A recent study suggests that older patients discharged from the hospital on several medications may struggle to regain their independence during rehabilitation. This research, published on December 17 in BMC Geriatrics, focused on the effects of polypharmacy, which is taking six or more prescription drugs regularly, in convalescent rehabilitation hospitals across Japan.
The observational study surveyed 1,903 individuals aged 65 and above, who participated in rehabilitation from April 2017 to March 2024. These patients were primarily dealing with one of three health issues: cerebrovascular disease, movement disorders, or disuse syndrome, which generally involves muscle weakness due to inactivity.
Interestingly, about 62.1% of the participants were on multiple medications at discharge, and a significant portion—over 76%—were aged 80 and older. Many of these individuals were also prescribed benzodiazepine receptor agonists, commonly used for anxiety and insomnia, along with laxatives and other psychotropic medications aimed at addressing mood disorders.
Findings indicated that patients dealing with cerebrovascular diseases and disuse syndrome who were on multiple medications scored notably lower on the Functional Independence Scale (FIM), which gauges a patient’s ability to manage daily activities post-illness or hospitalization. On the other hand, those with movement disorders did not exhibit a connection between polypharmacy and their FIM scores.
The adverse effects of taking multiple medications appeared to be more pronounced among adults over 80, particularly for those recovering from strokes or general weakness stemming from insufficient physical activity.
Researchers recommend evaluating and potentially reducing unnecessary medications as a way to foster swifter recovery in rehabilitation patients.
Dr. Mark Siegel, a senior medical analyst, emphasized that polypharmacy can pose significant risks for older adults. He noted that while each medication has its purpose, the ability to tolerate and metabolize drugs typically declines with age. He added that medications with sedative properties could become more confusing as one gets older.
Dr. Siegel also pointed out that interactions between drugs are more likely in this age group, suggesting that careful monitoring by healthcare providers is crucial. Sometimes, taking fewer medications might lead to better outcomes.
However, the study does have its limitations. Its design was retrospective and observational, which means it cannot definitively establish causation between medication usage and rehabilitation outcomes. Moreover, there was no detailed data on specific drug dosages or the intensity of rehabilitation efforts. Conducted at a single hospital, the findings may not translate broadly to a wider population.
Further studies are necessary to identify which specific medications negatively influence recovery and to find effective strategies for managing prescriptions in older patients.
