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Nutritional Status and Potentially Inappropriate Medications in Elderly
Simona Loddo1, Francesco Salis1, Samuele Rundeddu1
1Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.
Journal of Clinical Medicine
|June 24, 2022
Summary
Malnutrition in elderly patients is linked to potentially inappropriate medications (PIM), increased adverse drug reaction (ADR) risk, and lower survival rates. Nutritional status significantly impacts PIM identification using BEERS, STOPP, and START criteria.
Area of Science:
- Gerontology
- Clinical Pharmacy
- Nutritional Science
Background:
- Polypharmacy is a growing concern in elderly care.
- The relationship between malnutrition and potentially inappropriate medications (PIM) requires further investigation.
- Nutritional status may influence PIM, survival, and adverse drug reaction (ADR) risk in older adults.
Purpose of the Study:
- To assess the impact of nutritional status, using the Mini Nutritional Assessment (MNA), on PIM, estimated 10-year survival, and ADR risk in elderly patients.
- To compare the effectiveness of BEERS 2019, STOPP, and START criteria in identifying PIM relative to nutritional status.
Main Methods:
- A descriptive study involving 3091 elderly patients (median age 80 years) from an outpatient frail older people service.
- Assessment included MNA, Charlson Comorbidity Index, 10-year survival estimation, BEERS 2019, STOPP and START criteria, and ADR Risk scores.
- Patients were categorized into three groups based on MNA scores: MNA1 (≥24), MNA2 (17-23.5), and MNA3 (<17).
Main Results:
- Worse comorbidity severity, higher rates of STOPP/START alerts, and increased BEERS criteria use were observed in MNA2 and MNA3 groups compared to MNA1.
- Estimated 10-year survival was significantly higher in MNA1 than MNA2/MNA3, and in MNA2 compared to MNA3.
- ADR risk scores were significantly lower in the MNA1 group than in the MNA2 and MNA3 groups.
Conclusions:
- Nutritional status is significantly associated with PIM identified by BEERS 2019 criteria.
- This study provides the first evidence linking nutritional status to PIM identified by STOPP and START criteria.
- Optimizing nutritional status in the elderly may reduce PIM, ADR risk, and improve survival.
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