Polypharmacy Increases Frailty Risk: Study

Researchers claim that polypharmacy is associated with frailty and that reducing the number of medications taken could lessen the risks for frailty (J Am Geriatr Soc. 2017; doi:10.1111/jgs.14718).

The study team analyzed information from a large German study of older adults called ESTHER (Epidemiological Study on Chances for Prevention, Early Detection, and Optimized Therapy of Chronic Diseases at Old Age). The ESTHER study began in 2000 with almost 10,000 participants between the age of 50 and 75; follow-ups were conducted after 2, 5, 8, and 11 years.

To learn how taking more than five medicines might affect frailty in older adults, investigators studied data from 2000 of the ESTHER study participants. Frailty was assessed according to the frailty phenotype (Fried Criteria); polypharmacy and hyperpolypharmacy were defined as the concomitant use of 5 or more and 10 or more drugs, respectively.

Associations between polypharmacy and prevalent and incident frailty were assessed within 3 years of follow-up by logistic regression models controlled for multiple potential confounders including comorbidity. Two pharmacists individually reviewed all medications taken and excluded medicines and supplements that were not known to cause side effects.

The researchers learned that people who were at risk for frailty, as well as people who were frail, were more likely to be in the polypharmacy or hyperpolypharmacy groups compared with people who were not frail.

Researchers also discovered that people who took between 5 to 9 medicines were 1.5 times more likely to become frail within 3 years compared with people who took fewer than 5 medications. People who took more than 10 medicines were twice as likely to become frail within three years as people who took less than five.

Study coauthor Kai-Uwe Saum, PhD, MPH, said in a Science Daily article, “In a perfect world, [a] physician would talk about…medications with a pharmacist and a geriatrician. This might help to reduce avoidable multiple drug prescriptions and possibly also lessen medication-induced risks for frailty and other negative effects of unnecessary, avoidable polypharmacy.”—Amanda Del Signore