中枢神経系を活性化する薬剤と高齢の多発性成人における再入院リスク
Mirah J Stuber1,2, Lara A Brockhus1,2, Anne Spinewine3,4
1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Journal of the American Geriatrics Society
|August 29, 2025
まとめ
中枢神経系 (CNS) 活性薬を含む多剤療法により,高齢者の再入院と死亡リスクが増加します. これらの薬は生活の質と 機能状態にも悪影響を及ぼします
科学分野:
- ゲロントロジー
- 臨床薬理学
- 医療サービス研究
背景:
- 多剤薬は複数の併発性疾患を持つ高齢者に多く見られ,健康への悪影響が増加しています.
- 多重の中枢神経系 (CNS) 活性薬の特異的な影響は,この集団において十分に研究されていない.
研究 の 目的:
- 退院時に処方された中枢神経系活性薬の数と,ポリファーマシーを受けた高齢者の有害な結果との関連を評価する.
- 評価されたアウトカムには,1年間の全原因再入院,薬物関連再入院 (DRA),死亡率,生活の質 (QoL),機能状態が含まれています.
主な方法:
- ポリファーマシーを施した2008人の高齢の入院患者群を分析した.
- コックスの比例リスクモデルと回帰分析では,中枢神経系活性薬の数と研究結果の関係が評価されました.
- 年齢,併発症,退院状態など,多くの共変数で調整された.
主要な成果:
- 各追加の中枢神経活性薬は,あらゆる原因による再入院 (HR1. 07) とDRA (HR1. 07) のリスクを有意に増加させた.
- 中枢神経系活性薬の追加で死亡リスクも増加した (HR1. 14).
- 1年後にQOL (EQ- 5D- VAS) と機能状態 (バルテル指数) の有意な低下が観察されました.
結論:
- 中枢神経系活性薬を含む退院処方箋は,多剤療法を受けた高齢者の1年間の再入院とDRAリスクの増加と関連しています.
- 中枢神経系活性薬の使用は,この集団における生活の質と機能能力の低下と関連しています.
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