Polypharmacy and Associated Health Outcomes in the PARI-HD Study

Article type: Research Article

Authors: Torres-Atencio, Ivonne^{a; 1} | Carreira, Maria B.^{b; 1} | Méndez, Alondra^a | Quintero, Maryonelly^a | Broce, Adriana^a | Oviedo, Diana C.^{b; c} | Rangel, Giselle^b | Villarreal, Alcibiades E.^b | Tratner, Adam E.^d | Rodríguez-Araña, Sofía^b | Britton, Gabrielle B.^{b; *} | for the Panama Aging Research Initiative-Health Disparities (PARI-HD) Study

Affiliations: [a] Departamento de Farmacología, Facultad de Medicina, Universidad de Panamá, Panama City, Panama | [b] Centro de Neurociencias, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Ciudad del Saber, Panama City, Panama | [c] Escuela de Psicología, Universidad Católica Santa María La Antigua, Panama City, Panama | [d] Florida State University, Republic of Panama Campus, Ciudad del Saber, Panama City, Panama

Correspondence: [*] Correspondence to: Gabrielle B. Britton, PhD, Centro de Neurociencias, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Ciudad del Saber #208, Clayton, Apartado Postal 0843-01103, Panama City, Panama. Tel.: +507 5170735; E-mail: gbritton@indicasat.org.pa; ORCID: 0000-0002-1758-2495.

Note: [1] These authors contributed equally to this work.

Abstract: Background:A growing body of evidence points to potential risks associated with polypharmacy (using ≥5 medications) in older adults, but most evidence is derived from studies where racial and ethnic minorities remain underrepresented among research participants. Objective:Investigate the association between polypharmacy and cognitive function, subjective health state, frailty, and falls in Hispanic older adults. Methods:Panama Aging Research Initiative–Health Disparities (PARI-HD) is a community-based cohort study of older adults free of dementia at baseline. Cognitive function was measured with a neuropsychological test battery. Frailty assessment was based on the Fried criteria. Subjective health state and falls were self-reported. Linear and multinomial logistic regression analyses were used to examine association. Results:Baseline evaluations of 468 individuals with a mean age of 69.9 years (SD = 6.8) were included. The median number of medications was 2 (IQR: 1–4); the rate of polypharmacy was 19.7% (95% confidence interval [CI] = 16.1–23.3). Polypharmacy was inversely associated with self-rated overall health (b =−5.89, p < 0.01). Polypharmacy users had 2.3 times higher odds of reporting two or more falls in the previous 12 months (odds ratio [OR] = 2.31, 95% CI = 1.06–5.04). Polypharmacy was independently associated with Fried’s criteria for pre-frailty (OR = 2.90, 95% CI = 1.36–5.96) and frailty (OR = 5.14, 95% CI = 1.83–14.42). Polypharmacy was not associated with cognitive impairment. Conclusions:These findings illustrate the potential risks associated with polypharmacy among older adults in Panama and may inform interventions to improve health outcomes in this population.

Keywords: Aging, Alzheimer’s disease, Central America, cognitive impairment, dementia, falls, frailty, Latin America, polypharmacy

DOI: 10.3233/JAD-231001

Journal: Journal of Alzheimer's Disease, vol. 98, no. 1, pp. 287-300, 2024