Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study

Vetrano, Davide Liborio; Villani, Emanuele Rocco; Grande, Giulia; Giovannini, Silvia; Cipriani, Maria Camilla; Manes-Gravina, Ester; Bernabei, Roberto; Onder, Graziano

doi:10.1016/j.jamda.2018.04.008

Cited by 54 publications

(43 citation statements)

References 25 publications

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“…This association was independent of confounders such as comorbidities [15]. In the SHELTER study, which stands for "Services and Health for Elderly in Long TERm care", conducted in Europe and Israel, polypharmacy was predictive of worsened cognitive function but not functional decline [51].…”

Section: Discussionmentioning

confidence: 96%

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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Section: Discussionmentioning

confidence: 96%

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

et al. 2020

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“…All the studies were observational and specifically, nine were prospective cohort studies, [8][9][10][11][12][13][14][15][16] eight were crosssectional studies, [17][18][19][20][21][22][23][24] and one was a case-control study. 25 Six studies were conducted in the USA; [10][11][12][17][18][19] two each in Germany, 21,24 Japan, 22,23 Italy, 13,15 and the UK; 16,25 and one study each in Australia, 20 Taiwan, 8 and Finland.…”

Section: Studies Characteristicsmentioning

confidence: 99%

“…The study size ranged between 294 and 29,544 individuals and for most of the studies, the sample consisted of community-dwelling individuals who were surveyed, interviewed, or assessed while living at their home. In two studies, 13,15 the population of interest was older patients admitted to the geriatric and internal medicine acute wards of specific hospitals and in two studies, 12,14 the study sample comprised of institutionalized individuals. The lower limit of age of the population in most of the studies was 65 years except for two studies, 9,21 which included people older than 70 years old, one study with a lower limit of age being 50 years, 25 and two studies without age restriction.…”

Section: Studies Characteristicsmentioning

confidence: 99%

The Association Between Polypharmacy and Physical Function in Older Adults: a Systematic Review

et al. 2019

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BACKGROUND: Reduced physical function and polypharmacy (PPha) are two highly prevalent negative effects of aging, which are expected to increase more, since demographic aging is expected to grow rapidly within the next decades. Previous research suggests that polypharmacy (PPha) is a predictor of poor physical function and vice versa in older adults and therefore we conducted a systematic review of the literature to summarize and critically analyze the relationship between physical function and PPha and vice versa in older adults, in order to provide recent scientific evidence. METHODS: We searched MEDLINE and Embase from their inception to 19th October 2018 for Englishlanguage observational studies or trials assessing the effect of PPha on physical function and vice versa in older adults. Two investigators independently extracted study data and assessed the quality of the studies, after having screened the available studies from the literature search. Any disagreement was resolved by consensus. RESULTS: Eighteen observational studies met the inclusion criteria. Eight studies assessed the impact of physical function on PPha and ten studies assessed the impact of PPha on physical function. Regarding the studies with PPha measurements as the outcome, all of them, except for one, found that better physical function is associated with lower risk of PPha. Likewise, all the studies with physical function measurements as the outcome, except for one, suggested that PPha is associated with lower physical function. DISCUSSION: Evidence examining the effect of PPha on physical function and vice versa in older adults suggests a strong bidirectional association between these two factors and clinicians should be aware of this strong relationship. The limitations of our study include the high variability in PPha definitions and physical function measures, and the treatment of PPha and physical function as constant instead of time-varying variables in the studies' analyses.

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“…Present guidelines recommend antidepressants and specifically selective serotonin reuptake inhibitors (SSRIs) as the first-line treatment of depression in older patients [11,12]. Previous studies have documented that prescription rates of psychotropic medications in NHs may be influenced by facility factors including the presence of a professional geriatrician [13].…”

Section: Introductionmentioning

confidence: 99%

Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study

et al. 2020

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Background: Late-life depression is common among older adults living in nursing homes (NHs). Over the last 30 years there has been an increase in the rates of prescription of antidepressant medications across all ages, with the largest rise reported in older adults. This study aimed to describe the pattern of antidepressant medication use among NH residents from 7 European countries and Israel and to examine patient and facilities characteristics that may account for it. Methods: We conducted a cross-sectional analysis of data from the SHELTER study, an observational longitudinal cohort study that collected comprehensive resident data using the interRAI Long-Term Care Facility instrument in 7 European Countries and Israel. Descriptive statistics were used to examine sample characteristics. Potential correlates of antidepressant medication use were identified using multiple logistic regression modeling. Results: Among 4023 residents entering the study, 32% had depressive symptoms and nearly half of these individuals used antidepressants. Antidepressant medication use varied by country, with a prevalence in the overall sample of 35.6% (n = 1431). Among antidepressant users, 59.9% were receiving selective serotonin reuptake inhibitors (SSRI). The strongest correlates of antidepressant use included reported diagnosis of anxiety, depression, bipolar disorder, pain, falls and high level of social engagement. Age over 85 years, living in facilities located in rural areas and a diagnosis of schizophrenia reduced the likelihood of being prescribed with an antidepressant. Conclusions: A large proportion of residents in European long-term care facilities receive antidepressant medications. The decision to prescribe antidepressants to NH residents seems to be influenced by both patient and facility characteristics. Future longitudinal studies should evaluate the efficacy and safety of antidepressant use in NHs thus providing evidence for recommendations for clinical practice.

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Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study

Cited by 54 publications

References 25 publications

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

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

The Association Between Polypharmacy and Physical Function in Older Adults: a Systematic Review

Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study

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