The objective of this study is to evaluate the effect of polypharmacy on ADL and cognitive function at both admission and discharge in hospitalized elderly patients with multimorbidity.
This study included 157 multimorbidity patients aged 65 and older (mean age: 85.0 years ± 8.8) who were admitted to our hospital between April 2019 and March 2020 and subsequently discharged to home or elderly care facilities. Patients were divided into two groups: a polypharmacy group (n=127), defined as those taking five or more medications at admission, and a control group (n=30), defined as those taking fewer than five medications. Age, gender, length of hospital stay, physical therapy duration, number of medications at admission and discharge, and functional independence measures (FIM) for motor and cognitive function were compared between the two groups. The study also assessed Mini-Mental State Examination (MMSE) scores at admission and discharge. Multiple regression analysis was performed to identify factors associated with motor FIM improvement.
The polypharmacy group showed significantly less improvement in motor FIM compared to the control group (p0.05). Additionally, the polypharmacy group had a significantly higher number of chronic conditions and medications at both admission and discharge (p0.01). Factors associated with motor FIM improvement included motor FIM scores and MMSE scores at both admission and discharge.
Polypharmacy appears to suppress improvements in motor FIM in elderly patients with multimorbidity. This suggests that the simultaneous use of multiple medications may hinder physical recovery in such patients. Additionally, the improvement of motor FIM is closely tied to cognitive function, highlighting the need for an interdisciplinary approach in rehabilitation that incorporates medication adjustment and cognitive enhancement strategies. Effective management of polypharmacy may be critical for optimizing rehabilitation outcomes.
This study highlights the potential importance of optimizing both pharmacological and physical therapy interventions for improving outcomes in elderly patients with multimorbidity. However, the study has some limitations. The types of medications used were not investigated, and the study was conducted at a single center, necessitating caution in generalizing the results. Further research is needed to explore the specific drugs that may influence motor FIM improvements.
Multimorbidity
FIM
