Prescribed medication and polypharmacy determine frailty status in community-dwelling older adults from the VERISAUDE Study

Abstract

[Abstract] Introduction. A more profound understanding of how specific medication use contributes to the development of frailty is increasingly critical for optimizing geriatric care. This study aimed to describe the prevalence of medication use and quantify the utilization of prescribed medication groups across all five levels of the Anatomical Therapeutic Chemical Classification System (ATC) and to identify potential differences between robust and non-robust older individuals.

Methods. A cross-sectional study was conducted with a representative sample (n = 749) of community-dwelling active older people. Frailty status was determined using the frailty phenotype, categorizing participants as robust and non-robust (pre-frail or frail). Polypharmacy and hyperpolypharmacy were defined as the concurrent use of ≥ 5 or ≥ 10 medications over 3 months. Descriptive statistics and stepwise logistic regression analyses were performed to assess associations between frailty status and medication use across all five ATC classification levels.

Results. Polypharmacy was present in 48.1% of participants. Logistic regression analysis showed the polypharmacy was independently associated with non-robustness [OR = 1.550 (1.105–2.175), P = 0.011]. Specific medication groups were determinants of loss of robustness: Nervous system, (including psycholeptics, anxiolytics, benzodiazepine derivatives, particularly lorazepam); Musculo-skeletal system (notably non-steroidal anti-inflammatory drugs and propionic acid derivatives); Respiratory system; Cardiovascular system (Diuretics); and Sensory organs (Artificial tears and other indifferent preparations). Collectively, these variables explained 75.6% of the variance in non-robustness.

Conclusions. Polypharmacy is associated with non-robust status in active older people. Certain medications belonging to the nervous, sensory, muscle-skeletal, respiratory, and cardiovascular groups were the most frequent in frail status. Our findings highlight the need for vigilant monitoring and tailored interventions, including deprescribing strategies, to avoid adverse drug reactions in non-robust older individuals.