Drug Burden Index Score and Functional Decline in Older People - 12/08/11
Health ABC Study
Requests for reprints should be addressed to Darrell R. Abernethy, MD, PhD, 3740 Thomas Point Road, Annapolis, MD 21403Abstract |
Background |
The Drug Burden Index (DBI), a measure of exposure to anticholinergic and sedative medications, has been independently associated with physical and cognitive function in a cross-sectional analysis of community-dwelling older persons participating in the Health, Aging and Body Composition study. Here we evaluate the association between DBI and functional outcomes in Health, Aging and Body Composition study participants over 5 years.
Methods |
DBI was calculated at years 1 (baseline), 3, and 5, and a measure of the area under the curve for DBI (AUCDB) over the whole study period was devised and calculated. Physical performance was measured using the short physical performance battery, usual gait speed, and grip strength. The association of DBI at each time point and AUCDB with year 6 function was analyzed in data from participants with longitudinal functional measures, controlling for sociodemographics, comorbidities, and baseline function.
Results |
Higher DBI at years 1, 3, and 5 was consistently associated with poorer function at year 6. On multivariate analysis, a 1-unit increase in AUCDB predicted decreases in short physical performance battery score of .08 (P=.01), gait speed of .01 m/s (P=.004), and grip strength of .27 kg (P=.004) at year 6.
Conclusion |
Increasing exposure to medication with anticholinergic and sedative effects, measured with DBI, is associated with lower objective physical function over 5 years in community-dwelling older people.
Le texte complet de cet article est disponible en PDF.Keywords : Clinical pharmacology, Geriatrics, Physical function
Plan
| Funding: Supported by the Intramural Research Program of the National Institutes of Health, National Institute on Aging, and National Institute on Aging Contracts NO1-AG-6-2101, NO1-AG-6-2103, and NO1-AG-6-2106. |
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| Conflict of Interest: Drs. Hilmer, Mager, and Abernethy have applied for an international patent for the Drug Burden Index. |
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| Authorship: All authors had access to the data and a role in writing the manuscript. |
Vol 122 - N° 12
P. 1142 - décembre 2009 Retour au numéro
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