Study Suggests Multiple Medications Limit Rehabilitation Independence in Older Adults
Older adults who are discharged from hospitals on several medications tend to struggle more with regaining independence during rehabilitation, according to recent findings.
A study conducted in Japan and published in the journal BMC Geriatrics on December 17 examined the effects of polypharmacy, defined as having six or more medications regularly, in rehabilitation hospitals across the country.
This retrospective observational study analyzed data from 1,903 patients aged 65 and above who received rehabilitation from April 2017 to March 2024.
Patients in the study presented with one of three conditions: cerebrovascular disease, movement disorders, or disuse syndrome, which refers to muscle weakness from inactivity.
Notably, 62.1% of those studied were on multiple medications at discharge, with over 76% being over 80 years old.
Moreover, those taking several medications commonly included benzodiazepine receptor agonists (used for anxiety and sleep issues), laxatives, and psychotropic drugs aimed at tackling mood disorders.
Researchers found that patients with cerebrovascular disease and disuse syndrome exhibited significantly lower scores on the Functional Independence Measure (FIM), which assesses how well individuals perform daily activities post-illness or hospitalization. Interestingly, no link was observed between polypharmacy and FIM scores for patients with movement disorders.
The negative implications seemed to intensify for those over 80 years old and individuals recovering from strokes or general muscle weakness.
Researchers recommend reviewing and potentially reducing unnecessary medications as a way to enhance recovery for rehabilitation patients.
Dr. Mark Siegel, a Senior Medical Analyst, highlights the risks of polypharmacy in older adults, calling it a “dangerous proposition.” He mentioned that while each medication might hold significance, older individuals’ ability to tolerate and metabolize drugs often diminishes with age.
He pointed out that sedating or disorienting medications could further complicate matters for aging patients, leading to more interactions between drugs. This underscores the need for vigilant monitoring by healthcare providers, emphasizing that sometimes, “less is more.”
However, the study isn’t without its limitations. Being observational and retrospective, it doesn’t confirm causation related to medication use and rehabilitation results. There was also a noted lack of information regarding dosages and rehabilitation intensity, and since it was confined to one hospital, the findings may not necessarily reflect the broader population.
Future investigations are warranted to identify which specific drugs might most significantly impact recovery and to determine the most effective strategies for minimizing prescriptions.
