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

Jure Peklar; Aisling M. O'Halloran; Ian D. Maidment; Martin C. Henman; Rose Anne Kenny; Mitja Kos

doi:10.1016/j.jamda.2014.10.010

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

Jure Peklar^*, Aisling M. O'Halloran, Ian D. Maidment, Martin C. Henman, Rose Anne Kenny, Mitja Kos

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	282-289
Number of pages	8
Journal	Journal of the American Medical Directors Association
Volume	16
Issue number	4
Early online date	26 Nov 2014
DOIs	https://doi.org/10.1016/j.jamda.2014.10.010
Publication status	Published - Apr 2015

Bibliographical note

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

Keywords

sedative load
frailty
drug utilization
aging
frailty index

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10.1016/j.jamda.2014.10.010

Sedative load and frailty among community-dwelling population above 65
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
Accepted author manuscript, 344 KB

Cite this

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title = "Sedative load and frailty among community-dwelling population aged ≥65 years",

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.",

keywords = "sedative load, frailty, drug utilization, aging, frailty index",

author = "Jure Peklar and O'Halloran, {Aisling M.} and Maidment, {Ian D.} and Henman, {Martin C.} and Kenny, {Rose Anne} and Mitja Kos",

note = "NOTICE: this is the author{\textquoteright}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",

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T1 - Sedative load and frailty among community-dwelling population aged ≥65 years

AU - Peklar, Jure

AU - O'Halloran, Aisling M.

AU - Maidment, Ian D.

AU - Henman, Martin C.

AU - Kenny, Rose Anne

AU - Kos, Mitja

N1 - 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

PY - 2015/4

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N2 - 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.

AB - 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.

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KW - drug utilization

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JF - Journal of the American Medical Directors Association

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ER -

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

Abstract

Bibliographical note

Keywords

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