Effect of potentially inappropriate medication on frailty among community-dwelling elderly patients with mild cognitive impairment: a propensity score-matched analysis / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.