PMID- 36259580 OWN - NLM STAT- MEDLINE DCOM- 20221020 LR - 20240317 IS - 1760-4788 (Electronic) IS - 1279-7707 (Linking) VI - 26 IP - 10 DP - 2022 TI - Intrinsic Capacity Impairment Patterns and their Associations with Unfavorable Medication Utilization: A Nationwide Population-Based Study of 37,993 Community-Dwelling Older Adults. PG - 918-925 LID - 10.1007/s12603-022-1847-z [doi] AB - OBJECTIVES: Our aim was to explore the patterns of intrinsic capacity (IC) impairments among community-dwelling older adults and the associations of these different patterns with excessive polypharmacy, potentially inappropriate medications, and adverse drug reactions in a nationwide population-based study. DESIGN: A cross-sectional study included older adults from the Taiwan Integrated Care for Older People (ICOPE) program in 2020. SETTING AND PARTICIPANTS: The study subjects comprised 38,308 adults aged 65 years and older who participated in the ICOPE Step 1 screening and assessed six domains of IC following the World Health Organization (WHO) ICOPE approach. METHODS: Latent class analysis was adopted to identify distinct subgroups with different IC impairments patterns. The associations between different IC impairments patterns and unfavorable medication utilization, including excess polypharmacy (EPP), potentially inappropriate medications (PIMs), and adverse drug reactions (ADRs), were assessed by multivariate logistic regression models. RESULTS: Latent class analysis identified five distinct subgroups with different IC impairment patterns: robust (latent class prevalence: 59.4%), visual impairment (17.7%), physio-cognitive decline (PCD) with sensory impairment (12.3%), depression with cognitive impairment (7.7%), and impairments in all domains (2.9%). Compared to the robust group, all other groups were at higher odds for unfavorable medication utilization. The "depression with cognitive impairment" group (EPP: aOR=4.35, 95% CI 3.52-5.39, p<0.01; PIMs: aOR=2.73, 95% CI 2.46-3.02, p<0.01) and the "impairment in all domains" group (EPP: aOR=9.02, 95% CI 7.16-11.37, p<0.01; PIMs: aOR=3.75, 95% CI 3.24-4.34, p<0.01) remained at higher odds for EPP and PIMs after adjustment. CONCLUSIONS: We identified five distinct impairment patterns of IC, and each impairment pattern, particularly the "depression with cognitive impairment" and "impairment in all domains", was associated with higher odds of EPP and PIMs. Further longitudinal and intervention studies are needed to explore long-term outcomes of different impairment pattern and their reversibility. FAU - Meng, L-C AU - Meng LC AD - Li-Ning Peng, MD, PhD, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2 Shih-Pai Road, Taipei, Taiwan, TEL: +886-2-28757830, FAX: +886-2-28757711, Email: lining.peng@gmail.com. FAU - Hsiao, F-Y AU - Hsiao FY FAU - Huang, S-T AU - Huang ST FAU - Lu, W-H AU - Lu WH FAU - Peng, L-N AU - Peng LN FAU - Chen, L-K AU - Chen LK LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - France TA - J Nutr Health Aging JT - The journal of nutrition, health & aging JID - 100893366 SB - IM MH - Humans MH - Aged MH - *Independent Living MH - Inappropriate Prescribing MH - Cross-Sectional Studies MH - Potentially Inappropriate Medication List MH - Polypharmacy MH - *Drug-Related Side Effects and Adverse Reactions/epidemiology OTO - NOTNLM OT - Intrinsic capacity OT - adverse drug reaction OT - healthy aging OT - polypharmacy OT - potentially inappropriate medication COIS- All authors declare no conflicts of interest. EDAT- 2022/10/20 06:00 MHDA- 2022/10/21 06:00 CRDT- 2022/10/19 07:22 PHST- 2022/10/19 07:22 [entrez] PHST- 2022/10/20 06:00 [pubmed] PHST- 2022/10/21 06:00 [medline] AID - S1279-7707(23)00418-9 [pii] AID - 10.1007/s12603-022-1847-z [doi] PST - ppublish SO - J Nutr Health Aging. 2022;26(10):918-925. doi: 10.1007/s12603-022-1847-z.