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What Should Clinicians Do for Older Adults with Polypharmacy and Depression? [Response to Letter]

Authors Cheng C , Bai J

Received 16 April 2022

Accepted for publication 18 April 2022

Published 26 April 2022 Volume 2022:17 Pages 601—602


Cheng Cheng,1 Jie Bai2

1School of Nursing, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 2Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

Correspondence: Cheng Cheng, Email [email protected]

View the original paper by Dr Cheng and colleagues

This is in response to the Letter to the Editor

Dear editor

We greatly appreciate the comments of Zhu and Zhou on our recent paper1 and are glad to see more and more healthcare professionals start to focus on the mental health of Chinese older adults.

Multimorbidity is becoming a major public health concern in China. Evidence showed that the prevalence of multimorbidity was 44% among Chinese older adults.2 Multimorbidity is a principal cause of polypharmacy, which lead to many negative consequences such as an increased risk of adverse drug events (ADEs).3 In addition, as some studies added,1,4 having polypharmacy may contribute to the development of depression.

By reading the clinical cases shared by Zhu and Zhou, we first suggested that healthcare professionals should understand the possible existence of depression and/or other mood disorders, which may complicate the management of older adults with polypharmacy. Next, the link between polypharmacy and depression should be interpreted with caution. Accurate and comprehensive measurement for polypharmacy is a priority for further research. Information regarding self-medication and non-prescribed medication should be taken into consideration. Last, there was no strong evidence to support that interventions addressing appropriate polypharmacy can improve clinical outcomes such as medication appropriateness.5 This suggests that whether mental health can be enhanced by interventions that emphasize polypharmacy remains to be elucidated. Also, it is necessary for healthcare professionals to further develop innovative interventions by focusing on the format, structure, features, and content to promote health among older adults with polypharmacy.


The authors declare that there is no conflict of interest in this communication.


1. Cheng C, Bai J. Association Between Polypharmacy, Anxiety, and Depression Among Chinese Older Adults: evidence from the Chinese Longitudinal Healthy Longevity Survey. Clin Interv Aging. 2022;17:235–244. doi:10.2147/cia.S351731

2. Li C, Zhou R, Yao N, Cornwell T, Wang S. Health Care Utilization and Unmet Needs in Chinese Older Adults With Multimorbidity and Functional Impairment. J Am Med Dir Assoc. 2020;21(6):806–810. doi:10.1016/j.jamda.2020.02.010

3. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57–65. doi:10.1517/14740338.2013.827660

4. Palapinyo S, Methaneethorn J, Leelakanok N. Association between polypharmacy and depression: a systematic review and meta-analysis. J Pharm Practice Res. 2021;51(4):280–299. doi:10.1002/jppr.1749

5. Rankin A, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2018;9(9):CD008165–CD008165. doi:10.1002/14651858.CD008165.pub4

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