Longitudinal associations of polypharmacy and frailty with major cardiovascular events and mortality among more than half a million middle-aged participants of the UK Biobank

• Verfasst von: Chen, Li-Ju [VerfasserIn]
• Verfasst von: Sha, Sha [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Verfasst von: Schöttker, Ben [VerfasserIn]
• Titel: Longitudinal associations of polypharmacy and frailty with major cardiovascular events and mortality among more than half a million middle-aged participants of the UK Biobank
• Verf.angabe: Li-Ju Chen, Sha Sha, Hermann Brenner, Ben Schöttker
• E-Jahr: 2024
• Jahr: July 2024
• Umfang: 9 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 08.01.2025
• Titel Quelle: Enthalten in: Maturitas
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1978
• Jahr Quelle: 2024
• Band/Heft Quelle: 185(2024) vom: Juli, Artikel-ID 107998, Seite [1]-9
• ISSN Quelle: 1873-4111
• DOI: doi:10.1016/j.maturitas.2024.107998
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cardiovascular disease mortality
• Sach-SW: Frailty
• Sach-SW: MACE
• Sach-SW: Mortality
• Sach-SW: Polypharmacy
• K10plus-PPN: 1913843890

Abstract

Background - Studies of the associations of polypharmacy and frailty with adverse health outcomes in middle-aged adults are limited. Furthermore, a potentially stronger association of polypharmacy with adverse health outcomes in frail than in non-frail adults is of interest. - Objective - To evaluate associations of frailty (assessed using a frailty index) and polypharmacy (defined as taking five or more drugs) with major cardiovascular events, cancer incidence, all-cause, cardiovascular disease-specific, and cancer-specific mortality. - Methods - Cox proportional hazards regression models were used to analyze 501,548 participants of the UK Biobank cohort study aged 40-69 years who were followed up for an average of 12 years. - Results - The prevalence of pre-frailty and frailty were 43.2 % and 2.3 %, respectively, and that of polypharmacy was 18.3 %. Although strongly associated with each other, frailty and polypharmacy were independently, statistically significantly associated with major cardiovascular events, cardiovascular disease-specific, and all-cause mortality. In addition, the hazard ratios of polypharmacy were stronger among (pre-)frail than non-frail study participants. No profound associations with cancer incidence and cancer mortality were observed. No sex and age differences were observed. - Conclusions - This large cohort study showed that polypharmacy and frailty are independent risk factors for major cardiovascular events, cardiovascular disease-specific and all-cause mortality in both middle-aged (40-64 years) and older people (≥ 65 years). In addition, the hazard ratios of polypharmacy were stronger among (pre-)frail than non-frail study participants. This underlines the need to avoid polypharmacy as far as possible not only in older but also in middle-aged subjects (40-64 years), especially if they are pre-frail or frail.