El consumo de medicamentos como factor asociado al estado de fragilidad en personas mayores de 65 años en España

Abstract

Introduction

Frailty in the elderly is a concept in constant evolution, with a significant impact on the morbidity and mortality of patients. We assessed the associative strength of the Timed Up and Go test (TUG) and medication consumption in frailty and associated risk using various methods.

Material and methods

Observational, cross-sectional, multicenter study carried out in 128 Primary Care Centers distributed throughout Spain, has a total sample of 2422 patients over 65 years of age, estimating the prevalence of frailty with the TUG test. Descriptive analysis of the categorical variables and associative strength of TUG for frailty and medication consumption was performed with distribution of absolute and relative frequencies and multinomial logistic regression. SPSS 22.0 was used, considering statistical significance p = 0.05.

Results

The prevalence of frailty in the sample was 13.7%, accepting as frailty those subjects who obtained a score >20 s in performing the TUG test. A third of these subjects classified as frail took more than 30 s to complete the test and 32.5% of those studied would be classified as “pre-frail”.

We found a slight difference in the prevalence of frailty if we analyze the data according to sex, being 10.8% in men compared to 15.8% in women.

Regarding pharmacological consumption, 72.8% of the subjects consume 5 or more drugs daily with similar proportions by sex, and with an average consumption of 6.57 drugs.

The drugs with the greatest association with the degree of frailty were drugs used for dementia (40% of individuals who consumed them were considered frail), antiparkinsonian drugs (38%), antipsychotics (34%), antianemics (26.2%), anticoagulants (22.2%) and antiepileptics (21.1%).

Conclusions

The incidence of frailty in elderly patients in Spain is initially notable, being present in 13.7% through the application of the TUG test.

The age variable is the one that is most significantly associated with the frailty of the elderly patient.

An association was demonstrated between the degree of frailty and total medication consumption. The prevalence of frailty was 4.7% in the non-polypharmacy group compared to 15.4% in the polypharmacy group and reaching 23.4% in the extreme polypharmacy group.

The drugs with a greater association with the patient's degree of frailty were those used in the neurological/psychiatric sphere (antidementia, antiparkinsonian, antipsychotic or antiepileptic drugs).