Abstract
BackgroundPolypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study—a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).MethodsThe prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2–4, 5–9 and ≥10 medicines—so-called ‘no polypharmacy’, ‘monotherapy’, ‘minor polypharmacy’, ‘polypharmacy’ and ‘hyperpolypharmacy.’ Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5–90.5). Participant characteristics were examined through descriptive statistics.ResultsComplex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4–8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.ConclusionConsidering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. More support for managing preventative medicines, of uncertain benefit, might be helpful in this population.
Highlights
Polypharmacy is potentially harmful and under-researched amongst the fastest growing section of society, the very old [1]
Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women
The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care
Summary
Polypharmacy is potentially harmful and under-researched amongst the fastest growing section of society, the very old (aged 85) [1]. Few studies have explored polypharmacy in this population [2,3,4,5,6,7,8,9,10], despite medication sensitivity often increasing with the late-life problems of physiological decline, multimorbidity and frailty. The contribution of gender to polypharmacy is seldom studied in the very old [4, 6,7,8,9, 12,13,14,15]. Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged 85).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
