Impact of Drug–Drug and Drug–Disease Interactions on Gait Speed in Community-Dwelling Older Adults

Autor: Susan L. Greenspan, Subashan Perera, Douglas C. Bauer, Anne B. Newman, Ronald I. Shorr, Zachary A. Marcum, Jennifer G. Naples, Eleanor M. Simonsick, Joseph T. Hanlon, Shelly L. Gray
Rok vydání: 2016
Předmět:
Adult
Male
Aging
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
Health Status
Poison control
030204 cardiovascular system & hematology
Article
Dose-Response Relationship
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Clinical Research
Statistical significance
Injury prevention
Prevalence
Odds Ratio
medicine
Humans
Drug Interactions
Pharmacology (medical)
Longitudinal Studies
030212 general & internal medicine
Gait
Generalized estimating equation
Aged
Dose-Response Relationship
Drug
business.industry
Evaluation of treatments and therapeutic interventions
Pharmacology and Pharmaceutical Sciences
Odds ratio
Drug interaction
medicine.disease
Confidence interval
Walking Speed
Brain Disorders
Good Health and Well Being
Pharmaceutical Preparations
Geriatrics
6.1 Pharmaceuticals
Female
Medical emergency
Drug
Geriatrics and Gerontology
business
Zdroj: Drugs & aging, vol 33, iss 6
ISSN: 1179-1969
1170-229X
DOI: 10.1007/s40266-016-0373-2
Popis: BackgroundGait speed decline, an early marker of functional impairment, is a sensitive predictor of adverse health outcomes in older adults. The effect of potentially inappropriate medications, including drug-disease and drug-drug interactions, on gait speed decline is not well known.ObjectiveThe aim of this study was to determine if drug interactions impair functional status as measured by gait speed.MethodsThe sample included 2402 older adults with medication and gait speed data from the Health, Aging and Body Composition study. The independent variable was the frequency of drug-disease and/or drug-drug interactions at baseline and 3 additional years. The main outcome was a clinically meaningful gait speed decline of ≥0.1m/s the year following drug interaction assessment. Adjusted odds ratios and 95% confidence intervals (CIs) were calculated using multivariate generalized estimating equations for both the overall sample and a sample stratified by gait speed at time of drug interaction assessment.ResultsThe prevalence of drug-disease and drug-drug interactions ranged from 7.6 to 9.3 and 10.5 to 12.3%, respectively, with few participants (3.8-5.7%) having multiple drug interactions. At least 22% of participants had a gait speed decline of ≥0.1m/s annually. Drug interactions were not significantly associated with gait speed decline overall or in the stratified sample of fast walkers. There was some evidence, however, that drug interactions increased the risk of gait speed decline among those participants with slower gait speeds, though p values did not reach statistical significance (adjusted odds ratio 1.22; 95% CIs 0.96-1.56; p=0.11). Moreover, a marginally significant dose-response relationship was seen with multiple drug interactions and gait speed decline (adjusted odds ratio 1.40; 95% CIs 0.95-2.04; p=0.08).ConclusionsDrug interactions may increase the likelihood of gait speed decline among older adults with evidence of preexisting debility. Future studies should focus on frail elders with less physiological reserve who may be more susceptible to the harms associated with potentially inappropriate medications.
Databáze: OpenAIRE
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