Polypharmacy is associated with functional decline in Alzheimer's disease and Lewy body dementia.
| Title: | Polypharmacy is associated with functional decline in Alzheimer's disease and Lewy body dementia. |
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| Authors: | Borda MG; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway. Electronic address: migbor@sus.no.; Castellanos-Perilla N; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia.; Tovar-Rios DA; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Universidad Del Valle, Grupo de Investigación en Estadística Aplicada - INFERIR, Faculty of Engineering, Santiago De Cali, Valle Del Cauca, Colombia.; Universidad Del Valle, Prevención y Control de la Enfermedad Crónica - PRECEC, Faculty of Health, Santiago De Cali, Valle Del Cauca, Colombia.; Oesterhus R; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; The Hospital Pharmacy Enterprise of Western Norway, Bergen, Norway.; Soennesyn H; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Aarsland D; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. |
| Source: | Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2021 Sep-Oct; Vol. 96, pp. 104459. Date of Electronic Publication: 2021 Jun 24. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Elsevier Biomedical Press Country of Publication: Netherlands NLM ID: 8214379 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6976 (Electronic) Linking ISSN: 01674943 NLM ISO Abbreviation: Arch Gerontol Geriatr Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam : Elsevier Biomedical Press, c1982- |
| MeSH Terms: | Alzheimer Disease*/drug therapy ; Alzheimer Disease*/epidemiology ; Cognitive Dysfunction*/epidemiology ; Lewy Body Disease*/drug therapy ; Lewy Body Disease*/epidemiology; Cohort Studies ; Humans ; Polypharmacy |
| Abstract: | Background: In dementia, a number of factors may influence functional decline in addition to cognition. In this study, we aimed to study the potential association of the number of prescribed medications with functional decline trajectories over a five-year follow-up in people diagnosed with mild Alzheimer's disease (AD) or Lewy Body dementia (LBD).; Methods: This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway". We included 196 patients newly diagnosed with AD (n=111) and LBD (n=85), followed annually for 5 years. We conducted linear mixed-effects models to analyse the association of the number of medications with functional decline measured by the Rapid Disability Rating Scale - 2.; Results: The mean prescribed medications at baseline was 4.18∓2.60, for AD 3.92∓2.51 and LBD 4.52∓2.70. The number of medications increased during the follow-up; at year five the mean for AD was 7.28∓4.42 and for LBD 8.11∓5.16. Using more medications was associated with faster functional decline in AD (Est 0.04, SE 0.01, p-value 0.003) and LBD (Est 0.08, SE 0.03, p-value 0.008) after adjusting for age, sex, comorbidity, neuropsychiatric symptoms, and cognition. For each medication added during the follow-up, functional trajectories worsened by 1% for AD and 2% for LBD. The number of medications was not associated with cognitive decline.; Conclusion: We found that higher number of medications was related to a faster functional decline, both in AD and LBD. With disease progression, there was an increase in the number of medications. Prescription in dementia should be carefully assessed, possibly improving the functional prognosis.; (Copyright © 2021 Elsevier B.V. All rights reserved.) |
| Contributed Indexing: | Keywords: Alzheimer's disease; Dementia; Functional disability; Lewy body dementia; Medications; Polypharmacy |
| Entry Date(s): | Date Created: 20210705 Date Completed: 20210906 Latest Revision: 20210906 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.archger.2021.104459 |
| PMID: | 34225098 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't