Chronic Polypharmacy with Increasing Drug Burden Index Exacerbates Frailty and Impairs Physical Function, with Effects Attenuated by Deprescribing, in Aged Mice.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
John MachSarah N Hilmer

Abstract

Polypharmacy (use of ≥5 medications) and increasing Drug Burden Index (DBI) score (measure of person's total exposure to anticholinergic/sedative medications) are associated with impaired physical function in observational studies of older adults. Deprescribing, the supervised withdrawal of medications for which harms outweigh benefits for an individual, may be a useful intervention. Current knowledge is limited to clinical observational studies that are unable to determine causality. Here, we establish a preclinical model that investigates the effects of chronic polypharmacy, increasing DBI, and deprescribing on global health outcomes in aging. In a longitudinal study, middle-aged (12 months) male C57BL/6J (B6) mice were administered control feed or feed and/or water containing polypharmacy or monotherapy with different DBI scores. At 21 months, each treatment group was subdivided (stratified by frailty at 21 months) to either continue on treatment for life or to have treatment withdrawn (deprescribed). Frailty and physical function were evaluated at 12, 15, 18, and 24 months, and were analyzed using a mixed modeling approach. Polypharmacy with increasing DBI and monotherapy with citalopram caused mice to become frailer, less ...Continue Reading

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Citations

Mar 23, 2021·Age and Ageing·Sarah N Hilmer, Carl M J Kirkpatrick
Apr 7, 2021·BMC Medical Informatics and Decision Making·Melissa T BaysariSarah N Hilmer
Aug 3, 2021·International Journal of General Medicine·Harry WuSarah N Hilmer
Jun 26, 2021·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Trang TranSarah N Hilmer
Oct 17, 2021·Clinical Pharmacology and Therapeutics·Qi LiuRobert Temple

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