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Association Between Polypharmacy and Physical Function in Middle-aged Adults: Findings from the CARDIA Function
Caroline E Sloan1,2,3,4, Marissa C Ashner5, Cara L McDermott6,7
1Duke University School of Medicine, Department of Medicine, Durham, NC, USA. caroline.sloan@duke.edu.
Journal of General Internal Medicine
|July 7, 2025
Summary
Polypharmacy, the use of five or more medications, is linked to reduced physical function in middle-aged adults. This highlights the need for early assessment of physical decline in patients with multiple prescriptions.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Polypharmacy (≥5 medications) and potentially inappropriate medications (PIMs) are prevalent in midlife.
- These medication practices are linked to adverse outcomes in older adults, but their impact on middle-aged physical function is understudied.
Purpose of the Study:
- To determine the association between polypharmacy and PIM use with physical performance in middle-aged individuals.
Main Methods:
- Analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) Function study, a prospective cohort.
- Included 1842 participants with medication data and physical performance tests (gait speed, grip strength, chair stand, balance, 6-min walk) at year 35.
- Used multivariable linear regression to assess the association with the CARDIA Physical Performance (CAPP) score, adjusting for covariates.
Main Results:
- 29% of participants had polypharmacy, and 25% used PIMs.
- Polypharmacy was associated with a 1.24-point lower CAPP score (p < 0.001).
- PIM use was associated with a 0.88-point lower CAPP score (p < 0.001) initially, but this association disappeared after adjusting for polypharmacy.
Conclusions:
- Polypharmacy is significantly associated with diminished physical function in middle-aged adults.
- Clinicians should proactively assess physical function in middle-aged patients with polypharmacy to detect early decline.
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