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- Aljeaidi, Muhamad S., et al.
(författare)
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The association between polypharmacy and cognitive ability in older adults : A national cohort study
- 2022
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411 .- 1934-8150. ; 18:3, s. 2505-2509
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Tidskriftsartikel (refereegranskat)abstract
- Background: Polypharmacy, the use of multiple medications by one individual, may be associated with adverse health outcomes including poor cognition. However, it remains unclear whether a longitudinal relationship exists.Objectives: To investigate the association between polypharmacy and 3-year cognitive ability in older adults.Methods: A longitudinal cohort study of older adults 65 years and older, residing in the community, who participated in waves 12 (2012), 13 (2013) and 16 (2016) of the Household Income and Labour Dynamics (HILDA) Survey was conducted. Polypharmacy was defined as the regular use of 5 or more prescription medications. Cognitive ability was assessed using backwards digit span test (BDS), 25-item version of the National Adult Reading Test (NART-25) and symbol-digit modalities test (SDM). Linear regression was used to test the longitudinal association between polypharmacy and cognitive test scores at 3 years. All analyses were adjusted for age, sex, education, comorbidities, socioeconomic and lifestyle factors, and baseline cognitive test scores.Results: A total of 2141 participants (mean age 72.9 years, 54.4% female) were included in the study sample. Polypharmacy was present in 27.3%. After adjusting for potential confounders, polypharmacy was negatively associated with cognitive ability at 3 years: BDS: −0.067 (95% CI = −0.353 to −0.051), NART-25: −0.071 (95% CI = −1.428 to −0.294), SDM: −0.073 (95% CI = −2.960 to −0.696).Conclusion: Polypharmacy was associated with poorer cognitive ability at 3 years, even after adjusting for comorbidities and other confounders. Future research should consider the long-term impact of polypharmacy on cognitive ability, and identify strategies to optimise medication use and cognition in older adults.
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| 2. |
- Tan, Edwin C. K., et al.
(författare)
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Validating a model for medication-related dental outcomes in older people
- 2022
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Ingår i: Oral Diseases. - : Wiley. - 1354-523X .- 1601-0825. ; 28:6, s. 1697-1704
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To externally validate a model for medication-related dental outcomes in (a) a general older population with dementia and (b) a matched population without dementia.Subjects and Methods: This validation study used population-based data from seven Swedish national registers (2008–2017). Individuals aged 60+ with dementia were matched to those without dementia on age, gender, and county of residence at the date of diagnosis (index date). The exposure was continuous use of xerogenic medications during the 3-year period before index date. The primary outcome was the number of tooth extraction and restorative procedures within 3 years after index date.Results: A total of 334,220 individuals were included in the final sample. In the dementia cohort, the use of urological drugs (incidence rate ratio [IRR] 1.08, 95% CI 1.03–1.13), respiratory medicines (IRR 1.10, 95% CI 1.04–1.17), and proton-pump inhibitors (IRR 1.09, 95% CI 1.05–1.13) was associated with the primary outcome. In the non-dementia cohort, respiratory medicines (IRR 1.03, CI 1.00–1.05), proton-pump inhibitors (IRR 1.06, CI 1.04–1.08), opioids (IRR 1.05, CI 1.03–1.07), and antidepressants (IRR 1.06, CI 1.04–1.08) were associated with the primary outcome.Conclusions: Although there were differences in prescription patterns, the model performed similarly in both those with and without dementia.
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| 3. |
- Wojt, Ilsa R., et al.
(författare)
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Clinical factors associated with increased length of stay and readmission in patients with medication-related hospital admissions : a retrospective study
- 2022
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411 .- 1934-8150. ; 18:7, s. 3184-3190
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adverse drug events (ADEs) remain a key contributor to hospitalisations, resulting in long hospital stays and readmissions. Information pertaining to the specific medications and clinical factors associated with these outcomes is limited. Hence, a better understanding of these factors and their relationship to ADEs is required.Objectives: To investigate medications involved, clinical manifestations of ADE-related hospitalisations, and their association with length of stay and readmission.Methods: A retrospective medical record review of patients admitted to a major, tertiary referral hospital in NSW, Australia, from January 2019 to August 2020 was conducted. ADEs were identified using Australian Refined Diagnosis Related Group (AR-DRG) codes: X40, X61, X62 and X64. Medications were classified per the Anatomical Therapeutic Chemical (ATC) classification system and clinical symptoms were classified per the International Classification of Disease (ICD) 9-CM. Logistic regression was performed to assess the relationship between medication and presentation classes with length of stay (≥2 days vs <2 days) and readmission.Results: There were 125 patients who met inclusion criteria (median age = 64 [interquartile range, 45–75] years; 53.6% male). Anti-thrombotic agents, opioids, antidepressants, antipsychotics, insulins and NSAIDs were the most implicated pharmacological classes. Neurological medications and falls were associated with a length of stay ≥2 days (adjusted odds ratio [aOR] 3.92, 95% confidence interval [CI] 1.48–10.33 and aOR 3.24, 95% CI 1.05–10.06, respectively). Neurological medications and neurological and cognitive disorders were associated with an increased likelihood of 90-day readmission (aOR 2.63, 95% CI 1.05–6.57 and aOR 3.20, 95% CI 1.17–8.75, respectively).Conclusion: This study identified neurological medications as high-risk for increased length of stay and readmission in those hospitalised due to ADEs. This highlights the need for judicious prescribing and monitoring of these medications.
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