The relationship between polypharmacy and physical performance in patients with early-stage Alzheimer’s disease

Abstract

Introduction

Our aim was to evaluate the association between polypharmacy and certain physical performance measures used to assess ambulation in early-stage Alzheimer patients.

Materials and methods

This cross-sectional study was conducted in the dementia outpatient clinic of a tertiary care center. The usage of five or more drugs per day was accepted as polypharmacy and patients with moderate and severe dementia were excluded. Usual gait speed (UGS), timed up and go (TUG), and chair sit-to-stand test (CSST) were applied to assess physical performance status.

Results

There were 134 participants in our study (67.9% female, mean age 80.2 ± 7.9 years) and 75 (56%) patients were polypharmacy patients. The patients with polypharmacy showed poor physical performance compared to the patients without polypharmacy (UGS p = .005, TUG p < .001, CSST p < .001). The parameters that were significantly higher and more common in the polypharmacy group were body mass index (p = .026), hypertension (p = .013), diabetes mellitus (p = .018), ischemic heart disease (p < .001), atrial fibrillation (p = .030), depression (p = .012), and hypothyroidism (p = .007). In multivariate analyses, polypharmacy was independently associated with slow UGS [Odds ratio (OR) 1.248 (95%) confidence interval (CI) 1.145–1.523, p = .007]; long TUG [OR 1.410 (95%) CI 1.146–1.736, p = .001]; and long CSST [OR 1.892 (95%) CI 1.389–2.578, p < .001].

Conclusion

Our study demonstrated the association of polypharmacy with poor physical performance in patients with early stage Alzheimer’s disease. Prospective long-term studies investigating the relationship of polypharmacy and drug subgroups with physical performance in elderly patients with Alzheimer’s disease would be appropriate.

Keywords:

• Alzheimer’s disease
• physical functional performance
• polypharmacy

Transparency

Declaration of funding

This paper was not funded.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

AAS conceived and designed the analysis, BOB and AAS collected the data, AAS wrote the paper, AAS performed the analysis, BOB contributed analysis tools and revised the paper. All authors agree to be accountable for all aspects of the work.

Acknowledgements

None.

Ethical statement

This study was approved by the local ethics committee (Approval number: 2022/514/232/9). Informed consent was obtained from all participants