Polypharmacy is Associated with Frailty Risk in Older Adults

A recent study found that frailty was associated with polypharmacy in older patients.

The study included 3058 adults between 57 and 84 years old who were followed-up with for 3 years. Polypharmacy was defined as the use of 5 to 9 drugs, and hyperpolypharmacy was defined as the use of 10 or more drugs.
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Overall, polypharmacy was present in 1194 participants (39.1%), and hyperpolypharmacy in 273 participants (8.9%). Frailty was present in 271 participants (8.9%).

In addition, 186 out of 1998 participants that were non-frail at the start of the study were frail within the 3-year follow-up. Of the participants who developed frailty during the follow-up, 13% were taking 5 to 9 drugs, and 19.3% were taking 10 or more drugs.

“Frailty incidence was higher in older age groups, ranging from 6.2% in participants aged ≤64 years to 18.7% in participants aged ≥75 years. Even within age groups, incident frailty showed a clear upward trend with increasing number of drugs,” the researchers wrote.

Overall, patients had a 1.5-fold increased risk for frailty if taking 5 to 9 drugs, and patients had a 2-fold increased risk for frailty when on 10 or more drugs.

Researchers cautioned against deprescribing certain drugs as the target group for the study includes those who need multiple drugs to treat comorbidities.

“It is necessary to evaluate the medication regimen for each individual with polypharmacy carefully because the beneficial effect of “deprescribing” has not been studied in [randomized controlled trials] yet. This is a difficult task which could be facilitated if not only the [general practitioner] but also a pharmacist and a geriatrician will contribute to tailor the best practicable medication regimen for the individual patient,” the researchers stated.

—Melissa Weiss

Reference:

Saum KU, Schöttker B, Meid AD, et al. Is polypharmacy associated with frailty in older people? results from the ESTHER Cohort Study [published online December 26, 2016]. Journal of the American Geriatrics Society. doi:10.1111/jgs.14718.