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Polypharmacy tied to lower physical, cognitive capability

07 Jun 2018

Polypharmacy at ages 60–64 years and at age 69 years, especially in those with longstanding polypharmacy, is linked to lower physical and cognitive capability, according to a recent study.

Polypharmacy (5–8 prescribed medications) at age 69 years was reported in 18.2 percent of the study cohort, while excessive polypharmacy (9 prescribed medications) was observed in 4.7 percent. Both were associated with poorer physical and cognitive capabilities.

For instance, cross-sectional analysis with fully adjusted linear regression models showed significant impacts of polypharmacy (coefficient, –2.0; 95 percent CI, –2.8 to –1.1) and excessive polypharmacy (coefficient, –2.9; –4.4 to –1.4) on scores in the third edition of Addenbrooke’s Cognitive Examination (ACE-III; p<0.001).

Similar effects were observed for chair rise speed (polypharmacy: coefficient, –2.2; –3.2 to –1.2; excessive polypharmacy: coefficient, –3.7; –5.6 to –1.8; p<0.001) and grip strength (polypharmacy: coefficient, –2.0; –2.8 to –1.1; excessive polypharmacy: coefficient, –3.7; –5.3 to –2.1; p<0.001).

In the longitudinal analysis, participants with polypharmacy at age 60–64 years showed impaired cognitive (word learning task: coefficient, –0.4; –1.3 to –0.5) and physical (chair rise speed: coefficient, –1.2; –2.6 to 0.3) outcomes.

The effect was stronger when polypharmacy was present at both ages 60–64 years and 69 years (word learning task: coefficient, –0.7; –1.4 to 0.0; chair rise speed: coefficient, –2.4; –3.6 to –1.2).

For the present prospective birth cohort study, researchers recruited 2,007 adults (51.2 percent female) with complete medication data at age 69 years. A word learning test, visual search speed task and the ACE-III were used to assess cognitive capability, while the chair rise speed, standing balance time, walking speed and grip strength measures were used to evaluate physical capability.

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