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Sirpa Hartikainen - One of the best experts on this subject based on the ideXlab platform.
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association of Polypharmacy with nutritional status functional ability and cognitive capacity over a three year period in an elderly population
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-Polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive Polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the follow-up. The mixed model analysis revealed that Polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time. Conclusions Excessive Polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by Polypharmacy status. Copyright © 2011 John Wiley & Sons, Ltd.
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Association of Polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population.
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p
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Polypharmacy Status as an Indicator of Mortality in an Elderly Population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:BackgroundIncreased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality.ObjectiveTo assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons.MethodsThis was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality.ResultsIn the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases.ConclusionThis study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
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Polypharmacy status as an indicator of mortality in an elderly population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:Increased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality. To assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons. This was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality. In the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases. This study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
Johanna Jyrkkä - One of the best experts on this subject based on the ideXlab platform.
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association of Polypharmacy with nutritional status functional ability and cognitive capacity over a three year period in an elderly population
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-Polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive Polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the follow-up. The mixed model analysis revealed that Polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time. Conclusions Excessive Polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by Polypharmacy status. Copyright © 2011 John Wiley & Sons, Ltd.
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Association of Polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population.
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p
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Polypharmacy Status as an Indicator of Mortality in an Elderly Population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:BackgroundIncreased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality.ObjectiveTo assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons.MethodsThis was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality.ResultsIn the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases.ConclusionThis study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
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Polypharmacy status as an indicator of mortality in an elderly population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:Increased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality. To assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons. This was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality. In the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases. This study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
Joel Ankri - One of the best experts on this subject based on the ideXlab platform.
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Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people
Pharmacoepidemiology and Drug Safety, 2015Co-Authors: Marie Herr, Jean-marie Robine, Juliette Pinot, Jean-jacques Arvieu, Joel AnkriAbstract:PURPOSE: To assess the prevalence of Polypharmacy and frailty, to examine their association, and to establish their independent and combined effects on mortality in a sample of French old people. METHODS: This is a cross-sectional population study of people aged 70 years and over. A total of 2350 respondents were interviewed at home in 2008-2010. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility, in the absence of difficulties in basic activities of daily living. Mortality data were documented after a mean follow-up period of 2.6 years. RESULTS: Mean age of the population was 83.3 +/- 7.5 years, with 59.4% of women. Prevalence of frailty was 17.0%. Polypharmacy (5-9 drugs) was reported in 53.6% of the population, and excessive Polypharmacy (10 drugs or more) in 13.8%. After adjustment for socio-demographic and health variables, Polypharmacy and excessive Polypharmacy were associated with frailty with odds ratio 1.77 [1.20-2.61] and 4.47 [2.37-8.42], respectively. Frailty (hazard ratio [HR] 2.56 [1.63-4.04]) and excessive Polypharmacy (HR 1.83 [1.28-2.62]) were independent predictors of mortality. Compared with non-frail people without Polypharmacy, frail people with excessive Polypharmacy were six times more likely to die during the follow-up period (HR 6.30 [3.09-12.84]). CONCLUSION: By showing the independent and combined effects of Polypharmacy and frailty on mortality risk, this study should reinforce the awareness of clinicians with regard to these factors, rather prevalent in old people.
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Polypharmacy and frailty prevalence relationship and impact on mortality in a french sample of 2350 old people
Pharmacoepidemiology and Drug Safety, 2015Co-Authors: Marie Herr, Jean-marie Robine, Juliette Pinot, Jean-jacques Arvieu, Joel AnkriAbstract:PURPOSE: To assess the prevalence of Polypharmacy and frailty, to examine their association, and to establish their independent and combined effects on mortality in a sample of French old people. METHODS: This is a cross-sectional population study of people aged 70 years and over. A total of 2350 respondents were interviewed at home in 2008-2010. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility, in the absence of difficulties in basic activities of daily living. Mortality data were documented after a mean follow-up period of 2.6 years. RESULTS: Mean age of the population was 83.3 +/- 7.5 years, with 59.4% of women. Prevalence of frailty was 17.0%. Polypharmacy (5-9 drugs) was reported in 53.6% of the population, and excessive Polypharmacy (10 drugs or more) in 13.8%. After adjustment for socio-demographic and health variables, Polypharmacy and excessive Polypharmacy were associated with frailty with odds ratio 1.77 [1.20-2.61] and 4.47 [2.37-8.42], respectively. Frailty (hazard ratio [HR] 2.56 [1.63-4.04]) and excessive Polypharmacy (HR 1.83 [1.28-2.62]) were independent predictors of mortality. Compared with non-frail people without Polypharmacy, frail people with excessive Polypharmacy were six times more likely to die during the follow-up period (HR 6.30 [3.09-12.84]). CONCLUSION: By showing the independent and combined effects of Polypharmacy and frailty on mortality risk, this study should reinforce the awareness of clinicians with regard to these factors, rather prevalent in old people. Copyright © 2015 John Wiley & Sons, Ltd. Language: en
Hannes Enlund - One of the best experts on this subject based on the ideXlab platform.
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association of Polypharmacy with nutritional status functional ability and cognitive capacity over a three year period in an elderly population
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-Polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive Polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the follow-up. The mixed model analysis revealed that Polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time. Conclusions Excessive Polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by Polypharmacy status. Copyright © 2011 John Wiley & Sons, Ltd.
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Association of Polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population.
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p
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Polypharmacy Status as an Indicator of Mortality in an Elderly Population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:BackgroundIncreased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality.ObjectiveTo assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons.MethodsThis was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality.ResultsIn the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases.ConclusionThis study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
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Polypharmacy status as an indicator of mortality in an elderly population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:Increased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality. To assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons. This was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality. In the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases. This study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
Raimo Sulkava - One of the best experts on this subject based on the ideXlab platform.
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association of Polypharmacy with nutritional status functional ability and cognitive capacity over a three year period in an elderly population
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-Polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive Polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the follow-up. The mixed model analysis revealed that Polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time. Conclusions Excessive Polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by Polypharmacy status. Copyright © 2011 John Wiley & Sons, Ltd.
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Association of Polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population.
Pharmacoepidemiology and Drug Safety, 2011Co-Authors: Johanna Jyrkkä, Hannes Enlund, Raimo Sulkava, Piia Lavikainen, Sirpa HartikainenAbstract:Purpose To determine the association of Polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons. Methods This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-Polypharmacy (0–5 drugs), Polypharmacy (6–9 drugs) and excessive Polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of Polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores. Results Excessive Polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p
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Polypharmacy Status as an Indicator of Mortality in an Elderly Population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:BackgroundIncreased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality.ObjectiveTo assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons.MethodsThis was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality.ResultsIn the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases.ConclusionThis study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
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Polypharmacy status as an indicator of mortality in an elderly population
Drugs & Aging, 2009Co-Authors: Johanna Jyrkkä, Maarit J. Korhonen, Hannes Enlund, Raimo Sulkava, Sirpa HartikainenAbstract:Increased use of drugs has raised concern about the risks of Polypharmacy in elderly populations. Adverse outcomes, such as hospitalizations and falls, have been shown to be associated with Polypharmacy. So far, little information is available on the association between Polypharmacy status and mortality. To assess whether Polypharmacy (six to nine drugs) or excessive Polypharmacy (ten or more drugs) could be indicators of mortality in elderly persons. This was a population-based cohort study conducted between 1998 and 2003 with mortality follow-up through to 2007. The data in this study were derived from the population-based Kuopio 75+ Study, which involved elderly persons aged ≥75 years living in the city of Kuopio, Finland. The initial sample (sample frame n=4518, random sample n=700) was drawn from the population register. For the purpose of this study, two separate analyses were carried out. In the first phase, participants (aged ≥75 years, n=601) were followed from 1998 (baseline) to 2002. In the second phase, survivors (aged ≥80 years, n=339) were followed from 2003 to 2007. Current medications were determined from drug containers and prescriptions during interviews conducted by a trained nurse. The Kaplan-Meier method and Cox proportional hazards regression were used to examine the association between Polypharmacy status and mortality. In the first phase, 28% (n=167) belonged to the excessive Polypharmacy group, 33% (n=200) to the Polypharmacy group, and the remaining 39% (n=234) to the non-Polypharmacy (0–5 drugs) group. The corresponding figures in the second phase were 28% (n=95), 39% (n=132) and 33% (n=112), respectively. The mortality rate was 37% in the first phase and 40% in the second phase. In both phases, the survival curves showed a significant difference in all-cause mortality between the three Polypharmacy groups. In the first phase, the univariate model showed an association between excessive Polypharmacy and mortality (hazard ratio [HR] 2.53, 95% CI 1.83, 3.48); however, after adjustment for demographics and other variables measuring functional and cognitive status, this association did not remain statistically significant (HR 1.28, 95% CI 0.86, 1.91). In the second phase, the association between excessive Polypharmacy and mortality (HR 2.23, 95% CI 1.21, 4.12) remained significant after adjustments. Age, male sex and dependency according to the Instrumental Activities of Daily Living screening instrument were associated with mortality in both phases. This study points to the importance of excessive Polypharmacy as an indicator for mortality in elderly persons. This association needs to be confirmed following adjustment for co-morbidities.
