in prevention is vital.

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Polypharmacy trajectories among older women with and without dementia: A longitudinal cohort study

Cited by 7 publications

References 57 publications

Potentially Inappropriate Medication Use in Patients with Dementia

Potentially Inappropriate Medication Use in Patients with Dementia

Polypharmacy Among People Living with Dementia — Israel and 24 Countries in European Union, 2015–2019

Data‐driven lifestyle patterns and risk of dementia in older Australian women

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