Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review

The Lancet Healthy Longevity, Год журнала: 2024, Номер 5(4), С. e287 - e296

Опубликована: Март 4, 2024

Multimorbidity (multiple conditions) and polypharmacy medications) are increasingly common, yet there is a need to better understand the prevalence of co-occurrence. In this systematic review, we examined multimorbidity among adults (≥18 years) older (≥65 in clinical community settings. Six electronic databases were searched, 87 studies retained after two levels screening. Most focused on 65 years done population-based Although operational definitions varied across studies, consistent cut-points (two or more conditions five used most studies. adult samples, ranged from 4·8% 93·1%, while 2·6% 86·6%. High heterogeneity between indicates for reporting specific lists medications definitions.

Язык: Английский

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The FORTA (Fit fOR The Aged) List 2021: Fourth Version of a Validated Clinical Aid for Improved Pharmacotherapy in Older Adults

Drugs & Aging, Год журнала: 2022, Номер 39(3), С. 245 - 247

Опубликована: Фев. 23, 2022

Язык: Английский

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Association of polypharmacy and potential drug‐drug interactions with adverse treatment outcomes in older adults with advanced cancer

Cancer, Год журнала: 2023, Номер 129(7), С. 1096 - 1104

Опубликована: Янв. 24, 2023

Abstract Background Polypharmacy is common in older adults who are starting cancer treatment and associated with an increased risk of potentially inappropriate medications (PIMs) potential drug‐drug interactions (PDIs). The authors evaluated the association medication measures adverse outcomes advanced were receiving systemic therapy. Methods This secondary analysis from GAP 70+ Trial (ClinicalTrials.gov identifier NCT02054741; principal investigator, Supriya G. Mohile) enrolled patients aged 70 years planned to start a new regimen ( n = 718). was assessed before initiation defined as concurrent use eight or more medications. PIMs categorized using 2019 Beers Criteria Screening Tool Older Persons' Prescriptions. PDIs Lexi‐Interact Online. Study within 3 months included: (1) number grade ≥2 ≥3 toxicities according National Cancer Institute Common Toxicity Criteria, (2) treatment‐related unplanned hospitalization, (3) early discontinuation. Multivariable regression models examined outcomes. Results mean patient age 77 years, 57% had lung gastrointestinal cancers. median five (range, 0–24 medications), 28% received medications, 67% one PIM, 25% major PDI. polypharmacy 9.8 versus 7.7 those without (adjusted β 1.87; standard error, 0.71; p <.01). 2.9 2.2 0.59; 0.29; .04). Patients PDI 59% higher odds discontinuation (odds ratio, 1.59; 95% confidence interval, 1.03–2.46; .03). Conclusions In cohort cancer, Providing meaningful screening interventional tools optimize may improve these patients.

Язык: Английский

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Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta‐analysis

Journal of Cachexia Sarcopenia and Muscle, Год журнала: 2023, Номер 14(2), С. 671 - 683

Опубликована: Фев. 13, 2023

Abstract Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim this systematic review and meta‐analysis was to investigate association sarcopenia polypharmacy higher number medications. A literature search observational studies using PubMed, Web Science, Scopus Cochrane Library databases conducted inception until June 2022. To determine if a risk increased medications, random‐effects model used calculate pooled effects (CRD42022337539). Twenty‐nine were included meta‐analysis. Sarcopenia prevalence (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I 2 = 84%, P < 0.01) medications (mean difference: 1.39, CI [0.59, 2.19], 95%, compared individuals without sarcopenia. Using meta‐regression, high variance observed due different populations (i.e., community‐dwelling, nursing home residents, inpatients, outpatients) for both outcomes ( r −0.338, SE 0.1669, [−0.67, −0.01], z −2.03, 0.04) 0.589, 0.2615, [0.08, 1.10], 2.25, 0.02). This reported significantly people condition. Future research should clarify whether specificity direct contributor accelerating progression muscle wasting dysfunction contributing adults.

Язык: Английский

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Polypharmacology: promises and new drugs in 2022

Pharmacological Reports, Год журнала: 2023, Номер 75(4), С. 755 - 770

Опубликована: Июнь 6, 2023

Abstract Polypharmacology is an emerging strategy of design, synthesis, and clinical implementation pharmaceutical agents that act on multiple targets simultaneously. It should not be mixed up with polytherapy, which based the use selective drugs considered a cornerstone current practice. However, this ‘classic’ approach, when facing urgent medical challenges, such as multifactorial diseases, increasing resistance to pharmacotherapy, multimorbidity, seems insufficient. The ‘novel’ polypharmacology concept leads more predictable pharmacokinetic profile multi-target-directed ligands (MTDLs), giving chance avoid drug-drug interactions improve patient compliance due simplification dosing regimens. Plenty recently marketed interact biological or disease pathways. Many offer significant additional benefit compared standard treatment In paper, we will briefly outline genesis its differences polytherapy. We also present leading concepts for obtaining MTDLs. Subsequently, describe some successfully drugs, mechanisms action are interaction targets. To get idea, whether MTDLs indeed important in contemporary pharmacology, carefully analyzed approved 2022 Germany: 10 out them were found multi-targeting, including 7 antitumor agents, 1 antidepressant, hypnotic, drug indicated eye disease.

Язык: Английский

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Knee osteoarthritis: disease burden, available treatments, and emerging options

Therapeutic Advances in Musculoskeletal Disease, Год журнала: 2024, Номер 16

Опубликована: Янв. 1, 2024

Osteoarthritis (OA) is a prevalent condition that affects nearly 528 million people worldwide, including 23% of the global population aged ⩾40, and characterized by progressive damage to articular cartilage, which often leads substantial pain, stiffness, reduced mobility for affected patients. Pain related OA barrier maintaining physical activity leading cause disability, accounting 2.4% all years lived with disability globally, reducing ability work in 66% US patients increasing absenteeism 21% OA. The joint most commonly involved knee, about 60%–85% cases. aging longer life expectancy, coupled earlier younger diagnoses, translate into growing cohort symptomatic need alternatives surgery. Despite large number knee (OAK) high degree variability patient presentation can lead challenges diagnosis treatment. Multiple society guidelines recommend therapies OAK, but departures from healthcare professionals clinical settings reflect discordance between evidence-based treatment algorithms routine practice. Furthermore, disease-modifying pharmacotherapies are limited, OAK focuses solely on symptom relief, rather than underlying causes. In this narrative review, we summarize journey, analyze current disease burden nonsurgical therapy recommendations highlight emerging promising therapies—such as cryoneurolysis, long-acting corticosteroids, gene therapies—for debilitating condition.

Язык: Английский

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Chronic diseases spectrum and multimorbidity in elderly inpatients based on a 12-year epidemiological survey in China

BMC Public Health, Год журнала: 2024, Номер 24(1)

Опубликована: Фев. 17, 2024

Abstract Background The number and proportion of the elderly population have been continuously increasing in China, leading to elevated prevalence chronic diseases multimorbidity, which ultimately brings heavy burden society families. Meanwhile, status multimorbidity tends be more complex inpatients than community population. In view above concerns, this study was designed investigate health by analyzing clinical data Chinese People's Liberation Army (PLA) General Hospital from 2008 2019, including constitution common diseases, comorbidities, in-hospital death polypharmacy among inpatients, so as better understand spectrum also provide supporting evidence for targeted management elderly. Methods A database set up collecting medical records 2019 PLA Hospital, focusing on characteristics inpatients. study, we collected aged ≥ 65 years old, further analyzed rates mortality causes past decade. addition, prescriptions were Results total 210,169 patients hospitalized January 1st, December 31st, 2019. corresponding hospitalizations 290,833. average age 72.67 old. Of population, 73,493 re-admitted within one year, with re-hospitalization rate 25.27%. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus cerebrovascular disease top 5 diseases. Among two or long-term conditions 267,259, accounting 91.89%, an 4.68 medications taken 5.4, which, taking types accounted 55.42%. Conclusions By found that has turned out a prominent problem greatly affecting process healthy aging families society. Therefore, multidisciplinary treatment should strengthened make reasonable preventive therapeutic strategies improve life quality attention paid avoid preventable side effects caused irrational medication therapy.

Язык: Английский

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The co-occurrence of multimorbidity and polypharmacy among middle-aged and older adults in Canada: A cross-sectional study using the Canadian Longitudinal Study on Aging (CLSA) and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN)

PLoS ONE, Год журнала: 2025, Номер 20(1), С. e0312873 - e0312873

Опубликована: Янв. 15, 2025

Background There is an increasing prevalence of multiple conditions (multimorbidity) and medications (polypharmacy) across many populations. Previous literature has focused on the impact these health states separately, but there a need to better understand their co-occurrence. Methods findings This study reported multimorbidity polypharmacy among middle-aged older adults in two national datasets: Canadian Longitudinal Study Aging (CLSA) Primary Care Sentinel Surveillance Network (CPCSSN). Using consistent methodology, we conducted cross-sectional analysis CLSA participants CPCSSN patients aged 45 85 years as 2015. When was defined or more conditions, 66.7% 52.0% cohorts, respectively. The 14.9% cohort 22.6% when five medications. same cut-points, co-occurrence similar between cohorts (CLSA: 14.3%; CPCSSN: 13.5%). Approximately 20% (65 years) were living with both 21.4%; 18.3%), compared almost 10% (45 64 this 9.2%; 9.9%). Across age groups, females had consistently higher estimates multimorbidity, polypharmacy. Conclusions found that are not interchangeable understanding population needs. one polypharmacy, double proportion younger cohorts. implications for future research, well policy clinical practice, aim reduce occurrence unnecessary enhance well-being aging

Язык: Английский

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Building Consensus on the Relevant Criteria to Screen for Depressive Symptoms Among Near-Centenarians and Centenarians: Modified e-Delphi Study

JMIR Aging, Год журнала: 2025, Номер 8, С. e64352 - e64352

Опубликована: Март 5, 2025

The number of centenarians worldwide is expected to increase dramatically, reaching 3.4 million by 2050 and >25 2100. Despite these projections, depression remains a prevalent yet underdiagnosed undertreated condition among this population that carries significant health risks. This study aimed identify achieve consensus on the most representative signs symptoms in near-centenarians (aged ≥95 years) through an e-Delphi with international interdisciplinary panel experts. Ultimately, outcomes might help create screening instrument specifically designed for unique population. A modified was carried out expert depressive centenarians. 28 experts recruited. Consensus defined as 70% agreement relevance each item. Data were collected web-based questionnaire over 3 rounds. Experts rated 104 items divided into 24 dimensions 80 criteria age group. consisted from various countries, including physicians experience old psychiatry or geriatrics well nurses psychologists. response rate remained consistent rounds (20/28, 71% 21/28, 75%). In total, 4 new 8 proposed experts, reached 86% (24/28) 80% (70/88) criteria. consensual potentially relevant lack hope (21/21, 100%), loss interest (27/28, 96%), reactivity pleasant events depressed mood (26/28, 93%), previous episodes diagnosed (19/21, 90%). addition, despondency, gloom, despair (25/25, 100%); (27/27, circumstances (28/28, suicidal ideation suicide attempt(s) ruminations 96%); recurrent thoughts death feelings worthlessness (25/26, critical life (20/21, 95%); anhedonia activities 93%); pleasure sadness (24/26, 92%). Moreover, when assessing very age, duration, number, frequency, severity should also be considered, evidenced high agreement. classification elements highlights importance multidimensional approach optimal individuals age. offers first step toward improving assessment development more adapted tool could improve early detection intervention, enhancing quality mental care

Язык: Английский

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Sarcopenia and polypharmacy among older adults: A scoping review of the literature

Archives of Gerontology and Geriatrics, Год журнала: 2021, Номер 98, С. 104520 - 104520

Опубликована: Сен. 22, 2021

Язык: Английский

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