The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆
Background: Mental disorders increase the risk factor for developing physical comorbidity conditions, such as cardiometabolic diseases. There is a high prevalence of multimorbidity and polypharmacy in the elderly population which hampers clinical response. Studies have shown that this positive corre...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | IBRO Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451830120300315 |
| _version_ | 1818857600599457792 |
|---|---|
| author | Juliana Dias de Lima Ivan Abdalla Teixeira Felipe de Oliveira Silva Andrea Camaz Deslandes |
| author_facet | Juliana Dias de Lima Ivan Abdalla Teixeira Felipe de Oliveira Silva Andrea Camaz Deslandes |
| author_sort | Juliana Dias de Lima |
| collection | DOAJ |
| description | Background: Mental disorders increase the risk factor for developing physical comorbidity conditions, such as cardiometabolic diseases. There is a high prevalence of multimorbidity and polypharmacy in the elderly population which hampers clinical response. Studies have shown that this positive correlation between the aging process and enhancement of physical comorbidities is especially high among older adults who live in low or middle income countries. Objective: To investigate the association between physical disease comorbidities and polypharmacy in older adults with a clinical diagnosis of Alzheimer’s disease (AD), mild cognitive impairment (MCI) or major depressive disorder (MDD), living in a middle income country. Methods: Cross-sectional study of community-dwelling elderly individuals who are cognitively healthy and those with AD, MCI, or MDD. The severity scale of the Charlson Comorbidity Index (CCI) was calculated to classify the severity of comorbidity condition. Logistic regression model (unadjusted and adjusted for age) were used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for cardiometabolic comorbidity (hypertension, diabetes, dyslipidemia and overweight), and polypharmacy. Results: Although there was not an increased risk of hypertension, diabetes, and obesity among the groups, elderly people with mental disorders presented higher odds for polypharmacy condition. Polypharmacy was significantly higher for all groups in comparison with cognitively healthy participants: AD (OR 22.00, 95 % CI 6.11–79.11), MDD (OR 14.73, 95 % CI 3.69–58.75) and MCI (OR 10.31, 95 % CI 2.44–43.59). Elderly patients with AD presented more severe comorbidities and higher risks for dyslipidemia. Conclusion: Elderly patients with depression, dementia and mild cognitive impairment have considerably higher odds for polypharmacy. People with dementia also have greater comorbidity severity than those who are cognitively healthy. In middle income countries, there is an urgent need to focus on promoting age-appropriate health approaches for the elderly with mental illness to prevent the development of aggravated cardiometabolic conditions and polypharmacy. |
| first_indexed | 2024-12-19T08:42:58Z |
| format | Article |
| id | doaj.art-7fecbe28c36e417794639fdda50e4e3f |
| institution | Directory Open Access Journal |
| issn | 2451-8301 |
| language | English |
| last_indexed | 2024-12-19T08:42:58Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IBRO Reports |
| spelling | doaj.art-7fecbe28c36e417794639fdda50e4e3f2022-12-21T20:28:53ZengElsevierIBRO Reports2451-83012020-12-01996101The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆Juliana Dias de Lima0Ivan Abdalla Teixeira1Felipe de Oliveira Silva2Andrea Camaz Deslandes3Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilInstitute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilInstitute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilCorresponding author at: Sylvio da Rocha Pollis St. 300, house 02, Rio de Janeiro, Brazil.; Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilBackground: Mental disorders increase the risk factor for developing physical comorbidity conditions, such as cardiometabolic diseases. There is a high prevalence of multimorbidity and polypharmacy in the elderly population which hampers clinical response. Studies have shown that this positive correlation between the aging process and enhancement of physical comorbidities is especially high among older adults who live in low or middle income countries. Objective: To investigate the association between physical disease comorbidities and polypharmacy in older adults with a clinical diagnosis of Alzheimer’s disease (AD), mild cognitive impairment (MCI) or major depressive disorder (MDD), living in a middle income country. Methods: Cross-sectional study of community-dwelling elderly individuals who are cognitively healthy and those with AD, MCI, or MDD. The severity scale of the Charlson Comorbidity Index (CCI) was calculated to classify the severity of comorbidity condition. Logistic regression model (unadjusted and adjusted for age) were used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for cardiometabolic comorbidity (hypertension, diabetes, dyslipidemia and overweight), and polypharmacy. Results: Although there was not an increased risk of hypertension, diabetes, and obesity among the groups, elderly people with mental disorders presented higher odds for polypharmacy condition. Polypharmacy was significantly higher for all groups in comparison with cognitively healthy participants: AD (OR 22.00, 95 % CI 6.11–79.11), MDD (OR 14.73, 95 % CI 3.69–58.75) and MCI (OR 10.31, 95 % CI 2.44–43.59). Elderly patients with AD presented more severe comorbidities and higher risks for dyslipidemia. Conclusion: Elderly patients with depression, dementia and mild cognitive impairment have considerably higher odds for polypharmacy. People with dementia also have greater comorbidity severity than those who are cognitively healthy. In middle income countries, there is an urgent need to focus on promoting age-appropriate health approaches for the elderly with mental illness to prevent the development of aggravated cardiometabolic conditions and polypharmacy.http://www.sciencedirect.com/science/article/pii/S2451830120300315Chronic diseasesPotentially inappropriate medicationsOlder adultsMental health |
| spellingShingle | Juliana Dias de Lima Ivan Abdalla Teixeira Felipe de Oliveira Silva Andrea Camaz Deslandes The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ IBRO Reports Chronic diseases Potentially inappropriate medications Older adults Mental health |
| title | The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ |
| title_full | The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ |
| title_fullStr | The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ |
| title_full_unstemmed | The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ |
| title_short | The comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country: a cross-sectional study⋆ |
| title_sort | comorbidity conditions and polypharmacy in elderly patients with mental illness in a middle income country a cross sectional study⋆ |
| topic | Chronic diseases Potentially inappropriate medications Older adults Mental health |
| url | http://www.sciencedirect.com/science/article/pii/S2451830120300315 |
| work_keys_str_mv | AT julianadiasdelima thecomorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT ivanabdallateixeira thecomorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT felipedeoliveirasilva thecomorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT andreacamazdeslandes thecomorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT julianadiasdelima comorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT ivanabdallateixeira comorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT felipedeoliveirasilva comorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy AT andreacamazdeslandes comorbidityconditionsandpolypharmacyinelderlypatientswithmentalillnessinamiddleincomecountryacrosssectionalstudy |