Longitudinal Impact of CNS Polypharmacy on Geriatric Syn

中枢神经系统多重用药对老年综合症的纵向影响

• 批准号: 7008319
• 负责人: JOSEPH T HANLON
• 金额: $ 18.27万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7008319
• 关键词: balance; behavioral /social science research tag; clinical research; cognition disorders; drug adverse effect; drug interactions; functional ability; geriatrics; human data; human old age (65+); longitudinal human study; patient oriented research; urinary incontinence

DESCRIPTION (provided by applicant): Multiple drug use or polypharmacy due to medications from different classes that share similar pharmacological side effects is of concern in older adults. CNS polypharmacy is a common and important example of this phenomenon. CNS polypharmacy may contribute to the development of geriatric syndromes. Geriatric syndromes such as cognitive impairment, urinary incontinence and mobility/instability problems are also common, morbid and costly for older adults. With the trend towards increased use of medications, information is needed regarding the impact of CNS polypharmacy on geriatric syndromes in older adults. The long term objective is to enhance the health of the elderly by determining the dynamic effects over time of exposure and changes in CNS polypharmacy on geriatric syndromes, so that interventions can be designed, health outcomes improved and health care costs reduced. Using a longitudinal design, the immediate objective is to determine the impact over time of CNS polypharmacy on geriatric syndromes. CNS poly- pharmacy will be defined as: 1) the use of 2 or more medications from any of six medication classes (i.e., benzodiazepines, other anxiolytics/ hypnotics, opioid analgesics, antidepressants, antipsychotics and anti- epileptics) and 2) combined standardized daily dosage of these multiple CNS medications. We will determine mobility/instability performance (i.e., EPESE lower extremity battery, 400 meter walk, balance, self-reported falls), cognitive function (i.e., 3MS), and self-reported urinary incontinence. The specific hypotheses to be tested are that, compared with non affected elders, elderly participants with prevalent, incident and increasing CNS polypharmacy will have greater mobility/instability decline, increased cognitive decline, and increased likelihood of urinary incontinence after controlling for important covariates (e.g. comorbidities).This study capitalizes on data from the NIA-funded longitudinal Health ABC study. The current proposal is likely to be highly cost-effective and can be expected to yield results that are valid and generalizable to older adults.

描述（由申请人提供）：由于不同类别具有相似药理副作用的药物而导致多种药物使用或多药，在老年人中引起了人们的关注。中枢神经系统多药是这种现象的常见且重要的例子。中枢神经系统多药可能有助于老年综合征的发展。老年人的老年综合症，例如认知障碍，尿失禁和流动性/不稳定问题，对于老年人来说也很常见，病态且昂贵。随着使用药物使用的趋势，需要有关中枢神经系统多药对老年人老年综合征的影响的信息。长期目标是通过确定暴露时间的动态影响以及中枢神经系统多药对老年综合症的变化来提高老年人的健康，以便设计干预措施，改善健康状况并减少健康保健成本。使用纵向设计，直接目标是确定CNS多药对老年综合征的影响。 CNS多药房将定义为：1）使用六种药物中任何一种的两种或多种药物（即苯二氮卓类药物，其他抗焦虑药/催眠药，阿片类镇痛药，抗抑郁药，抗精神病药和抗癫痫病）和2）组合这些多种cns的标准化剂量。我们将确定移动性/不稳定性能（即Epese下肢电池，400米的步行，平衡，自我报告的瀑布），认知功能（即3ms）和自我报告的尿失禁。要测试的具体假设是，与未受到影响的老年人相比，患有普遍性，事件和中枢神经系统多药的老年参与者将具有更大的流动性/不稳定性下降，认知能力下降，并增加了对重要协方差的控制后的尿液无关性，例如，对研究的研究（例如，研究）研究了。当前的提案可能具有高度成本效益，并且可以预期产生对老年人有效且可推广的结果。