Cargando…

Nutritional Status and Potentially Inappropriate Medications in Elderly

(1) Background: The association between polypharmacy and malnutrition has been investigated in several studies; however, few of these specifically deepened the relationship between potentially inappropriate medication and malnutrition. With a descriptive approach, the primary aim of our study was to...

Descripción completa

Detalles Bibliográficos
Autores principales: Loddo, Simona, Salis, Francesco, Rundeddu, Samuele, Serchisu, Luca, Peralta, Maria Monica, Mandas, Antonella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225321/
https://www.ncbi.nlm.nih.gov/pubmed/35743535
http://dx.doi.org/10.3390/jcm11123465
_version_ 1784733590121086976
author Loddo, Simona
Salis, Francesco
Rundeddu, Samuele
Serchisu, Luca
Peralta, Maria Monica
Mandas, Antonella
author_facet Loddo, Simona
Salis, Francesco
Rundeddu, Samuele
Serchisu, Luca
Peralta, Maria Monica
Mandas, Antonella
author_sort Loddo, Simona
collection PubMed
description (1) Background: The association between polypharmacy and malnutrition has been investigated in several studies; however, few of these specifically deepened the relationship between potentially inappropriate medication and malnutrition. With a descriptive approach, the primary aim of our study was to evaluate the impact of the nutritional status, assessed with the Mini Nutritional Assessment (MNA), on potentially inappropriate medications (PIM), estimated 10-year survival, and the risk of adverse drug reactions in elderly patients; the secondary aim was to evaluate how the Screening Tool of Older People’s Prescriptions (STOPP), Screening Tool to Alert to Right Treatment (START), and BEERS 2019 criteria identify PIM compared to nutritional status. (2) Methods: In this study, 3091 subjects were enrolled, of whom 2748 (71.7%) were women; the median age was 80 years, with an interquartile range between 75 and 85 years of age. The subjects were assessed at the outpatient service for frail older people of the University Hospital of Cagliari. The study population was evaluated for their: MNA, Charlson Comorbidity Index, 10-year survival estimation, BEERS 2019, STOPP and START criteria, and ADR Risk scores. (3) Results: We divided the study population into three groups: MNA1 (MNA score ≥ 24), MNA2 (23.5–17), and MNA3 (<17): the severity of comorbidities, STOPP and START alerts, and BEERS 2019 criteria were significantly worse in both MNA2 and MNA3 compared to MNA1—with the exception of BEERS “non-anti-infective medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults”. Moreover, the estimated 10-year survival was significantly higher in MNA1 than in MNA2 and MNA3, and also in MNA2 compared to MNA3. Finally, the ADR risk scores were significantly lower in MNA1 than in MNA2 and MNA3. (4) Conclusions: Our study demonstrated the association between nutritional status and PIM checked with the BEERS 2019 criteria, and, for the first time, with the STOPP and START criteria.
format Online
Article
Text
id pubmed-9225321
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-92253212022-06-24 Nutritional Status and Potentially Inappropriate Medications in Elderly Loddo, Simona Salis, Francesco Rundeddu, Samuele Serchisu, Luca Peralta, Maria Monica Mandas, Antonella J Clin Med Article (1) Background: The association between polypharmacy and malnutrition has been investigated in several studies; however, few of these specifically deepened the relationship between potentially inappropriate medication and malnutrition. With a descriptive approach, the primary aim of our study was to evaluate the impact of the nutritional status, assessed with the Mini Nutritional Assessment (MNA), on potentially inappropriate medications (PIM), estimated 10-year survival, and the risk of adverse drug reactions in elderly patients; the secondary aim was to evaluate how the Screening Tool of Older People’s Prescriptions (STOPP), Screening Tool to Alert to Right Treatment (START), and BEERS 2019 criteria identify PIM compared to nutritional status. (2) Methods: In this study, 3091 subjects were enrolled, of whom 2748 (71.7%) were women; the median age was 80 years, with an interquartile range between 75 and 85 years of age. The subjects were assessed at the outpatient service for frail older people of the University Hospital of Cagliari. The study population was evaluated for their: MNA, Charlson Comorbidity Index, 10-year survival estimation, BEERS 2019, STOPP and START criteria, and ADR Risk scores. (3) Results: We divided the study population into three groups: MNA1 (MNA score ≥ 24), MNA2 (23.5–17), and MNA3 (<17): the severity of comorbidities, STOPP and START alerts, and BEERS 2019 criteria were significantly worse in both MNA2 and MNA3 compared to MNA1—with the exception of BEERS “non-anti-infective medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults”. Moreover, the estimated 10-year survival was significantly higher in MNA1 than in MNA2 and MNA3, and also in MNA2 compared to MNA3. Finally, the ADR risk scores were significantly lower in MNA1 than in MNA2 and MNA3. (4) Conclusions: Our study demonstrated the association between nutritional status and PIM checked with the BEERS 2019 criteria, and, for the first time, with the STOPP and START criteria. MDPI 2022-06-16 /pmc/articles/PMC9225321/ /pubmed/35743535 http://dx.doi.org/10.3390/jcm11123465 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Loddo, Simona
Salis, Francesco
Rundeddu, Samuele
Serchisu, Luca
Peralta, Maria Monica
Mandas, Antonella
Nutritional Status and Potentially Inappropriate Medications in Elderly
title Nutritional Status and Potentially Inappropriate Medications in Elderly
title_full Nutritional Status and Potentially Inappropriate Medications in Elderly
title_fullStr Nutritional Status and Potentially Inappropriate Medications in Elderly
title_full_unstemmed Nutritional Status and Potentially Inappropriate Medications in Elderly
title_short Nutritional Status and Potentially Inappropriate Medications in Elderly
title_sort nutritional status and potentially inappropriate medications in elderly
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225321/
https://www.ncbi.nlm.nih.gov/pubmed/35743535
http://dx.doi.org/10.3390/jcm11123465
work_keys_str_mv AT loddosimona nutritionalstatusandpotentiallyinappropriatemedicationsinelderly
AT salisfrancesco nutritionalstatusandpotentiallyinappropriatemedicationsinelderly
AT rundeddusamuele nutritionalstatusandpotentiallyinappropriatemedicationsinelderly
AT serchisuluca nutritionalstatusandpotentiallyinappropriatemedicationsinelderly
AT peraltamariamonica nutritionalstatusandpotentiallyinappropriatemedicationsinelderly
AT mandasantonella nutritionalstatusandpotentiallyinappropriatemedicationsinelderly