Polypharmacy Is Significantly and Positively Associated with the Frailty Status Assessed Using the 5-Item FRAIL Scale, Cardiovascular Health Phenotypic Classification of Frailty Index, and Study of Osteoporotic Fractures Scale.

Chi-Di Hung,Chen-Cheng Yang,Hung-Yi Chuang,Chih-Hsing Hung,Chao-Hung Kuo,Chun-Ying Lee,Szu-Chia Chen,Stephen Chu-Sung Hu,Ching-Yu Chen

doi:10.3390/jcm10194413

Abstract

The aim of this study was to investigate the association between frailty and polypharmacy using three different frailty screening tools. This was a cross-sectional study of people aged ≥65 years. Participants were included and interviewed using questionnaires. Polypharmacy was defined as the daily use of eight or more pills. Frailty was assessed using a screening tool, including (1) the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index (5-item FRAIL scale), (2) the Cardiovascular Health Phenotypic Classification of Frailty (CHS_PCF) index (Fried’s Frailty Phenotype), and (3) the Study of Osteoporotic Fracture (SOF) scale. A total of 205 participants (mean age: 71.1 years; 53.7% female) fulfilled our inclusion criteria. The proportion of patients with polypharmacy was 14.1%. After adjustments were made for comorbidity or potential confounders, polypharmacy was associated with frailty on the 5-item FRAIL scale (adjusted odds ratio [aOR]: 9.12; 95% confidence interval [CI]: 3.6–23.16), CHS_PCF index (aOR: 8.98; 95% CI: 2.51–32.11), and SOF scale (aOR: 6.10; 95% CI: 1.47–25.3). Polypharmacy was associated with frailty using three frailty screening tools. Future research is required to further enhance our understanding of the risk of frailty among older adults.

Highlights

Frailty is a clinical syndrome characterized by physical activities, cognition and emotional impairment [1]
We classified these participants into robust health, pre-frail, and frail groups by the 5-item FRAIL scale, CHS_PCF, and Study of Osteoporotic Fracture (SOF) scale according to these scale definitions, respectively
In Korea, Jung et al [21] reported that frailty using the 5-item FRAIL scale was associated with the use of an increased number of medications

Summary

Introduction

Frailty is a clinical syndrome characterized by physical activities, cognition and emotional impairment [1] It is a state of increased vulnerability to stressors, especially in older adults [1], that leads to adverse health outcomes such as falls, disability, hospitalization, institutionalization and mortality [2,3,4]. Because there is no gold standard for assessing frailty, multiple assessment methods have been developed, such as Fried’s phenotype model [8], and the frailty index of Rockwood’s cumulated deficit model [9] These screening tools help to identify frail patients at high risk for negative health outcomes and provide an opportunity to prevent the progression of comorbidity [10]

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Discussion

Conclusion