Association of polypharmacy with occurrence of loneliness and social isolation among older adults

Polypharmacy Prevalence Among Older Adults Based on the Survey of Health, Ageing and Retirement in Europe: An Update

Polypharmacy, a common condition among the older population, is associated with adverse outcomes, including higher mortality, falls and hospitalization rates, adverse drug reactions, drug-drug interactions, medication nonadherence, and consequently increased healthcare costs. Background/Objectives: This study aims to explore the prevalence of polypharmacy and its associated factors among older adults across 27 European countries and Israel. Methods: In this cross-sectional analysis, we used data from participants aged 65 years or older from Wave 9 of the Survey of Health, Aging, and Retirement in Europe (SHARE) database. The variables studied were classified into the following categories: sociodemographic, behavioral factors, physical functioning, physical health, mental health, and living conditions. Results: Our results showed an overall prevalence of polypharmacy of 36.2%, ranging from 25.0 to 51.8%. Slovenia, Greece, and Switzerland were the countries with the lowest prevalence, whereas Portugal, Israel, and Poland were the countries where the prevalence of polypharmacy was the highest. Polypharmacy was shown to be associated with variables from all categories. Conclusions: Polypharmacy is a highly prevalent condition in the older population. Identification of variables associated with polypharmacy, such as those identified in this study, is important to identify and monitor older groups, which are most vulnerable to polypharmacy. Interventions designed to reduce polypharmacy should consider these associations.

The effect of sociodemographic characteristics and polypharmacy on loneliness and social isolation in community-dwelling older adults

The aim of this study was to assess the impact of sociodemographic factors and polypharmacy on loneliness and social isolation in older adults. This cross-sectional study included 370 older adults with and without polypharmacy. The data were gathered via the Personal Information Form, Loneliness Scale for Elderly, and Lubben Social Network Scale-Revised. A multivariate ANOVA (MANOVA) was conducted to assess the impact of independent variables on the combined dependent variables. Loneliness and social isolation were found higher in older adults with polypharmacy. In addition, loneliness and social isolation are more common in women, individuals with low educational attainment, single individuals, individuals with low income, individuals living in rural areas, individuals with poor family relationships, individuals not living with their families and individuals with chronic diseases. It is thought that the findings of this study will be guiding for all health professionals working in the field of elderly health in interventions to be planned for the elderly population.

Polypharmacy and potentially inappropriate medications in older adults who use long-term care services: a cross-sectional study

BACKGROUND

Older adults requiring care often have multiple morbidities that lead to polypharmacy, including the use of potentially inappropriate medications (PIMs), leading to increased medical costs and adverse drug effects. We conducted a cross-sectional study to clarify the actual state of drug prescriptions and the background of polypharmacy and PIMs.

METHODS

Using long-term care (LTC) and medical insurance claims data in the Ibaraki Prefecture from April 2018 to March 2019, we included individuals aged ≥ 65 who used LTC services. The number of drugs prescribed for ≥ 14 days and the number of PIMs were counted. A generalized linear model was used to analyze the association between the backgrounds of individuals and the number of drugs; logistic regression analysis was used for the presence of PIMs. PIMs were defined by STOPP-J and Beers Criteria.

RESULTS

Herein, 67,531 older adults who received LTC services were included. The median number of total prescribed medications and PIMs was 7(IQR 5-9) and 1(IQR 0-1), respectively. The main PIMs were loop diuretics/aldosterone antagonists (STOPP-J), long-term use of proton pump inhibitors (Beers Criteria), benzodiazepines/similar hypnotics (STOPP-J and Beers Criteria), and nonsteroidal anti-inflammatory drugs (STOPP-J and Beers Criteria). Multivariate analysis revealed that the number of medications and presence of PIMs were significantly higher in patients with comorbidities and in those visiting multiple medical institutions. However, patients requiring care level ≥1, nursing home residents, users of short-stay service, and senior daycare were negatively associated with polypharmacy and PIMs.

CONCLUSIONS

Polypharmacy and PIMs are frequently observed in older adults who require LTC. This was prominent among individuals with comorbidities and at multiple consulting institutions. Utilization of nursing care facilities may contribute to reducing polypharmacy and PIMs.

Perceived Loneliness, Social Isolation, and Social Support Resources of Frail Older People Ageing in Place Alone in Italy

This paper presents some findings from the IN-AGE ("Inclusive ageing in place") study, which the authors carried out in 2019 in Italy. It explores the available social support resources for frail older people with functional limitations ageing in place alone, and possible links between their social isolation and perceived loneliness. The authors conducted qualitative/semi-structured interviews involving 120 participants aged 65 years and over, and used a mixed-methods analysis (quantitative/qualitative). The main results show the family as the main help resource for daily activities, but also for intimate confidences against social isolation, especially when said relatives live close. Family confidants are less present when seniors are supported by friends/neighbours or/and public services. Moreover, the family is valuable for decreasing loneliness, although not always. However, some older people feel particularly alone when they are supported by public services. Such a complex context draws attention on the need of support for frail seniors living alone and could provide insights for policymakers on adequate policies for preventing and managing loneliness and social isolation in later life. This is especially relevant when family (and other) resources are not available or scarce, also considering the opportunities offered by technology, which can help seniors remain socially connected to relatives, friends and their overall community.