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Psychoactive Drugs as Risk Factors for Functional Decline Among Noninstitutionalized Dependent Elderly People

2010; Elsevier BV; Volume: 11; Issue: 7 Linguagem: Inglês

10.1016/j.jamda.2009.12.001

1538-9375

Marcos Aparecido Sarriá Cabrera, Mara Solange Gomes Dellaroza, Celita Salmaso Trelha, Lílian Bruniera Brunelli Paccola, Sandra Perdigão, Meyre Eiras de Barros Pinto, Thadeu Jairo Guerra Silva, Daniel Gonçalves de Oliveira,

Health disparities and outcomes

Objective To analyze the association between use of psychoactive drugs and functional decline among noninstitutionalized dependent elderly people. Design Cross-sectional study. Participants A total of 161 community-dwelling elderly people with functional dependence. Measurements The data were analyzed using logistic regression with adjustment for age models. The independent variables were the following: use of psychoactive drugs (antidepressants, anticonvulsants, anxiolytics, antipsychotics, or sedatives), cognitive decline (Mini-Mental State Examination score<20), and daytime sleepiness. The dependent variables were the following: dependence relating to activities of daily living (ADLs) and dependence relating to instrumental activities of daily living (IADLs). Results Data on 131 individuals of mean age 77.5 years were analyzed. Psychoactive drugs were used by 33.6%. Age-adjusted univariate analysis showed associations between psychoactive drug use and both ADLs and IADLs. However, in multivariate analysis, only ADLs showed a significant association with psychoactive drug use, independent of cognitive decline and daytime sleepiness (OR=2.67; 95% CI: 1.04–6.85; P=.04). Conclusions There is a greater risk of impairment of ADLs among noninstitutionalized elderly people using psychoactive drugs. These results indicate the need for rational use of medication groups among this population with greater risk of functional impairment. To analyze the association between use of psychoactive drugs and functional decline among noninstitutionalized dependent elderly people. Cross-sectional study. A total of 161 community-dwelling elderly people with functional dependence. The data were analyzed using logistic regression with adjustment for age models. The independent variables were the following: use of psychoactive drugs (antidepressants, anticonvulsants, anxiolytics, antipsychotics, or sedatives), cognitive decline (Mini-Mental State Examination score<20), and daytime sleepiness. The dependent variables were the following: dependence relating to activities of daily living (ADLs) and dependence relating to instrumental activities of daily living (IADLs). Data on 131 individuals of mean age 77.5 years were analyzed. Psychoactive drugs were used by 33.6%. Age-adjusted univariate analysis showed associations between psychoactive drug use and both ADLs and IADLs. However, in multivariate analysis, only ADLs showed a significant association with psychoactive drug use, independent of cognitive decline and daytime sleepiness (OR=2.67; 95% CI: 1.04–6.85; P=.04). There is a greater risk of impairment of ADLs among noninstitutionalized elderly people using psychoactive drugs. These results indicate the need for rational use of medication groups among this population with greater risk of functional impairment.