Affiliations: [a]
Department of Community Healthcare & Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| [b]
Center for Comprehensive Care and Research on Memory Disorder, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| [c]
Department of Cognition and Behaviour Science, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
Correspondence:
[*]
Correspondence to: Hiroyuki Umegaki, Department of Community Healthcare & Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. Tel.: +81 52 744 2364; Fax: +81 52 744 2371; E-mail: umegaki@med.nagoya-u.ac.jp.
Abstract: Background:Polypharmacy, usually defined as the use of 5 or more drugs, is associated with reduced quality of life, adverse events, and frailty. Slow gait speed is a component of physical frailty, and some studies have suggested an association between polypharmacy and slow gait speed. Objective:We aimed to determine the effects of polypharmacy on the gait difference according to stages of cognitive decline in a cross-sectional study of memory clinic patients. Methods:Participants were 431 outpatients aged 65 year or older who were cognitively normal (CN) or had mild cognitive impairment (MCI) or dementia due to Alzheimer’s disease. Participants were divided into a polypharmacy group and a non-polypharmacy group in each group. Multiple regression analysis and logistic analysis were used for data analysis. Results:There were 182 patients in the polypharmacy group and 249 patients in the non-polypharmacy group. Multiple regression analysis revealed that gait speed had significant negative associations with number of medications and polypharmacy status in the CN group (β: –0.026 [–0.041 to –0.0018] and –0.128 [–0.022 to –0.0033], respectively) and MCI group (–0.018 [–0.028 to –0.0009] and –0.100 [–0.166 to –0.0034]). Logistic regression analysis also showed that number of medications was associated with slow gait status (< 1 m/s) in the CN group (OR: 1.336 [1.115 to 1.601]) and MCI group (1.128 [1.022 to 1.244]). Conclusion:CN and MCI patients with polypharmacy have slower gait speed. Attention should be paid to decreased gait speed in older adults with polypharmacy even when their cognitive function is relatively preserved.
