Researchers conducted a study to analyze the symptoms, health outcomes, and physical capabilities over time in older adults both with and without Alzheimer’s disease, related dementias, and the condition of polypharmacy.
Polypharmacy is typically defined as the consumption of five or more medications daily and poses a major health issue, affecting over 30% of elderly individuals. It can lead to adverse health outcomes, including falls, drug interactions, hospital admissions, and even mortality. Older adults are particularly susceptible to polypharmacy if they have several chronic health conditions. Although those with Alzheimer’s disease and related dementias are more inclined to take over five medications, there hasn’t been extensive research on how taking multiple medications daily affects their symptoms, health outcomes, and physical abilities.
Researchers at Drexel University’s College of Nursing and Health Professions have recently released a study in Biological Research For Nursing that investigated the symptoms, health outcomes, and physical function over time in older adults with and without Alzheimer’s disease and related dementias, as well as those on polypharmacy.
The study, led by Martha Coates, PhD, a postdoctoral research fellow, revealed that older adults facing polypharmacy along with Alzheimer’s disease and related dementias encounter a greater number of symptoms, falls, hospitalizations, and higher mortality rates, along with diminished physical function—which all adversely affect their quality of life.
“Previous research has linked the threshold of five or more daily medications with negative health outcomes. As the number of medications increases, so does the risk of harmful drug interactions and adverse events,” Coates stated.
Utilizing a publicly accessible dataset from the National Health and Aging Trends Study, which is a nationally representative sample of Medicare beneficiaries in the U.S. managed by Johns Hopkins University, the research team collected data annually since 2011 to analyze social, physical, technological, and functional aspects important to aging.
For this particular study, they examined data from 2016 to 2019 to evaluate changes in symptoms, health consequences, and physical function across four groups: 1) individuals with both Alzheimer’s disease and related dementias and polypharmacy; 2) those with only Alzheimer’s disease and related dementias; 3) individuals on polypharmacy only; and 4) participants without any instance of Alzheimer’s disease, related dementias, or polypharmacy.
Coates noted that the team applied analytic weights for data analysis, which provides national estimates and suggests that the 2,052 individuals in the sample are representative of about 12 million Medicare beneficiaries in the U.S., thus enhancing the applicability of the findings.
“Our findings indicate that older adults experiencing both Alzheimer’s disease and related dementias along with polypharmacy suffer from more troubling symptoms, a higher likelihood of falls, increased hospital stays, and greater mortality in comparison to those who do not have these conditions,” Coates explained. “Additionally, they exhibited more functional decline, needed more help with daily activities such as eating, bathing, and dressing, and were more likely to require assistive devices like canes or walkers.”
Coates highlighted that various resources exist to assist healthcare professionals in reviewing and managing medication plans for older adults dealing with polypharmacy, especially those taking medications that may no longer be beneficial. However, there are currently no specific resources tailored for older adults with Alzheimer’s disease and related dementias.
The results of this research emphasize the detrimental effects of polypharmacy on older individuals with Alzheimer’s disease and related dementias. Coates emphasized the necessity for more research to formulate strategies aimed at minimizing the incidence of polypharmacy among those with these conditions.
“The aging population is rising in the U.S., projected to reach 80 million individuals over the age of 65 by 2040,” Coates noted. “Consequently, the number of older adults diagnosed with Alzheimer’s disease and related dementias will also climb, and there remains no cure. Avoiding negative outcomes linked to polypharmacy could enhance the quality of life and reduce unnecessary disability for older adults facing these challenges.”
The research team expects this study to inform future investigations regarding the effects of specific medications on health outcomes for individuals with Alzheimer’s disease and related dementias, thereby laying the groundwork for developing interventions aimed at optimizing medications for older adults dealing with both Alzheimer’s disease and polypharmacy.
