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Polypharmacy Is Associated with Frailty, Nutritional Risk and Chronic Disease in Chilean Older Adults: Remarks from PIEI-ES Study

Authors Arauna D, Cerda A, García-García JF, Wehinger S, Castro F, Méndez D, Alarcón M, Fuentes E, Palomo I

Received 28 January 2020

Accepted for publication 7 May 2020

Published 29 June 2020 Volume 2020:15 Pages 1013—1022


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker

Diego Arauna,1,* Alvaro Cerda,2,3,* José Francisco García-García,4 Sergio Wehinger,1 Felipe Castro,5 Diego Méndez,1 Marcelo Alarcón,1 Eduardo Fuentes,1,2 Iván Palomo1,2

1Thrombosis Research Center, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Interdisciplinary Center on Aging, Universidad de Talca, Talca, Chile; 2Thematic Task Force on Healthy Aging, CUECH Research Network, Viña Del Mar, Chile; 3Center of Excellence in Translational Medicine, CEMT-BIOREN, Department of Basic Sciences, Universidad de la Frontera, Temuco, Chile; 4Department of Geriatric Medicine, Complejo Hospitalario de Toledo, Toledo, Spain; 5School of Medicine, Universidad de Talca, Talca, Chile

*These authors contributed equally to this work

Correspondence: Eduardo Fuentes; Iván Palomo Email [email protected]; [email protected]

Aim: To analyze the relationship between polypharmacy and variables as frailty and other chronic comorbidities in Chilean older adults.
Design: Cross-sectional study.
Participants: One thousand two hundred and five older adults aged 65 and older.
Methods: The presence or absence of frailty syndrome was determined according to Fried criteria. Data collection was made through questionnaires conducted by an interview.
Results: The prevalence of polypharmacy was 37.59%. The prevalence of hyperpolypharmacy was 2%. Increased prevalence of frailty was demonstrated regarding the progression of the state of polypharmacy. When analyzing the contribution of frailty respect polypharmacy condition, frail state, nutritional risk and obesity are founded as a factor associated with polypharmacy. Regarding chronic disease, hypertension (OR: 8.039, p< 0.0001), type 2 diabetes (OR: 4.001, p< 0.0001) and respiratory diseases (OR: 2.930, p< 0.0001) were associated to polypharmacy. It was found a strong and significant positive correlation between polypharmacy prevalence and frailty score (polypharmacy condition, Spearman R: 0.89, p=0.033; hyperpolypharmacy condition, Spearman R: 0.94, p=0.016). When analyzing the contribution of the polypharmacy to the presence of frailty, polypharmacy condition (OR: 1.510, p< 0.05), cognitive impairment (OR: 3.887, p< 0.001), obesity (OR: 1.560, p< 0.01) and nutritional risk (OR: 2.590, p< 0.001) are associated to frailty.
Conclusion: Frailty and chronic conditions as nutritional risk, obesity, hypertension, type 2 diabetes and respiratory disease are an important risk factor for the development of polypharmacy in Chilean older adults. Likewise, polypharmacy condition was observed to be a risk factor for frailty, demonstrating the bidirectional relationship between both conditions. Frailty syndrome evaluation in Chilean older adults could be an important alternative for polypharmacy prevention.

Keywords: frailty, polypharmacy, chronic disease, older adults, aging

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