The relationship between frailty and polypharmacy in older people: A systematic review

M. Gutiérrez-Valencia, M. Izquierdo, M. Cesari, A. Casas-Herrero, M. Inzitari, N. Martínez-Velilla

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Aims: Frailty is a complex geriatric syndrome resulting in decreased physiological reserves. Frailty and polypharmacy are common in older adults and the focus of extensive studies, although little is known about the impact they may have on each other. This is the first systematic review analysing the available evidence on the relationship between frailty and polypharmacy in older adults. Methods: Systematic review of quantitative studies. A comprehensive literature search for publications in English or Spanish was performed on MEDLINE, CINAHL, the Cochrane Database and PsycINFO in September 2017 without applying restrictions on the date of publication. Studies reporting any relationship between frailty and polypharmacy in older adults were considered. Results: A total of 25 publications were included, all of them observational studies. Evaluation of Fried's frailty criteria was the most common approach, followed by the Edmonton Frail Scale and FRAIL scale. Sixteen of 18 cross-sectional analyses and five of seven longitudinal analyses demonstrated a significant association between an increased number of medications and frailty. The causal relationship is unclear and appears to be bidirectional. Our analysis of published data suggests that polypharmacy could be a major contributor to the development of frailty. Conclusions: A reduction of polypharmacy could be a cautious strategy to prevent and manage frailty. Further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion or delay of frailty.

Original languageEnglish
Pages (from-to)1432-1444
JournalBritish Journal of Clinical Pharmacology
Volume84
Issue number7
DOIs
Publication statusPublished - 2018

Fingerprint

Polypharmacy
Publications
MEDLINE
Geriatrics
Observational Studies
Cross-Sectional Studies
Databases
Research

Keywords

  • Frailty
  • Older adults
  • Polypharmacy
  • Systematic review

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Gutiérrez-Valencia, M., Izquierdo, M., Cesari, M., Casas-Herrero, A., Inzitari, M., & Martínez-Velilla, N. (2018). The relationship between frailty and polypharmacy in older people: A systematic review. British Journal of Clinical Pharmacology, 84(7), 1432-1444. https://doi.org/10.1111/bcp.13590

The relationship between frailty and polypharmacy in older people : A systematic review. / Gutiérrez-Valencia, M.; Izquierdo, M.; Cesari, M.; Casas-Herrero, A.; Inzitari, M.; Martínez-Velilla, N.

In: British Journal of Clinical Pharmacology, Vol. 84, No. 7, 2018, p. 1432-1444.

Research output: Contribution to journalArticle

Gutiérrez-Valencia, M, Izquierdo, M, Cesari, M, Casas-Herrero, A, Inzitari, M & Martínez-Velilla, N 2018, 'The relationship between frailty and polypharmacy in older people: A systematic review', British Journal of Clinical Pharmacology, vol. 84, no. 7, pp. 1432-1444. https://doi.org/10.1111/bcp.13590
Gutiérrez-Valencia, M. ; Izquierdo, M. ; Cesari, M. ; Casas-Herrero, A. ; Inzitari, M. ; Martínez-Velilla, N. / The relationship between frailty and polypharmacy in older people : A systematic review. In: British Journal of Clinical Pharmacology. 2018 ; Vol. 84, No. 7. pp. 1432-1444.
@article{fe046b0372be4fd89cf3f0ed5223ae4e,
title = "The relationship between frailty and polypharmacy in older people: A systematic review",
abstract = "Aims: Frailty is a complex geriatric syndrome resulting in decreased physiological reserves. Frailty and polypharmacy are common in older adults and the focus of extensive studies, although little is known about the impact they may have on each other. This is the first systematic review analysing the available evidence on the relationship between frailty and polypharmacy in older adults. Methods: Systematic review of quantitative studies. A comprehensive literature search for publications in English or Spanish was performed on MEDLINE, CINAHL, the Cochrane Database and PsycINFO in September 2017 without applying restrictions on the date of publication. Studies reporting any relationship between frailty and polypharmacy in older adults were considered. Results: A total of 25 publications were included, all of them observational studies. Evaluation of Fried's frailty criteria was the most common approach, followed by the Edmonton Frail Scale and FRAIL scale. Sixteen of 18 cross-sectional analyses and five of seven longitudinal analyses demonstrated a significant association between an increased number of medications and frailty. The causal relationship is unclear and appears to be bidirectional. Our analysis of published data suggests that polypharmacy could be a major contributor to the development of frailty. Conclusions: A reduction of polypharmacy could be a cautious strategy to prevent and manage frailty. Further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion or delay of frailty.",
keywords = "Frailty, Older adults, Polypharmacy, Systematic review",
author = "M. Guti{\'e}rrez-Valencia and M. Izquierdo and M. Cesari and A. Casas-Herrero and M. Inzitari and N. Mart{\'i}nez-Velilla",
year = "2018",
doi = "10.1111/bcp.13590",
language = "English",
volume = "84",
pages = "1432--1444",
journal = "British Journal of Clinical Pharmacology",
issn = "0306-5251",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - The relationship between frailty and polypharmacy in older people

T2 - A systematic review

AU - Gutiérrez-Valencia, M.

AU - Izquierdo, M.

AU - Cesari, M.

AU - Casas-Herrero, A.

AU - Inzitari, M.

AU - Martínez-Velilla, N.

PY - 2018

Y1 - 2018

N2 - Aims: Frailty is a complex geriatric syndrome resulting in decreased physiological reserves. Frailty and polypharmacy are common in older adults and the focus of extensive studies, although little is known about the impact they may have on each other. This is the first systematic review analysing the available evidence on the relationship between frailty and polypharmacy in older adults. Methods: Systematic review of quantitative studies. A comprehensive literature search for publications in English or Spanish was performed on MEDLINE, CINAHL, the Cochrane Database and PsycINFO in September 2017 without applying restrictions on the date of publication. Studies reporting any relationship between frailty and polypharmacy in older adults were considered. Results: A total of 25 publications were included, all of them observational studies. Evaluation of Fried's frailty criteria was the most common approach, followed by the Edmonton Frail Scale and FRAIL scale. Sixteen of 18 cross-sectional analyses and five of seven longitudinal analyses demonstrated a significant association between an increased number of medications and frailty. The causal relationship is unclear and appears to be bidirectional. Our analysis of published data suggests that polypharmacy could be a major contributor to the development of frailty. Conclusions: A reduction of polypharmacy could be a cautious strategy to prevent and manage frailty. Further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion or delay of frailty.

AB - Aims: Frailty is a complex geriatric syndrome resulting in decreased physiological reserves. Frailty and polypharmacy are common in older adults and the focus of extensive studies, although little is known about the impact they may have on each other. This is the first systematic review analysing the available evidence on the relationship between frailty and polypharmacy in older adults. Methods: Systematic review of quantitative studies. A comprehensive literature search for publications in English or Spanish was performed on MEDLINE, CINAHL, the Cochrane Database and PsycINFO in September 2017 without applying restrictions on the date of publication. Studies reporting any relationship between frailty and polypharmacy in older adults were considered. Results: A total of 25 publications were included, all of them observational studies. Evaluation of Fried's frailty criteria was the most common approach, followed by the Edmonton Frail Scale and FRAIL scale. Sixteen of 18 cross-sectional analyses and five of seven longitudinal analyses demonstrated a significant association between an increased number of medications and frailty. The causal relationship is unclear and appears to be bidirectional. Our analysis of published data suggests that polypharmacy could be a major contributor to the development of frailty. Conclusions: A reduction of polypharmacy could be a cautious strategy to prevent and manage frailty. Further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion or delay of frailty.

KW - Frailty

KW - Older adults

KW - Polypharmacy

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=85046359239&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046359239&partnerID=8YFLogxK

U2 - 10.1111/bcp.13590

DO - 10.1111/bcp.13590

M3 - Article

AN - SCOPUS:85046359239

VL - 84

SP - 1432

EP - 1444

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

IS - 7

ER -