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老年人的多重疾病、药物及其与跌倒、身体活动和认知功能的关联:斯里兰卡的多中心研究

Multimorbidity, medications, and their association with falls, physical activity, and cognitive functions in older adults: multicenter study in Sri Lanka.

作者信息

De Zoysa Warsha, Mendis Sahan Achintha, Rathnayake Nirmala, Liyanage Achala, Palangasinghe Dhammika, Silva Shehan, Jayasekera Priyamali, Mettananda Chamila, Lekamwasam Sarath

机构信息

Department of Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka.

Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka.

出版信息

Sci Rep. 2025 Feb 20;15(1):6233. doi: 10.1038/s41598-025-91037-5.

Abstract

This study was aimed to examine the prevalence and associations between multimorbidity, polypharmacy, Falls Risk Increasing Drugs use (FRIDs), Anti Cholinergic Burden (ACB), and adverse health outcomes in older adults attending medical clinics. A cross-sectional study was conducted among 704 older adults attending medical clinics in four tertiary care hospitals. The mean (SD) age of study participants was 73 (5.5) years, and the majority were females (58.7%). Patients 305 (43.5%) reported at least one fall after age of 65 while 220 (31.3%) reported falls in the previous 12 months and 90 (12.8%) reported recurrent falls. The prevalence of multimorbidity was 77.4% while polypharmacy was seen in 51.2%. The use of at least one FRID was seen in 70.5% patients while higher ACB was seen in 5.4%. Multimorbidity, polypharmacy, use of FRIDs and ACB were not associated with negative health outcome (p > 0.05). Polypharmacy, however, was associated with high ACB (p < 0.001). This study highlights a high prevalence of multimorbidity and polypharmacy among older people in clinical settings. However, negative associations between drugs and multimorbidity with adverse health outcomes indicate that these relationships are complex, potentially influenced by other factors such as poor drug compliance, which can lead to falls.

摘要

本研究旨在调查就诊于医疗诊所的老年人中,多种疾病共存、多重用药、跌倒风险增加药物(FRIDs)使用、抗胆碱能负担(ACB)的患病率及其之间的关联,以及不良健康结局。对四家三级护理医院就诊的704名老年人进行了一项横断面研究。研究参与者的平均(标准差)年龄为73(5.5)岁,大多数为女性(58.7%)。305名(43.5%)患者报告在65岁后至少跌倒过一次,220名(31.3%)患者报告在过去12个月内跌倒过,90名(12.8%)患者报告有反复跌倒。多种疾病共存的患病率为77.4%,多重用药的患病率为51.2%。70.5%的患者使用了至少一种跌倒风险增加药物,5.4%的患者抗胆碱能负担较高。多种疾病共存、多重用药、跌倒风险增加药物的使用和抗胆碱能负担与不良健康结局无关(p>0.05)。然而,多重用药与高抗胆碱能负担相关(p<0.001)。本研究强调了临床环境中老年人多种疾病共存和多重用药的高患病率。然而,药物和多种疾病共存与不良健康结局之间的负相关表明,这些关系很复杂,可能受其他因素如药物依从性差的影响,而这可能导致跌倒。

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