Potentially inappropriate medication use and frailty phenotype among community-dwelling older adults: A population-based study

Aims and objectives To investigate the association between potentially inappropriate medication use and frailty phenotype among community-dwelling older adults and to identify factors associated with the use of these drugs according to frailty condition. Background There is insufficient evidence about the association between inappropriate medication use and the condition of frailty, particularly among community-dwelling older adults. Therefore, data obtained from population surveys should be made available in order to support the development of clinical guidelines about the prevention of frailty. Design This was a cross-sectional study conducted according to the STROBE Checklist. Methods This population-based study was conducted on 1,607 older adults. Potentially inappropriate medication use was assessed according to Beers criteria and frailty syndrome was determined according to the phenotype proposed by Fried and colleagues. Data were analysed statistically using multinomial or binary logistic regression models. Results About 13.6% of the subjects were frail, and 36.8% used at least one inappropriate medication. The adjusted model indicated that, the more potentially inappropriate medication use, the higher the prevalence of frailty, prefrailty and the walking slowness component. Female gender, one or more years of schooling, five or more reported morbidities, and instrumental dependence regarding daily life activities were factors associated with potentially inappropriate medication use in the nonfrail group. Conclusion Inappropriate medication use was prevalent among community-living older adults, and its presence was associated with the occurrence of frailty. Relevance to clinical practice Primary care nurses are the professionals with the greatest contact with the older adults in the community. Thus, the results support the inclusion of the assessment of potentially inappropriate medication use in the routine of nursing consultation. In case of a positive screening, the older person should be referred to geriatric evaluation in order to optimise drug treatment for the prevention of frailty.