Gut microbiota composition is associated with polypharmacy in elderly hospitalized patients

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Andrea Ticinesi1,2, Christian Milani3, Fulvio Lauretani4,5

  • 1Department of Medicine and Surgery, University of Parma, Parma, Italy. andrea.ticinesi@unipr.it.

Scientific Reports
|September 13, 2017
PubMed

Insights

Polypharmacy in older adults is linked to reduced gut microbial diversity, impacting health outcomes. This study highlights how multiple medications can alter the gut microbiome, potentially leading to adverse clinical consequences.

Area of Science:

  • Gerontology
  • Microbiology
  • Pharmacology

Background:

  • Aging is associated with decreased gut microbiota diversity and increased opportunistic pathogens.
  • The relationship between gut microbiota, polypharmacy, multimorbidity, and frailty in older adults is understudied.

Purpose of the Study:

  • To investigate the correlation between polypharmacy, multimorbidity, frailty, and gut microbiota composition in elderly inpatients.
  • To assess the impact of gut microbiota biodiversity on mortality, rehospitalizations, and incident sepsis over a 2-year follow-up.

Main Methods:

  • Analysis of fecal microbiota from 76 inpatients (mean age 83 years) using next-generation 16S rRNA sequencing.
  • Correlation analysis using multivariate linear regression models for drug number, multimorbidity, and frailty indexes.
  • Cox regression analysis to evaluate the association of gut microbiota biodiversity with clinical outcomes.

Main Results:

  • A significant negative correlation was found between the number of drugs and gut microbial diversity (Chao1 index).
  • Polypharmacy was associated with the relative abundance of 15 bacterial taxa, with proton pump inhibitors, antidepressants, and antipsychotics showing the strongest links.
  • Frailty and multimorbidity were not significantly associated with gut microbiota biodiversity.
  • A very low Chao1 index predicted mortality but not rehospitalizations or sepsis at follow-up.

Conclusions:

  • Polypharmacy, rather than frailty or multimorbidity, appears to be a key determinant of gut microbiota composition in aging.
  • Alterations in gut microbiota due to multiple medications may have detrimental clinical consequences for older individuals.
  • Reduced gut microbial diversity is a significant predictor of mortality in the elderly.

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