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High‐Risk Prescribing and Incidence of Frailty Among Older Community‐Dwelling Men
Author(s) -
Gnjidic D,
Hilmer S N,
Blyth F M,
Naganathan V,
Cumming R G,
Handelsman D J,
McLachlan A J,
Abernethy D R,
Banks E,
Le Couteur D G
Publication year - 2012
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 - 10.1038/clpt.2011.258
Subject(s) - polypharmacy , medicine , odds ratio , confidence interval , beers criteria , incidence (geometry) , anticholinergic , geriatrics , lower risk , gerontology , psychiatry , physics , optics
Evidence about the association between treatment with high–risk medicines and frailty in older individuals is limited. We investigated the relationship between high–risk prescribing and frailty at baseline, as well as 2–year incident frailty, in 1,662 men ≥70 years of age. High–risk prescribing was defined as polypharmacy (≥5 medicines), hyperpolypharmacy (≥10 medicines), and by the Drug Burden Index (DBI), a dose–normalized measure of anticholinergic and sedative medicines. At baseline, frail participants had adjusted odds ratios (ORs) of 2.55 (95% confidence interval, CI: 1.69–3.84) for polypharmacy, 5.80 (95% CI: 2.90–11.61) for hyperpolypharmacy, and 2.33 (95% CI: 1.58–3.45) for DBI exposure, as compared with robust participants. Of the 1,242 men who were robust at baseline, 6.2% developed frailty over two years. Adjusted ORs of incident frailty were 2.45 (95% CI: 1.42–4.23) for polypharmacy, 2.50 (95% CI: 0.76–8.26) for hyperpolypharmacy, and 2.14 (95% CI: 1.25–3.64) for DBI exposure. High–risk prescribing may contribute to frailty in community–dwelling older men. Clinical Pharmacology & Therapeutics (2012); 91 3, 521–528. doi: 10.1038/clpt.2011.258