Polypharmacy with potentially inappropriate medications as a risk factor of new onset sarcopenia among community-dwelling Japanese older adults: a 9-year Kashiwa cohort study

BMC Geriatrics

Research

Masahiro Akishita¹  Taro Kojima¹  Tomoki Tanaka²  Katsuya Iijima³  Bo-Kyung Son³ 

[1] Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Institute of Gerontology, The University of Tokyo, Tokyo, Japan;Institute of Gerontology, The University of Tokyo, Tokyo, Japan;Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan;

关键词: Polypharmacy;    Potentially inappropriate medication;    Muscle mass;    Physical function;   

DOI  :  10.1186/s12877-023-04012-y

 received in 2022-12-01, accepted in 2023-04-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundClinical evidence demonstrating a longitudinal association between prescribed medications and sarcopenia onset is lacking. We investigated the association of polypharmacy (the use of five or more medications) and potentially inappropriate medications (PIMs) with sarcopenia risk in community-dwelling older adults.MethodsIn this longitudinal population-based cohort study, 2,044 older residents with no long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data collection was conducted in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Prescribed medications and PIMs (drugs listed in the Screening Tool for Older Person’s Appropriate Prescriptions for the Japanese or potentially muscle-wasting drugs) were identified through interviews. New-onset sarcopenia was identified according to the 2019 criteria of the Asian Working Group for Sarcopenia over a 9-year period and analyzed. We used Cox proportional hazards models to test the longitudinal association of prescribed medications with sarcopenia onset.ResultsOf the 1,549 participants without sarcopenia at baseline (mean age, 72.5 ± 5.5 years; 49.1% women; median and interquartile range, 6.0 [4.0–9.0] years), 230 experienced new-onset sarcopenia during the follow-up. After adjusting for confounders, polypharmacy combined with PIM use was strongly associated with new-onset sarcopenia (adjusted hazard ratio, 2.35; 95% confidence interval, 1.58–3.51; P < 0.001). No significant associations were observed for either PIM use or polypharmacy alone.ConclusionsPolypharmacy combined with PIM use, but not polypharmacy alone, was associated with an increased risk of new-onset sarcopenia over the 9-year follow-up period among community-dwelling older adults. Limiting polypharmacy and imposing the prescription of appropriate medications may facilitate sarcopenia prevention.

【 授权许可】

CC BY   
© The Author(s) 2023

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