Polypharmacy and the risk of malnutrition among independently-living elderly persons in Trinidad

Abstract

Objective: In this study, we evaluated the association of polypharmacy and nutritional status among independently-living elderly persons attending the outpatient clinics at the Eric Williams Medical Sciences Complex (EWMSC). Method: Participants were recruited at the outpatient pharmacy at EWMSC. Face-to-face interviews were conducted using a questionnaire consisting of sociodemographic, health and nutritional status items. Anthropometry was taken using standard procedures. Participants gave oral and written consent prior to enrolment in the study. Participation was voluntary. The study was approved by the Ethics Committee, EWMSC. Results: One hundred and three persons - polypharmacy (≥ 6 medications) = 57; nonpolypharmacy (< 6 medications) = 46 persons) - participated in the study. There was no significant difference in the age, gender, weight, height, body mass index (BMI), mid-arm circumference, calf circumference, highest educational level achieved and marital status between the groups. The number of medications prescribed was significantly positively associated with the number of ailments (r = 0.56; p < 0.001) and the risk of malnutrition (r = 0.30; p = 0.006). Persons with polypharmacy were significantly more likely than their nonpolypharmacy counterparts to be at increased risk for malnutrition (OR = 3.94, 95% CI: 1.52, 10.13; p = 0.004). This finding remained highly significant after simultaneous adjustment for age, gender, ethnicity, highest educational level achieved, marital status and number of diseases (p = 0.03). Conclusion: Among participants, polypharmacy and number of ailments were positively associated with an increased risk of malnutrition. Nonetheless, the mechanisms underlying these associations remain unclear.