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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.
J Am Med Dir Assoc. 2018 08; 19(8):710-713.JA

Abstract

OBJECTIVES

To test the association between polypharmacy and 1-year change in physical and cognitive function among nursing home (NH) residents.

DESIGN

Longitudinal multicenter cohort study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study.

SETTING

NH in Europe (n = 50) and Israel (n = 7).

PARTICIPANTS

3234 NH older residents.

MEASUREMENTS

Participants were assessed through the interRAI long-term care facility instrument. Polypharmacy was defined as the concurrent use of 5 to 9 drugs and excessive polypharmacy as the use of ≥10 drugs. Cognitive function was assessed through the Cognitive Performance Scale (CPS). Functional status was evaluated through the Activities of Daily Living (ADL) Hierarchy scale. The change in CPS and ADL score, based on repeated assessments, was the outcome, and their association with polypharmacy was modeled via linear mixed models. The interaction between polypharmacy and time was reported [beta and 95% confidence intervals (95% CIs)].

RESULTS

A total of 1630 (50%) residents presented with polypharmacy and 781 (24%) excessive polypharmacy. After adjusting for potential confounders, residents on polypharmacy (beta 0.10, 95% CI 0.01-0.20) and those on excessive polypharmacy (beta 0.13, 95% CI 0.01-0.24) had a significantly higher decline in CPS score compared to those using <5 drugs. No statistically (P > .05) significant change according to polypharmacy status was shown for ADL score.

CONCLUSIONS

Polypharmacy is highly prevalent among older NH residents and, over 1 year, it is associated with worsening cognitive function but not functional decline.

Authors+Show Affiliations

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Geriatrics, Catholic University of Rome, Italy.Department of Geriatrics, Catholic University of Rome, Italy. Electronic address: emanuele.rocco.villani@gmail.com.Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.Department of Geriatrics, Catholic University of Rome, Italy.Department of Geriatrics, Catholic University of Rome, Italy.Department of Geriatrics, Catholic University of Rome, Italy.Department of Geriatrics, Catholic University of Rome, Italy.Department of Geriatrics, Catholic University of Rome, Italy.

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29861194

Citation

Vetrano, Davide Liborio, et al. "Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study." Journal of the American Medical Directors Association, vol. 19, no. 8, 2018, pp. 710-713.
Vetrano DL, Villani ER, Grande G, et al. Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. J Am Med Dir Assoc. 2018;19(8):710-713.
Vetrano, D. L., Villani, E. R., Grande, G., Giovannini, S., Cipriani, M. C., Manes-Gravina, E., Bernabei, R., & Onder, G. (2018). Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. Journal of the American Medical Directors Association, 19(8), 710-713. https://doi.org/10.1016/j.jamda.2018.04.008
Vetrano DL, et al. Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. J Am Med Dir Assoc. 2018;19(8):710-713. PubMed PMID: 29861194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study. AU - Vetrano,Davide Liborio, AU - Villani,Emanuele Rocco, AU - Grande,Giulia, AU - Giovannini,Silvia, AU - Cipriani,Maria Camilla, AU - Manes-Gravina,Ester, AU - Bernabei,Roberto, AU - Onder,Graziano, Y1 - 2018/05/31/ PY - 2018/02/20/received PY - 2018/03/29/revised PY - 2018/04/13/accepted PY - 2018/6/5/pubmed PY - 2019/11/22/medline PY - 2018/6/5/entrez KW - Polypharmacy KW - cognitive decline KW - functional decline KW - long-term care KW - nursing home SP - 710 EP - 713 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 19 IS - 8 N2 - OBJECTIVES: To test the association between polypharmacy and 1-year change in physical and cognitive function among nursing home (NH) residents. DESIGN: Longitudinal multicenter cohort study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study. SETTING: NH in Europe (n = 50) and Israel (n = 7). PARTICIPANTS: 3234 NH older residents. MEASUREMENTS: Participants were assessed through the interRAI long-term care facility instrument. Polypharmacy was defined as the concurrent use of 5 to 9 drugs and excessive polypharmacy as the use of ≥10 drugs. Cognitive function was assessed through the Cognitive Performance Scale (CPS). Functional status was evaluated through the Activities of Daily Living (ADL) Hierarchy scale. The change in CPS and ADL score, based on repeated assessments, was the outcome, and their association with polypharmacy was modeled via linear mixed models. The interaction between polypharmacy and time was reported [beta and 95% confidence intervals (95% CIs)]. RESULTS: A total of 1630 (50%) residents presented with polypharmacy and 781 (24%) excessive polypharmacy. After adjusting for potential confounders, residents on polypharmacy (beta 0.10, 95% CI 0.01-0.20) and those on excessive polypharmacy (beta 0.13, 95% CI 0.01-0.24) had a significantly higher decline in CPS score compared to those using <5 drugs. No statistically (P > .05) significant change according to polypharmacy status was shown for ADL score. CONCLUSIONS: Polypharmacy is highly prevalent among older NH residents and, over 1 year, it is associated with worsening cognitive function but not functional decline. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/29861194/Association_of_Polypharmacy_With_1_Year_Trajectories_of_Cognitive_and_Physical_Function_in_Nursing_Home_Residents:_Results_From_a_Multicenter_European_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(18)30192-0 DB - PRIME DP - Unbound Medicine ER -