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Associations Between Polypharmacy and Cognitive and Physical Capability: A British Birth Cohort Study
Mark James Rawle1, Rachel Cooper1, Diana Kuh1
1Unit for Lifelong Health and Ageing, Medical Research Council, University College London, London, United Kingdom.
Journal of the American Geriatrics Society
|March 26, 2018
Summary
Polypharmacy, the use of multiple medications, is linked to declines in cognitive and physical function. Cumulative exposure to many drugs over time worsens these effects, highlighting the need for medication review.
Area of Science:
- Gerontology
- Clinical Pharmacology
- Public Health
Background:
- Polypharmacy is a growing concern in aging populations, potentially impacting health outcomes.
- Understanding the long-term effects of multiple medication use on functional capabilities is crucial.
Purpose of the Study:
- To examine the longitudinal relationship between polypharmacy and cognitive/physical function.
- To assess if cumulative exposure to polypharmacy modifies these associations.
Main Methods:
- A prospective birth cohort study involving participants from England, Scotland, and Wales.
- Cognitive function assessed via word learning, visual search speed, and ACE-III; physical function measured by chair rise, balance, walking speed, and grip strength.
- Medication data collected at age 69, with analysis of cumulative exposure from age 60-64.
Main Results:
- Polypharmacy (5-8 medications) and excessive polypharmacy (≥9 medications) were associated with poorer cognitive and physical capability.
- Excessive polypharmacy showed stronger negative associations with cognitive function (ACE-III scores).
- Participants with polypharmacy at both age 60-64 and 69 exhibited the most significant declines in cognitive and physical function.
Conclusions:
- Polypharmacy is longitudinally associated with diminished cognitive and physical capability, independent of disease burden.
- A cumulative, dose-dependent relationship exists, where prolonged or higher-dose polypharmacy exacerbates functional decline.
- Interventions to reduce polypharmacy duration and intensity at earlier ages are recommended to preserve cognitive and physical health.
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