TY - JOUR
T1 - High-risk prescribing and incidence of frailty among older community-dwelling men
AU - Gnjidic, D.
AU - Hilmer, S. N.
AU - Blyth, F. M.
AU - Naganathan, V.
AU - Cumming, R. G.
AU - Handelsman, D. J.
AU - McLachlan, A. J.
AU - Abernethy, D. R.
AU - Banks, E.
AU - Le Couteur, D. G.
PY - 2012/3
Y1 - 2012/3
N2 - 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.
AB - 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.
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U2 - 10.1038/clpt.2011.258
DO - 10.1038/clpt.2011.258
M3 - Article
C2 - 22297385
AN - SCOPUS:84857238588
SN - 0009-9236
VL - 91
SP - 521
EP - 528
JO - Clinical pharmacology and therapeutics
JF - Clinical pharmacology and therapeutics
IS - 3
ER -