Abstract
Alzheimer's disease (AD) affects a large portion of the elderly worldwide and is the most common dementia in this population. AD is usually accompanied by concurrent comorbidities leading to the simultaneous use of several drugs to improve the quality of life, which renders AD patients vulnerable to drug interactions and adverse reactions. This study assessed the frequency of polypharmacy based on comorbidities in AD patients from the city of Guarapuava, Parana, Brazil. This is a cross-sectional study in non-institutionalized and volunteer AD patients. The Clinical Dementia Rating (CDR) scale was applied to classify the AD stage and a socio-economic survey was used to identify possible comorbidities and medications taken. Medications were evaluated according to the Kussano’s criteria (2010) to identify polypharmacy. The incidence of polypharmacy was high (up to 65.9%, n = 27); hypertension was the most frequent comorbidity (58.54%, n = 24). AD patients inappropriately take drugs, either because of inattention or lack of popular medical understanding and may be subjected to consequences such as drug interactions and iatrogenic adverse reactions. Hence, studies focusing on AD patients investigating further risks caused by drug interactions are relevant and can increase awareness in their health care assistance and caregivers. Key words: Alzheimer's disease, polypharmacy, iatrogeny, adverse reactions.
Highlights
The number of people over 65 years old has grown significantly in the last decades in Brazil (Silva et al, 2012; Secoli, 2010)
Polypharmacy was identified in 65.9% (n = 27) of the patients, mostly occurred in groups Clinical Dementia Rating (CDR) 2 and 3 (Table 2) and resulted from simultaneous administration of drugs due to the presence of comorbidities
Carvalho et al (2012) observed that the high prevalence of polypharmacy in elderlies was due to the presence of chronic non-transmissible diseases (NTDs) when studying 2,143 elderlies and observed that 36% of the group took more than five drugs, which is characterized as severe polypharmacy
Summary
The number of people over 65 years old has grown significantly in the last decades in Brazil (Silva et al, 2012; Secoli, 2010). Trombini et al 365 population) in 2060, with a life expectancy of 81 years This estimate represents four times the current elderly population in Brazil. Other figures show that about one in five Americans will be over 65 years old in 2030, which leads to the estimation that 88.5 million Americans will be 65 years and older in 2050 (Oster and Oster, 2015). This increased life expectancy has resulted from the emergence of new primary prevention programs for diseases and advances in medical technology (Silva et al, 2013). Dementias are often accompanied by comorbidities such as diabetes, hypertension, congestive heart failure and deglutition disorders among others (Caixeta et al, 2012) and can affect about 40 to 56% of people with cognitive decline (Martín-Garcia et al, 2013)
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