The researchers from Drexel University’s College of Nursing and Health Professions recently examined that issue in a study published in Biological Research For Nursing.
The results indicated that patients with both PPY and ADRD experience more symptoms, falls, hospitalizations, mortality and had lower physical function—indicating that PPY can also negatively impact their quality of life.
Led by Martha Coates, PhD, a postdoctoral research fellow at Drexel University’s College, the research team found that individuals who experiencing PPY and have ADRD.
“The cut-off of point of five or more medications daily has been associated with adverse health outcomes in previous research, and as the number of medications increase the risk of adverse drug events and harm increases,” said lead author Dr. Coates.
The authors suggested their study helps fill a “critical gap” in understanding the symptom experience and health outcomes of older adults with and without ADRD and PPY.
This study used longitudinal data from the National Health and Aging Trends Study, a nationally representative sample of Medicare beneficiaries from 2016–2019. The sample of 2,052 individuals was separated into four groups: neither ADRD or PPY (n = 1,048), PPY only (n = 761), ADRD only (n = 116), and both ADRD and PPY(n = 127).
The participants were predominately female (57.9%), white (70.9%), aged 84 years or younger (75%), married (46%), and had some college or a college degree (50%).
“Participants with both ADRD and PPY experienced more symptoms on average, had higher odds of falls, hospitalizations, and mortality than all other groups,” the authors pointed out. “Older adults with both ADRD and PPY had lower physical function, needed more assistance with activities of daily living and higher assistive device utilization compared to the other three groups.”
Dr. Coates explained that the researchers used analytic weights to analyze the data, which generates national estimates, making the sample of 2,052 individuals that represented 12 million Medicare beneficiaries in the United States, increasing the generalizability of the findings.
“We found that older adults with Alzheimer’s disease and related dementias and polypharmacy experienced more unpleasant symptoms, increased odds of falling, being hospitalized and mortality compared to those without Alzheimer’s disease and related dementias and polypharmacy,” said Dr. Coates. “They also experienced more functional decline, required more assistance with activities of daily living like eating, bathing and dressing, and were more likely to need an assistive device like a cane or walker.”
Dr. Coates added that further research is needed to develop strategies to reduce the occurrence of PPY in people with ADRD.
“The older adult population is growing in the U.S., with an estimated 80 million individuals over the age of 65 by 2040,” said Dr. Coates. “This means that the number of older adults diagnosed with Alzheimer’s disease and related dementias will also increase, and currently there is no cure. Avoiding adverse outcomes related to polypharmacy can improve quality of life and prevent excess disability for older adults with Alzheimer’s disease and related dementias.”
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