Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis.

Konstantinos Prokopidis, Panagiotis Giannos, Jean Yves Reginster, Olivier Bruyere, Mirko Petrovic, Antonio Cherubini, Konstantinos K Triantafyllidis, Konstantinos S Kechagias, Yannis Dionyssiotis, Matteo Cesari, Kinda Ibrahim, David Scott, Mario Barbagallo, Nicola Veronese

Journal: Journal of cachexia, sarcopenia and muscle 2023;14(2):671-683

PMID: 36781175

Free Full Text on ORBi (University of Liege) View on PubMed

Abstract

Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.

Address: Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.; Society of Meta-research and Biomedical Innovation, London, UK.; Society of Meta-research and Biomedical Innovation, London, UK.; Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, UK.; WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Liège, Belgium.; Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.; Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.; Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.; Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCA, Ancona, Italy.; Society of Meta-research and Biomedical Innovation, London, UK.; Department of Nutrition and Dietetics, Homerton University Hospital Foundation Trust, London, UK.; Society of Meta-research and Biomedical Innovation, London, UK.; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.; Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital Patras, University of Patras, Patras, Greece.; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.; Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy.; Academic Geriatric Medicine, Faculty of Medicine, University Hospital Southampton, University of Southampton, Southampton, UK.; Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR), University of Southampton, Southampton, UK.; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.; Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.

DOI: 10.1002/jcsm.13190

Link outs

Free resources

Full Text Sources:

Subscription / membership required

Full Text Sources:

MeSH Terms: Humans, Aged, Sarcopenia, Polypharmacy, Independent Living