Sedative load and frailty among community-dwelling population aged ≥65 years

Peklar, Jure, O'Halloran, Aisling M., Maidment, Ian D., Henman, Martin C., Kenny, Rose Anne and Kos, Mitja (2015). Sedative load and frailty among community-dwelling population aged ≥65 years. Journal of the American Medical Directors Association, 16 (4), pp. 282-289.

Abstract

OBJECTIVE: To explore the association between use of sedative drugs and frailty. DESIGN: Cross-sectional study. SETTING: First wave of The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort of the community-dwelling population aged 50 years or older in Ireland. PARTICIPANTS: Participants were 1642 men and 1804 women aged 65 years or older. MEASUREMENTS: Regular use of sedative drugs determined according to the sedative load (SL) model, frailty phenotype status, and frailty deficit index (FI) score assessed using validated, established protocols. RESULTS: Overall, 19% of the participants took sedative drugs, most frequently hypnotics and antidepressants. Sedative drug use was at 46% for frail, 23% for prefrail, and 9% for nonfrail participants. After adjustment for covariates, SL was positively associated with being prefrail (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.11-1.46) and frail (OR 1.30; 95% CI 1.02-1.64). Advancing age but not sex remained significant (P < .001). After adjustment for covariates, the association between SL and the FI was also significant at P ≤ .001 (β = 1.77; 95% CI 1.13-2.42). CONCLUSION: Higher SL was positively associated with phenotype frailty and the FI. This suggests that careful consideration must be given when prescribing sedatives to frail older adults, who are most vulnerable to adverse drug reactions and adverse health outcomes.

Publication DOI: https://doi.org/10.1016/j.jamda.2014.10.010
Divisions: Life & Health Sciences
Life & Health Sciences > Pharmacy
Life & Health Sciences > Chronic and Communicable Conditions
Life & Health Sciences > Applied Health Research Group
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Journal of the American Medical Directors Association. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Peklar, J., O'Halloran, A. M., Maidment, I. D., Henman, M. C., Kenny, R. A., & Kos, M. Sedative load and frailty among community-dwelling population aged ≥65 years. Journal of the American Medical Directors Association, Vol. 16, No. 4 (2014). DOI http://dx.doi.org/10.1016/j.jamda.2014.10.010
Uncontrolled Keywords: sedative load,frailty,drug utilization,aging,frailty index,Medicine(all),Nursing(all),Health Policy
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
Published Date: 2015-04
Authors: Peklar, Jure
O'Halloran, Aisling M.
Maidment, Ian D. ( 0000-0003-4152-9704)
Henman, Martin C.
Kenny, Rose Anne
Kos, Mitja

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