Polypharmacy and nutritional status in elderly people

Abstract

Increasing use of drugs among elderly people has raised concerns about possible negative health outcomes, including malnutrition, associated with polypharmacy. Evidence about the association of polypharmacy with nutritional status is scarce. This review summarizes the relevant evidence regarding polypharmacy and nutritional status in elderly people. The probability of nutritional problems as a consequence of drugs is highest in elderly people suffering from several diseases. Drug treatment may contribute to poor nutritional status by causing loss of appetite, gastrointestinal problems, and other alterations in body function. Some recently published studies add evidence on possible association between increasing number of drugs and malnutrition. Studies indicate also an association between polypharmacy and weight changes. In addition, there are available studies that have shown deficits in the intake of specific macronutrients and micronutrients (e.g. fiber, glucose, and specific vitamins) for those with a high number of drugs in use. On the basis of available evidence, the role of polypharmacy on nutritional status among elderly people is unclear. Some diseases promote malnutrition; thus, the independent role of drugs for nutritional status is challenging to determine. Longitudinal studies with careful adjustment for underlying diseases are needed to explore association between polypharmacy and malnutrition. Nutritional evaluation should be a routine part of comprehensive geriatric assessment that is conducted ideally in multiprofessional teams, including physician, pharmacist, and dietitian.