"Polypharmacy" is the term used when someone takes many (usually five or more) different medications. Experts suggest that, for most older adults, taking that many medications may not be medically necessary. Taking multiple medications also can be linked to problems such as falls, frailty, disability, and even death. Polypharmacy also is a problem for older adults due to side effects or interactions resulting from the use of different medications. Older adults may have difficulties taking the medications properly, and the medications may interfere with a person's ability to function well.
The ability to walk well is a sign of independence and good health for older adults, for example, and it may be affected by the use of multiple medications. Although healthcare providers know that some treatments can slow or hamper an older person's ability to walk, little is known about the effects of polypharmacy on walking while performing other tasks, like talking. In a new study, researchers examined how polypharmacy affected walking while talking. They published their study in the Journal of the American Geriatrics Society.
The researchers examined information from 482 people age 65 and older who were enrolled in the "Central Control of Mobility in Aging" study. That study's main purpose was to determine how changes to the brain and our central nervous system occur during aging, and how they might impact an older person's ability to walk.
Researchers confirmed the medications (prescriptions as well as herbal and other over-the-counter supplements) study participants were taking. The researchers defined "polypharmacy" as using five or more of these treatments.
Participants took detailed exams assessing physical health, mental well-being, and mobility at the start of the study and at yearly follow-up appointments. Among other evaluations, the researchers measured the participants' walking speed. None of the participants used walking aides (such as canes or walkers) or monitors. The participants were asked to walk at their normal pace on a special 20-foot long walkway, and to walk while talking. The research team also interviewed the participants to learn about their medical conditions, ability to think and make decisions, and brain function.
Among the 482 participants in the study, 34 percent used five or more medications during the study period (June 2011-February 2016); 10 percent used more than eight medications. The participants were mostly in their late 70s.
People in the polypharmacy group were more likely to have high blood pressure, congestive heart failure, diabetes, and a history of heart attacks. They were also more likely to have had a fall within the last year and were more overweight than people in the non-polypharmacy group.
After accounting for chronic health problems, a history of falls, and other issues, the people in the polypharmacy group had a slower walking speed (or gait) than the people in the non-polypharmacy group. Those who took 8 or more medications had slower walking speed when walking while talking. The researchers concluded that there was a link between polypharmacy and walking speed, and that more studies would be needed to follow-up on their findings and the effect specific medications might have on overall well-being.
The researchers also noted that at their check-ups, older adults should be asked about all the medications they take, including herbal and other over-the-counter supplements. They also suggested that healthcare professionals measure walking speed during regular check-ups.
This summary is from "Polypharmacy and Gait Performance in Community Dwelling Older Adults." It appears online ahead of print in the May 2017 issue of the Journal of the American Geriatrics Society. The study authors are C.J. George MD, RPh, and J. Verghese, MBBS, MS.
About the Health in Aging Foundation
This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has–for 75 years–worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.
Daniel E. Trucil
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