The association between polypharmacy and cognitive ability in older adults: A national cohort study

Aljeaidi, Muhamad S; Tan, Edwin C.K.

doi:10.1016/j.sapharm.2021.04.018

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…Frontiers in Medicine frontiersin.org clinical stabilization (60, 61). Third, we did not include patients gone to ED night-time, so our study does not consider whether this aspect could potentially influence the scores, as well as polypharmacy (20,62,63), which in turn can influence cognitive performances in elderly.…”

Section: Discussionmentioning

confidence: 99%

Six-item cognitive impairment test (6-CIT)’s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Salis,

Pili,

Collu

et al. 2023

Front. Med.

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BackgroundNowadays, elderly patients represent a significant number of accesses to the Emergency Department (ED). Working rhythms do not allow to perform complete cognitive analysis, which would, however, be useful for the health care. This study aims to define the optimal cut-off values of the six-item Cognitive Impairment Test (6-CIT) as a cognitive screening tool in ED.MethodsThis study included 215 subjects, evaluated at the Emergency Department of the University Hospital of Monserrato, Cagliari, Italy, from July to December 2021. The accuracy of 6-CIT as a cognitive screening tool was assessed by comparison with Mini Mental State Examination (MMSE).ResultsThe correlation coefficient between the two tests was −0.836 (CI: −0.87 to −0.79; p < 0.0001), and 6-CIT showed AUC = 0.947 (CI: 0.908–0.973; p < 0.0001). The 8/9 6-CIT cut-off score presented 86.76% sensitivity (CI: 76.4–93.8) and 91.84% specificity (CI: 86.2–95.7), and Youden index for this score was 0.786.ConclusionOur study demonstrates that 6-CIT is a reliable cognitive screening tool in ED, offering excellent sensitivity and specificity with a 8/9 points cut-off score.

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Section: Discussionmentioning

confidence: 99%

Six-item cognitive impairment test (6-CIT)’s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Salis,

Pili,

Collu

et al. 2023

Front. Med.

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“…8 (Wimmer) On the other hand, there is also an association with community dwelling older adults and polypharmacy, showing a decline in cognitive ability. 9,10 Additionally, polypharmacy may be a cause of medication errors, especially for older patients-this can be for many reasons including lack of knowledge by the prescriber of aging physiology and geriatric pharmacotherapy, overprescribing, inappropriate prescribing, and inappropriate drug omission. Recommendations to reduce medication errors due to polypharmacy include education of health care team, medication reconciliation, including pharmacists on the health care team, improving the work environment, role of information and communication technology.…”

Section: Consequences Of Polypharmacymentioning

confidence: 99%

“…8 (Wimmer) On the other hand, there is also an association with community dwelling older adults and polypharmacy, showing a decline in cognitive ability. 9,10…”

Section: Unintended Consequences Of Polypharmacymentioning

confidence: 99%

Polypharmacy, Unintended Consequences, and Impact of Lifestyle Medicine

Srivastava

2023

American Journal of Lifestyle Medicine

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The coexistence of more than one chronic condition is called multimorbidity. Polypharmacy is defined as the use of multiple medicines with the typical definition stating 5 or more medications. There are several risk factors associated with polypharmacy and it may occur due to many reasons. Polypharmacy has been associated with multiple negative outcomes including nonadherence to treatment, side effects, drug-drug or disease interactions, falls, fractures, impairments—physical and cognitive, and medical errors. Strategies to assess and address polypharmacy are necessary, and lifestyle medicine is shown to play a role in improving health outcomes even when polypharmacy exists.

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“…Polypharmacy is not without its own problems. Beside the fact that it is not sustainable at a global level in treating multi-comorbid-burdened patients, evidence suggests that polypharmacy is associated with reduced cognitive function [106]. Hence, reduced quality of life and increased caregiver needs are the rewards for additional prescriptions.…”

Section: Marching To Multimorbidity and Polypharmacy Through A Web Of Ncdsmentioning

confidence: 99%

Microbiome First Medicine in Health and Safety

Dietert¹

2021

Preprint

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Microbiome First Medicine is a suggested 21st century healthcare paradigm that prioritizes the entire human, the human superorganism, beginning with the microbiome. To date, much of medicine has protected and treated patients as if they were a single species. This has resulted in unintended damage to the microbiome and an epidemic of chronic disorders [e.g., noncommunicable diseases and conditions (NCDs)]. Along with NCDs came loss of colonization re-sistance, increased susceptibility to infectious diseases, and increasing multimorbidity and polypharmacy over the life course. To move toward sustainable healthcare, the human micro-biome needs to be front and center. This paper presents microbiome-human physiology from the view of systems biology regulation. It also details the ongoing NCD epidemic including the role of existing drugs and other factors that damage the human microbiome. Examples are provided for two entryway NCDs, asthma and obesity, regarding their extensive network of comorbid NCDs. Finally, the challenges of ensuring safety for the microbiome are detailed. Under Microbiome First Medicine and considering the importance of keystone bacteria and critical windows of development, changes in even a few microbiota-prioritized medical decisions could make a significant difference in health across the life course.

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The association between polypharmacy and cognitive ability in older adults: A national cohort study

Cited by 9 publications

References 20 publications

Six-item cognitive impairment test (6-CIT)’s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Six-item cognitive impairment test (6-CIT)’s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Polypharmacy, Unintended Consequences, and Impact of Lifestyle Medicine

Microbiome First Medicine in Health and Safety

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