| アブストラクト | This study aimed to investigate the association between cognitive impairment and polypharmacy in patients with atrial fibrillation prone to cognitive decline, and to elucidate if the Dementia Assessment Sheet for Community-based Integrated Care System 21-Items (DASC-21) severity classification indicates drug adjustment. This retrospective cohort study used the DASC-21 and Diagnosis Procedure Combination data at a specialised geriatric hospital with patients hospitalised between April 2019 and March 2022. The association between cognitive severity evaluated using the DASC-21 and polypharmacy was investigated using a multivariate logistic regression model. Data of 1191 inpatients (44.3% aged >/=85 years, 49.0% male) were analysed. Compared with severe cognitive impairment, mild (odds ratio [OR]: 3.33, 95% confidence interval [CI]: 1.29-8.57) and moderate (OR: 2.46, 95% CI: 1.06-5.72) impairments were associated with concurrent use of >/=6 medications. Antithrombotics were related to polypharmacy. The ORs did not change with 6, 8, or 10 medications (2.11 [95% CI: 1.51-2.95, p < 0.001], 2.42 [95% CI: 1.79-3.27, p < 0.001], and 2.01 [95% CI: 1.46-2.77, p < 0.001], respectively). DASC-21 severity was associated with polypharmacy in patients with atrial fibrillation, with a trend toward decreased polypharmacy from moderate to severe. The DASC-21 may serve as an indicator for drug adjustment in clinical practice. |
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| ジャーナル名 | Geriatrics (Basel, Switzerland) |
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| 投稿日 | 2024/2/23 |
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| 投稿者 | Shimazaki, Yoshitomo; Kishimoto, Keiko; Ishikawa, Joji; Iwakiri, Rika; Araki, Atsushi; Imai, Shinobu |
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| 組織名 | Division of Pharmacy, Tokyo Metropolitan Institute for Geriatrics and;Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.;Depertment of Pharmacoepidemiology, Showa University Graduate School of Pharmacy,;1-8-5, Hatanodai, Shinagawaku, Tokyo 142-8555, Japan.;Department of Social Pharmacy, Showa University Graduate School of Pharmacy,;Division of Cardiology, Tokyo Metropolitan Institute for Geriatrics and;Division of Elderly Care, Tokyo Metropolitan Institute for Geriatrics and;Frail Prevention Center, Training Center, Tokyo Metropolitan Institute for;Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38392102/ |
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