Polypharmacy is differentially associated with 20-year mortality among community-dwelling elderly women and men: The Israel Glucose Intolerance, Obesity and Hypertension cohort study. (April 2023)

• Record Type: Journal Article
• Authors: Orenstein, Liat; Chetrit, Angela; Goldman, Adam; Novikov, Ilya; Dankner, Rachel
• Is Part Of: Mechanisms of ageing and development. Volume 211(2023)
• Publication Date: 2023-04
• Subjects: SRH self-rated health -- IPTW inverse probability of treatment weighting -- PS propensity score -- GOH glucose intolerance, obesity and hypertension study; Sex-differences -- Polypharmacy -- Longitudinal study -- All-cause mortality -- Interaction; Aging -- Periodicals; Developmental biology -- Periodicals; Aging -- Periodicals; Developmental Biology -- Periodicals; Vieillissement -- Périodiques; Biologie du développement -- Périodiques; Aging; Developmental biology; Periodicals; 612.67
• DOI: 10.1016/j.mad.2023.111788
• Languages: English
• ISSNs: 0047-6374

Abstract

Abstract: Background: Elderly individuals are characterized by multimorbidity and high medication intake, entailing risks for adverse events. We examined the overall and sex-specific association of polypharmacy (≥5 drugs concurrently) with 20-year mortality among community-dwelling older adults. Methods: Survivors of the longitudinal Israel Study of Glucose Intolerance, Obesity, and Hypertension underwent extensive evaluation during 1999–2004, and were followed-up for all-cause mortality until 2019. Cox regression examined association of polypharmacy with all-cause mortality. Results: Data included 1210 participants (mean baseline age 72.9 ± 7.4 years, 53% females), 50.7% of them died over a median follow-up of 12.8 years. Women received a higher mean number of drugs (4.3 vs 3.5; p < 0.0001), were twice more likely to take vitamins, and had higher comorbidity. Polypharmacy prevalence was 38.3%, and more frequent with age, female sex, European-American origin, sedentary lifestyle and poor self-rated health. Polypharmacy was independently associated with mortality in women only (HR=1.41, 95%CI:1.05–1.89). An interaction was found with sex (p = 0.045). Conclusions: Polypharmacy was more prevalent in older women than men and associated with increased 20-year mortality in women only. Sex-specific adaptation of guidelines for appropriate drug use among community-dwelling older adults is warranted. Highlights: High medication intake, and consequent adverse events, are common among older adults. Women and men differed in overall survival, patterns of comorbidities and drug use. Polypharmacy was associated with increased 20-year mortality risk in women only. Sex-specific guidelines for appropriate drug use among elders are warranted.