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Taking multiple medications linked to frailty in older people

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A growing body of evidence suggests that taking multiple medications simultaneously (otherwise known as 'polypharmacy') is linked to frailty in older people, as well as a host of other conditions.

Medication should always be taken in line with doctors' recommendations. However, it's worth speaking to your loved one about their prescriptions and any associated side effects.

In this way, medical professionals can be given the information they need to adapt prescriptions if necessary.

Here's an introduction to polypharmacy, its potential effects and what you can do to minimise risks for your loved one.

What is 'polypharmacy'?

Polypharmacy is used to describe "the concurrent use of multiple medications" (usually more than three at any given time).

It's frequently associated with the provision of more medications, or medications with higher dosages than are thought therapeutically essential.

This can lead to a host of negative health effects. Although, multiple medications still constitute the best means of care for many people.

Polypharmacy is most prevalent among over 65s, and is thought to affect 40% of older adults still living in their own home.

What negative effects has polypharmacy been associated with?

Multiple studies into polypharmacy have identified potentially negative effects to both physical and cognitive health (Y. Rolland, J.E. Morley). These include:

  • Increased frailty (especially when six or more medications are taken regularly), fall and hip fracture risk
  • Reduction in both walking speed and gait strength
  • Increase in cognitive decline and delirium
  • Decreasing or non-adherence to recommended treatment regime
  • Reduction in ability to bathe, groom, dress, transfer and be active (when anticholinergic drugs are being taken)
  • Increased rates of dehydration, which is associated with a range of secondary health effects

There are a whole range of factors thought to influence why some medications have a different effect on older people.

Weight loss – a condition often associated with older people – can lead to an increase in side effects from fat soluble drugs. This can also lead to lower blood pressure, which increases the risk of hypertension when dosages are not adapted.

Dehydration and changes in metabolism can also play a significant role in how medications are absorbed, and how chemical compounds interact with one another.

Reducing the risk of frailty in older people

Limiting polypharmacy can lead to a reduction of negative effects without any additional risks (Y. Rolland, J.E. Morley).

Medical researchers recommend that older people speak to their pharmacist with a view to reducing the number of medications taken to six or fewer. This may not be the case for everyone, but has been found to be feasible for most older people.

Ask your loved one about the medications they're taking and any side effects they may have experienced. Depending on their situation, you may wish to help them communicate these effects to a medical professional.

The full effects of polypharmacy are only just starting to be realised. Help improve your loved one's quality of life by keeping up to date with the latest information.

The Good Care Group are expertly placed to help your loved one manage their medication effectively. Call on our friendly team to find out more.

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