The Relationship Between Number of Medications and Weight Loss or Impaired Balance in Older Adults

doi:10.1111/j.1532-5415.2004.52467.x

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Wiley InterScience

Journal of the American Geriatrics Society

Volume 52 Issue 10, Pages 1719 - 1723

Published Online: 23 Sep 2004

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.

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The Relationship Between Number of Medications and Weight Loss or Impaired Balance in Older Adults

Joseph V. Agostini, MD ^*† , Ling Han, MD, MSc ^† and Mary E. Tinetti, MD ^†‡

From the ^*Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut; and ^†Department of Internal Medicine and ^‡Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut

Address correspondence to Joseph V. Agostini, MD, Geriatrics and Extended Care 240, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516. E-mail: joseph.agostini@yale.edu

Supported by the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the Claude D. Pepper Older Americans Independence Center (P60AG10469) from the National Institute on Aging. Dr. Agostini was a Robert Wood Johnson Clinical Scholar, sponsored by the Veterans Administration, during the time of this work.

KEYWORDS

pharmacoepidemiology • aged • adverse effects • weight loss • balance

ABSTRACT

Objectives: To examine the relationship between cumulative medication exposure and risk of two common manifestations of adverse drug effects: weight loss and impaired balance.

Design: Cross-sectional and longitudinal cohort.

Setting: Urban Connecticut community.

Participants: Eight hundred eighty-five community-dwelling residents aged 72 and older.

Measurements: Weight loss (≥10 pounds) and balance, a composite of four balance measures.

Results: Participants took a mean±standard deviation of 2.2±1.9 medications (range 0–15). After adjustment for age, depressive symptoms, cognitive impairment, vision and hearing impairments, number of chronic diseases, and number of hospitalizations in the previous year, the adjusted odds ratio (OR) for weight loss was 1.48 (95% confidence interval (CI)=0.85–2.59) for those taking one to two medications, 1.96 (95% CI=1.08–3.54) for three to four medications, and 2.78 (95% CI=1.38–5.60) for five or more medications. For impaired balance, adjusted ORs were 1.44 (95% CI=0.94–2.19), 1.72 (95% CI=1.09–2.71), and 1.80 (95% CI=1.02–3.19), respectively.

Conclusion: A greater number of medications were associated with increased risk of adverse drug outcomes, after extensive adjustment for chronic illness. Clinicians should consider the adverse effects of total drug use and not merely the benefits or risks of individual medications for specific diseases.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1532-5415.2004.52467.x About DOI