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PI‐11
Author(s) -
Cao Y.,
Mager D. E.,
Simonsick E. M.,
Ling S.,
Windham G.,
Fried L. P.,
Abernethy D. R.
Publication year - 2006
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2005.12.032
Subject(s) - medicine , drug , gerontology , pharmacology
BACKGROUND/AIMS Expert consensus‐derived lists or numbers of drugs prescribed are two current approaches to evaluate appropriateness of drug therapy for older patients. We hypothesized that drugs with anticholinergic and/or sedative properties contribute to drug exposure related morbidity, and that development of a drug burden index to characterize extent of exposure to these drugs would have utility to predict drug‐induced disability independent of disease and other potential confounders. METHODS Drug burden based on pharmacodynamic principles was defined. A strong independent relation between anticholinergic burden and greater activities of daily living difficulty, poorer balance, chair stands, mobility, gait speed, MMSE performance, difficulty of upper extremity function, and weaker grip strength was demonstrated. Sedative burden was only associated with impaired grip strength and mobility. CONCLUSIONS (1) Burden of multiple drugs can be quantified with the recommended dose regimen and the actual dose and frequency of drug taken. (2) Anticholinergic burden is strongly associated with impaired performance of a variety of functions important to independent living. Sedative burden results in impairment of a more limited array of functions. Clinical Pharmacology & Therapeutics (2005) 79 , P9–P9; doi: 10.1016/j.clpt.2005.12.032