For many, good health and longevity is only achievable with the help of prescription drugs. However, researchers in Japan have recently identified that some "high-risk" prescribing practices may be a cause for concern among older adults.
In a new study published in Geriatrics and Gerontology International, a research team led by the University of Tsukuba evaluated the relationship between high-risk prescribing practices and the risk for disability in people aged 65 years and older. High-risk prescribing practices include polypharmacy (the use of five or more prescription drugs) and the use of drugs with sedative or anticholinergic properties, including antipsychotics, benzodiazepines, and antiparkinsonian drugs.
High-risk prescribing practices have been previously shown to be associated with physical frailty among older adults, and physical frailty corresponds with a risk for physical disability. In Japan, people who are aged 65 years and older and have a functional disability are eligible to receive long-term care (LTC) services. To receive these services, a LTC needs certification is granted based on the assessment of an applicant's eligibility and care requirements. Using LTC needs certification as a proxy for disability among older adults in Japan, researchers led by the University of Tsukuba conducted a population-based nested case-control study to determine whether high-risk prescribing practices are associated with an increased risk of disability.
To conduct our analysis, we used two health insurance datasets to form a comprehensive cohort that included 89% of Japanese adults aged 65 years and older as of October 2018."
Dr. Naoaki Kuroda, lead author
Among the cohort, the research team identified and control-matched over 2,100 cases who received their first long-term care needs certification within the observation period. The researchers then used conditional logistic regression analysis to estimate the risk of LTC certification associated with high-risk prescribing practices.
"We found that both polypharmacy and the use of drugs with sedative or anticholinergic properties exhibit dose-response relationships with the risk for LTC needs certification," says senior author Professor Nanako Tamiya. "In other words, these high-risk prescribing practices are associated with an increased risk of disability among older adults."
The findings of this study may encourage the development of public health initiatives regarding high-risking prescribing practices among older adults. Additional research is needed to determine whether a reduction in high-risk prescribing practices corresponds with a reduction in the risk of disability.
Kuroda, N., et al. (2022) Associations of polypharmacy and drugs with sedative or anticholinergic properties with the risk of long-term care needs certification among older adults in Japan: A population-based, nested case–control study. Geriatrics and Gerontology International. doi.org/10.1111/ggi.14393.