Relação entre Polifarmácia e características sociodemográficas e clínicas em Nonagenários e Centenários

Abstract

Introduction: Nonagenarians and centenarians often present with multiple chronic conditions, frequently requiring 5 or more medications (polypharmacy). Few studies address the relationship between polypharmacy and sociodemographic and clinical characteristics in nonagenarians and centenarians. Objective: To study the relationship between polypharmacy and sociodemographic and clinical characteristics among nonagenarians and centenarians. Methods: Analysis of home assessments (June to November 2016) from a descriptive, cross-sectional study with randomly identified nonagenarians and centenarians in Porto Alegre, RS. Sociodemographic and clinical data were analyzed between groups with polypharmacy (PP) and without polypharmacy (WP) tested by Chi-square (distribution) and t-Student (means). The project was approved and registered under CAAE: 55906216.0.0000.5336. Data were analyzed using Epi Info (7.4), with p<0.05 considered significant. Results: 243 participants were evaluated, with 163 (67%) classified as PP, with the same percentage between men and women (p=0.983). The mean age between groups was similar (92 years, p=0.597). The age group with the highest percentage of PP participants was centenarians (71%, p=0.864). Mean education level was higher in WP (6.4±4.18 years of study) compared to PP (5.9±4.58 years, p=0.237). Participants living with a caregiver (80%) or family member (68%) had higher percentages of PP compared to those living alone (54%, p=0.107). Self-perception of poor vision showed the highest percentage of PP (74%), with a significant relationship between groups (p=0.091). Regarding the relationship between polypharmacy and comorbidities, a high frequency of PP was observed among participants with cardiovascular disease (78%, p=0.001), gastrointestinal conditions (77%, p=0.023), anxiety (80%, p=0.041), respiratory conditions (83%, p=0.014), joint disorders (77%, p=0.010), and thyroid disorders (82%, p=0.025). Conclusion: This study provided a novel perspective on polypharmacy among nonagenarians and centenarians. The most important socioeconomic factors were family arrangement and education level. Living alone and having higher education were protective factors. Clinical characteristics were significant, highlighting comorbidities that in this age group could be either a cause or effect of polypharmacy. These results are relevant for understanding the safety of medication use in this age group.