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Is Polypharmacy Associated with Cognitive Frailty in the Elderly? Results from the Korean Frailty and Aging Cohort Study

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Cognitive frailty — the coexistence of physical frailty and cognitive impairment—is a phenotype of frailty in the elderly. The coexistence of physical frailty and cognitive impairment, known as cognitive frailty, is one of the phenotypes of frailty in the elderly. Cognitive frailty predicts adverse health outcome more accurately than does physical frailty. In this study, we aim to determine whether the polypharmacy common among the elderly is linked with cognitive frailty.

Design, Setting, and Participants

The elderly, aged between 70 and 84 years, who participated in the cross-sectional Korean Frailty and Aging Cohort Study were included in the present study.

Measurements

Polypharmacy and hyperpolypharmacy were defined as the use of at least five and ten medications, respectively. Physical frailty was assessed by the Korean version of the FRAIL scale, and cognitive status was measured by the Trail Making Test part A, word list recall test, the Korean version of the Frontal Assessment Battery, and the Digit Span Backward test.

Results

Among the 2,392 participants, 26.8% and 4.1% took more than five and ten prescribed medications, respectively. Polypharmacy and hyperpolypharmacy participants tend to have more cognitive impairment and physical frailty. Participants with cognitive frailty had the highest polypharmacy rate regardless of medication type. After controlling for the potential confounders including severity of comorbidities, frailty was found to be significantly related to polypharmacy, as defined by prescribed as well as total medications, including non-prescribed medications. However, cognitive impairment only showed a linkage to polypharmacy of prescribed medications, which—according to the results of multivariable analysis— could increase cognitive frailty, with an odds ratio of 2.70.

Conclusion

Although the elderly tend to depend on various medications, they should seriously consider the risk of polypharmacy for better health outcomes.

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Acknowledgements

This research was supported by a grant of the Korea Health Technology R&D Project through the Korean Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI15C3153).

Author information

Author notes

  1. Chang Won Won and Hyeon Ju Kim contributed equally to this work.

Authors and Affiliations

  1. Department of Family Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea

    J. H. Moon & Hyeon Ju Kim

  2. Department of Family Medicine, Jeju National University Hospital, Jeju, Republic of Korea

    J. H. Moon & Hyeon Ju Kim

  3. Department of Urology, Jeju National University School of Medicine, Jeju, Republic of Korea

    J. S. Huh

  4. Department of Urology, Jeju National University Hospital, Jeju, Republic of Korea

    J. S. Huh

  5. Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea

    Chang Won Won

  6. Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea

    Chang Won Won

Authors
  1. J. H. Moon
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Corresponding authors

Correspondence to Chang Won Won or Hyeon Ju Kim.

Ethics declarations

Conflicts of Interest: The authors declare no conflict of interest.

Ethical standards: This study was approved by the Institutional Review Board of Jeju University Hospital (approval number: JEJUNUH 2016-03-008) and complied with the tenets of the Declaration of Helsinki.

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Moon, J.H., Huh, J.S., Won, C.W. et al. Is Polypharmacy Associated with Cognitive Frailty in the Elderly? Results from the Korean Frailty and Aging Cohort Study. J Nutr Health Aging 23, 958–965 (2019). https://doi.org/10.1007/s12603-019-1274-y

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  • DOI: https://doi.org/10.1007/s12603-019-1274-y

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