Abstract：
BACKGROUND: We prospectively examined the effect of baseline multimorbidity and polypharmacy on the physical function of community-dwelling older adults over a three-year period.
METHODS: The analysis included 1,401 older adults (51.5 % women) who participated in both wave 1 and wave 2 (3-year follow-up) of the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC) study. Grip strength and walking speed were binarized into poor/not poor physical function according to the frailty definition. The number of chronic conditions and the number of prescribed medications were categorized into 3 and 4 groups, respectively. Multivariable logistic regression was used to examine associations between the number of chronic conditions, medication use at baseline, and poor physical function over a three-year period.
RESULTS: After adjusting for confounding factors, hyperpolypharmacy (≥ 10 medications) demonstrated associations with weak grip strength (adjusted odds ratio [aOR] = 2.142, 95 % confidence interval [CI] = 1.100-4.171) and slow walking speed (aOR = 1.878, 95 % CI = 1.013-3.483), while co-medication (1-4 medications) was negatively associated with slow walking speed (aOR = 0.688, 95 % CI = 0.480-0.986). There was no significant association between the number of chronic conditions and physical function.
CONCLUSIONS: The findings suggest that the number of medications can serve as a simple indicator to assess the risk of physical frailty. Given that many older individuals receive multiple medications for extended durations, medical management approaches must consider not only disease-specific treatment outcomes but also prioritize drug therapy while actively avoiding the progression towards frailty and geriatric syndromes.
METHODS: The analysis included 1,401 older adults (51.5 % women) who participated in both wave 1 and wave 2 (3-year follow-up) of the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC) study. Grip strength and walking speed were binarized into poor/not poor physical function according to the frailty definition. The number of chronic conditions and the number of prescribed medications were categorized into 3 and 4 groups, respectively. Multivariable logistic regression was used to examine associations between the number of chronic conditions, medication use at baseline, and poor physical function over a three-year period.
RESULTS: After adjusting for confounding factors, hyperpolypharmacy (≥ 10 medications) demonstrated associations with weak grip strength (adjusted odds ratio [aOR] = 2.142, 95 % confidence interval [CI] = 1.100-4.171) and slow walking speed (aOR = 1.878, 95 % CI = 1.013-3.483), while co-medication (1-4 medications) was negatively associated with slow walking speed (aOR = 0.688, 95 % CI = 0.480-0.986). There was no significant association between the number of chronic conditions and physical function.
CONCLUSIONS: The findings suggest that the number of medications can serve as a simple indicator to assess the risk of physical frailty. Given that many older individuals receive multiple medications for extended durations, medical management approaches must consider not only disease-specific treatment outcomes but also prioritize drug therapy while actively avoiding the progression towards frailty and geriatric syndromes.
摘要：
背景：我们前瞻性研究了基线多发病率和多药疗法对社区居住老年人身体功能的影响。
方法：该分析包括1,401名老年人（51.5％的女性），他们参加了七等人的第1波和第2波（3年随访），八位老人,与百岁老人调查(SONIC)研究。根据虚弱定义，握力和步行速度被二值化为差/不差的身体功能。慢性病的数量和处方药的数量分为3和4组，分别。多变量逻辑回归用于检查慢性病数量之间的关联，基线时的药物使用，三年来身体机能差。
结果：调整混杂因素后，多药（≥10种药物）显示与弱握力（调整比值比[aOR]=2.142，95％置信区间[CI]=1.100-4.171）和缓慢步行速度（aOR=1.878，95％CI=1.013-3.483）有关，而联合用药（1-4种药物）与缓慢的步行速度呈负相关（aOR=0.688，95％CI=0.480-0.986）。慢性病的数量与身体功能之间没有显着关联。
结论：研究结果表明，药物的数量可以作为评估身体虚弱风险的简单指标。鉴于许多老年人长期接受多种药物治疗，医学管理方法不仅必须考虑疾病特异性治疗结果,而且必须优先考虑药物治疗,同时积极避免向虚弱和老年综合征的进展.
方法：该分析包括1,401名老年人（51.5％的女性），他们参加了七等人的第1波和第2波（3年随访），八位老人,与百岁老人调查(SONIC)研究。根据虚弱定义，握力和步行速度被二值化为差/不差的身体功能。慢性病的数量和处方药的数量分为3和4组，分别。多变量逻辑回归用于检查慢性病数量之间的关联，基线时的药物使用，三年来身体机能差。
结果：调整混杂因素后，多药（≥10种药物）显示与弱握力（调整比值比[aOR]=2.142，95％置信区间[CI]=1.100-4.171）和缓慢步行速度（aOR=1.878，95％CI=1.013-3.483）有关，而联合用药（1-4种药物）与缓慢的步行速度呈负相关（aOR=0.688，95％CI=0.480-0.986）。慢性病的数量与身体功能之间没有显着关联。
结论：研究结果表明，药物的数量可以作为评估身体虚弱风险的简单指标。鉴于许多老年人长期接受多种药物治疗，医学管理方法不仅必须考虑疾病特异性治疗结果,而且必须优先考虑药物治疗,同时积极避免向虚弱和老年综合征的进展.
