Association of polypharmacy with postural instability and impaired balance in community-dwelling older adults in Turkey

Abstract

Objective: Polypharmacy, an important geriatric syndrome, has been shown to be an independent risk factor for falling. However, the data about effects of polypharmacy on balance is lacking. We aimed to evaluate the effects of polypharmacy and inappropriate drug use on balance in older adults. Patients and Methods: Fifty-one patients using ≥ 5 drugs and 50 patients using < 5 drugs were included in the study. Inappropriate drug usage of the patients was evaluated by Beers criteria. Postural stability and risk of falling was investigated by using Biosway Portable Balance System (BPBS). Activities and functional status of the patients were assessed by using Short Physical Performance Battery (SPPB) and Activities Specific Balance Confidence Scale (ABC). All patients underwent comprehensive geriatric assessment. Results: Age, gender, hand grip strength, SPPB scores of the patients were similar between polypharmacy and control groups (all had p>0.05). ABC score was higher in polypharmacy group than control (p<0.01). Overall, anterior-posterior, medial-lateral stability index and eyes closed firm surface scores detected in BPBS were higher, indicating worse stability in the polypharmacy group than control (p<0.05). Limit of stability score was lower in the polypharmacy group than control (p=0.03). Rates of polypharmacy and inappropriate drug usage were higher in patients with a history of falling than without (p<0.01, p<0.01, respectively). In multivariate analysis model, polypharmacy was found to be an independently correlated parameter for impaired balance (OR 24.31; 95%CI 3.05- 193.91; p<0.01). Conclusion: This study has demonstrated that polypharmacy might be a related factor for impaired balance. Struggling with polypharmacy should be one of the most important part of comprehensive geriatric assessment.