Exposure to potentially inappropriate medications (PIMs) significantly raises the odds of new disability and of hospitalization in generally healthy older adults, researchers report. 

Study subjects included more than 19,000 community-dwelling adults aged 65 years and older who participated in the ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial cohort. PIMs were identified based on a modified 2019 AGS Beers Criteria. 

Investigators analyzed links between baseline PIMs exposure and disability-free survival, death, incident dementia, disability and hospitalization..

50% higher disability risk

Fully 39% of study participants were prescribed at least one PIM, investigators found. When compared to their peers without PIM exposure, this cohort had a 50% increased risk of persistent physical disability and hospitalization. 

PIMs exposure also appeared to raise the odds of experiencing disability followed by hospitalization, the researchers reported. What’s more, almost half of the participants who developed disabilities had not previously been hospitalized, Jessica Lockery, PhD, of RMIT University in Australia, reported.

Drugs associated with an increased risk of disability included proton pump inhibitors, antipsychotics and benzodiazepines.

Clinicians take note 

Loss of function in older people has long been tied to a substantial reduction in health-related quality of life. With that in mind, the new results reveal an urgent need to carefully consider the potential costs when prescribing certain medications, investigators said. 

“Our findings suggest that PIMs use may start the disability cascade among healthy community-dwelling older adults, and confirm that caution is warranted when prescribing PIMs to older adults regardless of their health, function and polypharmacy status,” the authors concluded.

The study was published in JAGS.

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