Riesgo de caídas y consumo de fármacos en los pacientes mayores de 65 años. Estudio PYCAF / Risk of falls and drug use in patients over 65 years of age. The PYCAF study

OBJETIVO: Evaluar el riesgo de caídas y su relación con el policonsumo de fármacos en ancianos no institucionalizados. MATERIALES Y MÉTODOS: El estudio PYCAF (Prevalencia Y Características del Anciano Frágil) es un estudio transversal, descriptivo y multicéntrico en pacientes > 65 años. Se consideró riesgo elevado de caídas cuando se tardó más de 20 s en realizar el test Timed Up and Go. Se consideró polimedicación el consumo entre 5 y 9 fármacos, y polimedicación extrema (PE) el consumo de 10 o más fármacos. Mediante modelos de regresión logística ajustados se valoró la asociación de la polimedicación y la PE con el riesgo de caídas. RESULTADOS: Se incluyó a 2.461 pacientes (57,9% mujeres), edad media +/- desviación estándar 76,0 +/- 7,0 años. El consumo medio de medicamentos fue de 6,6 +/- 3,7, rango 0-23. La polimedicación estaba presente en el 50,6% y la PE en el 19,2% de los pacientes. El 13,7% de los pacientes presentaron elevado riesgo de caídas. La prevalencia de riesgo elevado de caídas fue más de 2veces superior en los pacientes con PE (ORa = 2,07; IC del 95%, 1,27-3,38) y polimedicados (ORa =1,95; IC del 95%, 1,26-2,99). CONCLUSIONES: La polimedicación y la PE se asocian con un elevado riesgo de caídas en pacientes de más de 65 años. Debe valorarse el riesgo de caídas de los pacientes ancianos antes de prescribir medicación

OBJECTIVE: To evaluate the risk of falls and its relationship with the multiple drug use in the non-institutionalised elderly. MATERIALS AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a cross-sectional, descriptive and multicentre study in patients> 65 years of age. A fall was considered high risk when it took more than 20seconds to perform the Timed Up and Go test. Consuming between 5 and 9 drugs is considered multiple drug (MD) use, and extreme multiple drug (EMD) use the consumption of 10 or more drugs. Adjusted logistic regression models evaluated the association between multiple drug use and EMD and the risk of falls. RESULTS: A total of 2,461 patients (57.9% women), with a mean age (SD) 76.0 (+/- 7.0) years, were included in the study. The mean consumption of medications was 6.6 +/- 3.7, range 0-23. Multiple drug use was present in 50.6%, and EMD in 19.2% of patients. A high risk of falls was observed in 13.7% of patients. The prevalence of high risk of falls was more than 2times higher in patients with EMD (ORa = 2.07, 95% CI = 1.27 - 3.38) and MD (ORa = 1.95, 95% CI = 1.26 - 2.99). CONCLUSIONS: MD and EMD are associated with a high risk of falls in patients over 65 years of age. The risk of falls in elderly patients should be assessed before prescribing medication

Características clínicas y sociosanitarias en mayores de 65 años asistidos en atención primaria. Estudio PYCAF / Clinical and socio-sanitary characteristics in adults older than 65 years attended in the Primary Care setting. The PYCAF study

OBJETIVO: Describir las características clínicas y sociosanitarias de los pacientes mayores de 65 años atendidos en consultas de atención primaria. MATERIAL Y MÉTODOS: El estudio PYCAF (Prevalencia Y Características del Anciano Frágil) es un estudio descriptivo, transversal y multicéntrico. Se incluyeron de manera consecutiva sujetos mayores de 65 años, atendidos en las consultas de atención primaria de toda España en condiciones de práctica clínica habitual. RESULTADOS: Se analizaron un total de 2.461 pacientes (edad media de 76,0+/-6,9 años; 57,9% mujeres). La coexistencia de factores de riesgo cardiovascular y comorbilidades fue frecuente, siendo las más prevalentes: hipertensión arterial (73,7%), dislipidemia (58,3%), artrosis (56,4%), obesidad (34,0%) y diabetes (28,9%). El 13,4% de los pacientes tenían algún grado de deterioro cognitivo. Las mujeres mostraron un mayor grado de fragilidad (61,0% vs.51,8%; p < 0,001). El 47,4% de los pacientes tomaban más de 6 fármacos, siendo mayor el consumo en las mujeres (44,2% vs.49,8%; p = 0,047). El 49,5% de los pacientes realizaron más de 10 visitas a atención primaria, el 25,9% 4 o más visitas a atención especializada y un 22,3% estuvieron ingresados en el último año. CONCLUSIONES: El estudio PYCAF nos muestra que los pacientes ancianos tienen mayor prevalencia de enfermedades crónicas cardiovasculares y no cardiovasculares, lo que conduce a una elevada polimedicación. Esta última tiene consecuencias tanto en la seguridad del paciente como en los costes directos e indirectos sobre el Sistema Nacional de Salud que emanan de la asistencia al paciente mayor de 65 años. La prevalencia de fragilidad alcanza a la mitad de la muestra

OBJECTIVE: To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting. MATERIAL AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included. RESULTS: A total of 2,461 patients (mean age 76.0+/-6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs.51.8%; P<.001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs.49.8%; P=.047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year. CONCLUSIONS: The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility

[Risk of falls and drug use in patients over 65 years of age. The PYCAF study]. / Riesgo de caídas y consumo de fármacos en los pacientes mayores de 65 años. Estudio PYCAF.

OBJECTIVE: To evaluate the risk of falls and its relationship with the multiple drug use in the non-institutionalised elderly. MATERIALS AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a cross-sectional, descriptive and multicentre study in patients> 65 years of age. A fall was considered high risk when it took more than 20seconds to perform the Timed Up and Go test. Consuming between 5 and 9 drugs is considered multiple drug (MD) use, and extreme multiple drug (EMD) use the consumption of 10 or more drugs. Adjusted logistic regression models evaluated the association between multiple drug use and EMD and the risk of falls. RESULTS: A total of 2,461 patients (57.9% women), with a mean age (SD) 76.0 (± 7.0) years, were included in the study. The mean consumption of medications was 6.6 ± 3.7, range 0-23. Multiple drug use was present in 50.6%, and EMD in 19.2% of patients. A high risk of falls was observed in 13.7% of patients. The prevalence of high risk of falls was more than 2times higher in patients with EMD (ORa = 2.07, 95% CI = 1.27 - 3.38) and MD (ORa = 1.95, 95% CI = 1.26 - 2.99). CONCLUSIONS: MD and EMD are associated with a high risk of falls in patients over 65 years of age. The risk of falls in elderly patients should be assessed before prescribing medication.

[Clinical and socio-sanitary characteristics in adults older than 65 years attended in the Primary Care setting. The PYCAF study]. / Características clínicas y sociosanitarias en mayores de 65 años asistidos en atención primaria. Estudio PYCAF.

OBJECTIVE: To describe the clinical and socio-sanitary characteristics of adults older than 65 years attended in a Primary Care setting. MATERIAL AND METHODS: The PYCAF study (Prevalence and Characteristics of the Fragile Elderly) is a descriptive, cross-sectional and multicentre study, in which patients older than 65 years attended in clinical practice in Primary Care in Spain were consecutively included. RESULTS: A total of 2,461 patients (mean age 76.0±6.9 years, 57.9% women) were included in the study. The coexistence of cardiovascular risk factors and comorbidities was frequent, with arterial hypertension (73.7%) being the most prevalent, followed by dyslipidaemia (58.3%), arthrosis (56.4%), obesity (34.0%), and diabetes (28.9%). Some degree of cognitive impairment was observed in 13.4% of patients. Women had higher rates of frailty (61.0% vs. 51.8%; P<.001). Just under half (47.4%) of subjects were taking more than 6 drugs, with the prescription being higher in women (44.2% vs. 49.8%; P=.047). Just under half (49.5%) of patients made more than 10 visits to Primary Care, 25.9% of patients 4 or more visits to the specialist, and 22.3% of patients were admitted to hospital in the last year. CONCLUSIONS: The PYCAF study shows that elderly patients have a higher prevalence of chronic cardiovascular and non-cardiovascular diseases, which leads to high polypharmacy. The latter has consequences both on patient safety and on the direct and indirect costs of the National Health System that emanate from the care of patients over 65 years of age. Half the sample has fragility.