Central nervous system medication use and incident mobility limitation in community elders

The health, aging, and body composition study

Robert M. Boudreau, Joseph T. Hanlon, Yazan F. Roumani, Stephanie A. Studenski, Christine M. Ruby, Rollin M. Wright, Sarah N. Hilmer, Ronald I. Shorr, Douglas C. Bauer, Eleanor Marie Simonsick, Anne B. Newman

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation. Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews. Summated standardized daily doses (low, medium, and high) and duration of CNS drug use were computed. Incident mobility limitation was operationalized as two consecutive self-reports of having any difficulty walking 1/4 mile or climbing 10 steps without resting every 6 months after baseline. Multivariable Cox proportional hazard analyses were conducted adjusting for demographics, health behaviors, health status, and common indications for CNS medications. Results: Each year at least 13.9% of participants used a CNS medication. By year 6, overall 49% had developed incident mobility limitation. In multivariable models, CNS medication users compared to never users showed a higher risk for incident mobility limitation (adjusted hazard ratio (Adj. HR) 1.28; 95% confidence interval (CI) 1.12-1.47). Similar findings of increased risk were seen in analyses examining dose- and duration-response relationships. Conclusions: CNS medication use is independently associated with an increased risk of future incident mobility limitation in community dwelling elderly. Further studies are needed to determine the impact of reducing CNS medication exposure on mobility problems.

Original languageEnglish (US)
Pages (from-to)916-922
Number of pages7
JournalPharmacoepidemiology and Drug Safety
Volume18
Issue number10
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Mobility Limitation
Body Composition
Central Nervous System
Health
Independent Living
Health Behavior
Opioid Receptors
GABA-A Receptors
Self Report
Antidepressive Agents
Antipsychotic Agents
Health Status
Longitudinal Studies
Cohort Studies
Demography
Confidence Intervals
Interviews
Pharmaceutical Preparations

Keywords

  • Aged
  • Central nervous system drugs
  • Mobility

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Epidemiology

Cite this

Boudreau, R. M., Hanlon, J. T., Roumani, Y. F., Studenski, S. A., Ruby, C. M., Wright, R. M., ... Newman, A. B. (2009). Central nervous system medication use and incident mobility limitation in community elders: The health, aging, and body composition study. Pharmacoepidemiology and Drug Safety, 18(10), 916-922. https://doi.org/10.1002/pds.1797

Central nervous system medication use and incident mobility limitation in community elders : The health, aging, and body composition study. / Boudreau, Robert M.; Hanlon, Joseph T.; Roumani, Yazan F.; Studenski, Stephanie A.; Ruby, Christine M.; Wright, Rollin M.; Hilmer, Sarah N.; Shorr, Ronald I.; Bauer, Douglas C.; Simonsick, Eleanor Marie; Newman, Anne B.

In: Pharmacoepidemiology and Drug Safety, Vol. 18, No. 10, 2009, p. 916-922.

Research output: Contribution to journalArticle

Boudreau, RM, Hanlon, JT, Roumani, YF, Studenski, SA, Ruby, CM, Wright, RM, Hilmer, SN, Shorr, RI, Bauer, DC, Simonsick, EM & Newman, AB 2009, 'Central nervous system medication use and incident mobility limitation in community elders: The health, aging, and body composition study', Pharmacoepidemiology and Drug Safety, vol. 18, no. 10, pp. 916-922. https://doi.org/10.1002/pds.1797
Boudreau, Robert M. ; Hanlon, Joseph T. ; Roumani, Yazan F. ; Studenski, Stephanie A. ; Ruby, Christine M. ; Wright, Rollin M. ; Hilmer, Sarah N. ; Shorr, Ronald I. ; Bauer, Douglas C. ; Simonsick, Eleanor Marie ; Newman, Anne B. / Central nervous system medication use and incident mobility limitation in community elders : The health, aging, and body composition study. In: Pharmacoepidemiology and Drug Safety. 2009 ; Vol. 18, No. 10. pp. 916-922.
@article{b26c6d164b0c48f1b4bedc6df930c7e5,
title = "Central nervous system medication use and incident mobility limitation in community elders: The health, aging, and body composition study",
abstract = "Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation. Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews. Summated standardized daily doses (low, medium, and high) and duration of CNS drug use were computed. Incident mobility limitation was operationalized as two consecutive self-reports of having any difficulty walking 1/4 mile or climbing 10 steps without resting every 6 months after baseline. Multivariable Cox proportional hazard analyses were conducted adjusting for demographics, health behaviors, health status, and common indications for CNS medications. Results: Each year at least 13.9{\%} of participants used a CNS medication. By year 6, overall 49{\%} had developed incident mobility limitation. In multivariable models, CNS medication users compared to never users showed a higher risk for incident mobility limitation (adjusted hazard ratio (Adj. HR) 1.28; 95{\%} confidence interval (CI) 1.12-1.47). Similar findings of increased risk were seen in analyses examining dose- and duration-response relationships. Conclusions: CNS medication use is independently associated with an increased risk of future incident mobility limitation in community dwelling elderly. Further studies are needed to determine the impact of reducing CNS medication exposure on mobility problems.",
keywords = "Aged, Central nervous system drugs, Mobility",
author = "Boudreau, {Robert M.} and Hanlon, {Joseph T.} and Roumani, {Yazan F.} and Studenski, {Stephanie A.} and Ruby, {Christine M.} and Wright, {Rollin M.} and Hilmer, {Sarah N.} and Shorr, {Ronald I.} and Bauer, {Douglas C.} and Simonsick, {Eleanor Marie} and Newman, {Anne B.}",
year = "2009",
doi = "10.1002/pds.1797",
language = "English (US)",
volume = "18",
pages = "916--922",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "John Wiley and Sons Ltd",
number = "10",

}

TY - JOUR

T1 - Central nervous system medication use and incident mobility limitation in community elders

T2 - The health, aging, and body composition study

AU - Boudreau, Robert M.

AU - Hanlon, Joseph T.

AU - Roumani, Yazan F.

AU - Studenski, Stephanie A.

AU - Ruby, Christine M.

AU - Wright, Rollin M.

AU - Hilmer, Sarah N.

AU - Shorr, Ronald I.

AU - Bauer, Douglas C.

AU - Simonsick, Eleanor Marie

AU - Newman, Anne B.

PY - 2009

Y1 - 2009

N2 - Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation. Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews. Summated standardized daily doses (low, medium, and high) and duration of CNS drug use were computed. Incident mobility limitation was operationalized as two consecutive self-reports of having any difficulty walking 1/4 mile or climbing 10 steps without resting every 6 months after baseline. Multivariable Cox proportional hazard analyses were conducted adjusting for demographics, health behaviors, health status, and common indications for CNS medications. Results: Each year at least 13.9% of participants used a CNS medication. By year 6, overall 49% had developed incident mobility limitation. In multivariable models, CNS medication users compared to never users showed a higher risk for incident mobility limitation (adjusted hazard ratio (Adj. HR) 1.28; 95% confidence interval (CI) 1.12-1.47). Similar findings of increased risk were seen in analyses examining dose- and duration-response relationships. Conclusions: CNS medication use is independently associated with an increased risk of future incident mobility limitation in community dwelling elderly. Further studies are needed to determine the impact of reducing CNS medication exposure on mobility problems.

AB - Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation. Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews. Summated standardized daily doses (low, medium, and high) and duration of CNS drug use were computed. Incident mobility limitation was operationalized as two consecutive self-reports of having any difficulty walking 1/4 mile or climbing 10 steps without resting every 6 months after baseline. Multivariable Cox proportional hazard analyses were conducted adjusting for demographics, health behaviors, health status, and common indications for CNS medications. Results: Each year at least 13.9% of participants used a CNS medication. By year 6, overall 49% had developed incident mobility limitation. In multivariable models, CNS medication users compared to never users showed a higher risk for incident mobility limitation (adjusted hazard ratio (Adj. HR) 1.28; 95% confidence interval (CI) 1.12-1.47). Similar findings of increased risk were seen in analyses examining dose- and duration-response relationships. Conclusions: CNS medication use is independently associated with an increased risk of future incident mobility limitation in community dwelling elderly. Further studies are needed to determine the impact of reducing CNS medication exposure on mobility problems.

KW - Aged

KW - Central nervous system drugs

KW - Mobility

UR - http://www.scopus.com/inward/record.url?scp=70450214091&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70450214091&partnerID=8YFLogxK

U2 - 10.1002/pds.1797

DO - 10.1002/pds.1797

M3 - Article

VL - 18

SP - 916

EP - 922

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

IS - 10

ER -