Medicamentos potencialmente inapropriados em idosos e que apresentam capacidade de induzir comprometimento cognitivo: prevalência e fatores associados

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DOI:

https://doi.org/10.30968/jhphs.2025.164.1309

Resumo

Objetivo: Investigar a prevalência do uso de medicamentos potencialmente inapropriados em idosos e que podem induzir comprometimento cognitivo (MPIs-cog) e os fatores associados. Métodos: Estudo transversal de abordagem quantitativa. MPIs-cog abrangem fármacos com efeitos anticolinérgicos, sedativos, hipnóticos e outros capazes de provocar delirium. Idosos foram entrevistados em ambulatórios de dois hospitais de ensino de Belo Horizonte (MG) e em domicílios da região metropolitana. Dividiuse as variáveis independentes em sociodemográficas, farmacoterapêuticas e clínico-funcionais. A análise descritiva compreendeu a determinação da frequência de proporção para as variáveis categóricas e medidas de tendência central e de dispersão para as variáveis numéricas. Avaliou-se a normalidade pelo teste de Shapiro-Wilk. Realizou-se a análise univariada pelo Teste Qui-quadrado de Pearson. Na análise multivariada incluíram-se variáveis com p<0,20. No modelo final, permaneceram variáveis com p<0,05. Resultados: Participaram do estudo 344 idosos, com mediana de idade de 67,5 anos. MPIs-cog foi utilizado por 14,5% dos idosos. O uso de pelo menos um MPI-cog esteve independentemente associado à presença de polifarmácia (OR = 5,84, IC = 2,67–12,80, p = 0,00), câncer (OR = 5,07, IC = 2,18–11,76, p = 0,00), doenças neuropsiquiátricas (OR = 4,09, IC = 2,03–8,25, p = 0,00) e doença reumática (OR = 2,06, IC = 1,04–4,06, p = 0,04). Conclusão: A prevalência do uso de MPIs-cog foi de 14,5% na amostra investigada e apresentou associação positiva e independente com polifarmácia, câncer, doenças neuropsiquiátricas e doenças reumáticas.

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Referências

1. Dziechciaż M, Filip R. Biological psychological and social determinants of old age: bio-psycho-social aspects of human aging. Ann Agric Environ Med. 2014;21(4):835-838. doi:10.5604/12321966.1129943

2. Kritsilis M, V Rizou S, Koutsoudaki PN, et al. Ageing, Cellular Senescence and Neurodegenerative Disease. Int J Mol Sci. 2018;19(10):2937. doi:10.3390/ijms19102937

3. Randles MA, O’Mahony D, Gallagher PF. Frailty and Potentially Inappropriate Prescribing in Older People with Polypharmacy: A Bi-Directional Relationship?. Drugs Aging. 2022;39(8):597-606. doi:10.1007/s40266-022-00952-z

4. Reallon E, Chavent B, Gervais F, et al. Medication exposure and frailty in older community-dwelling patients: a cross-sectional study. Int J Clin Pharm. 2020;42(2):508-514. doi:10.1007/s11096-020-01007-2

5. Do D, Schnittker J. Utilization of Medications With Cognitive Impairment Side Effects and the Implications for Older Adults’ Cognitive Function. J Aging Health. 2020;32(9):1165-1177. doi:10.1177/0898264319895842

6. Sunwoo Y, Eom SH, Yun JS, et al. Real-World Data-Derived Pharmacovigilance on Drug-Induced Cognitive Impairment Utilizing a Nationwide Spontaneous Adverse Reporting System. Medicina (Kaunas). 2024;60(7):1028. doi:10.3390/medicina60071028

7. Taylor-Rowan M, Kraia O, Kolliopoulou C, et al. Anticholinergic burden for prediction of cognitive decline or neuropsychiatric symptoms in older adults with mild cognitive impairment or dementia. Cochrane Database Syst Rev. 2022;8(8):CD015196. doi:10.1002/14651858.CD015196.pub2em

8. American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372

9. O’Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1007/s41999-023-00777-y

10. Hefner G, Hahn M, Toto S, et al. Potentially inappropriate medication in older psychiatric patients. Eur J Clin Pharmacol. 2021;77(3):331-339. doi:10.1007/s00228-020-03012-w

11. Kristensson JH, Zahirovic I, Londos E, et al. Medications causing potential cognitive impairment are common in nursing home dementia units - A cross-sectional study. Explor Res Clin Soc Pharm. 2021;3:100054. doi:10.1016/j.rcsop.2021.100054

12. Dos Santos ANM, Farias-Itao DS, Benseñor IM, et al. Potentially inappropriate medications and cognitive performance: cross-sectional results from the ELSA-Brasil study. Eur J Clin Pharmacol. 2023;79(7):927-934. doi:10.1007/s00228-023-03504-5

13. Cross AJ, George J, Woodward MC, et al. Potentially Inappropriate Medication, Anticholinergic Burden, and Mortality in People Attending Memory Clinics. J Alzheimers Dis. 2017;60(2):349-358. doi:10.3233/JAD-170265

14. Pantuzza LLN. Desenvolvimento e validação de um instrumento para mensuração do Medication Literacy em idosos [tese]. UFMG: Belo Horizonte;2022.

15. Masnoon N, Shakib S, Kalisch-Ellett L, et al. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. doi:10.1186/s12877-017-0621-2

16. Teng EL, Hasegawa K, Homma A, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr. 1994;6(1):45-62. doi:10.1017/s1041610294001602

17. Damasceno A, Delicio AM, Mazo DF, et al. Validation of the Brazilian version of mini-test CASI-S. Arq Neuropsiquiatr. 2005;63(2B):416-421. doi:10.1590/s0004-282x2005000300010

18. Cross AJ, George J, Woodward MC, et al. Potentially Inappropriate Medications and Anticholinergic Burden in Older People Attending Memory Clinics in Australia. Drugs Aging. 2016;33(1):37-44. doi:10.1007/s40266-015-0332-3

19. Caçador C, Teixeira-Lemos E, Oliveira J, et al. The prevalence of polypharmacy and potentially inappropriate medications and its relationship with cognitive status in Portuguese institutionalized older adults: a cross-sectional study. Int J Environ Res Public Health. 2022;19(5):2637. doi:10.3390/ijerph19052637

20. Niikawa H, Okamura T, Ito K, et al. Association between polypharmacy and cognitive impairment in an elderly Japanese population residing in an urban community. Geriatr Gerontol Int. 2017;17(9):1286-1293. doi:10.1111/ggi.12862

21. Bandidwattanawong C, Rattanaserikulchai P, Jetsadavanit N. Polypharmacy and potentially-inappropriate medications are prevalent in the elderly cancer patients receiving systemic cancer therapy and they co-relate with adverse outcomes. BMC Geriatr. 2023;23(1):775. doi:10.1186/s12877-023-04471-3

22. Ozkan M, Karahan I, Yalcin S, et al. Effects of Potentially Inappropriate Medications in Older Patients with Gastrointestinal System Cancer. Medeni Med J. 2023;38(4):284-290. doi:10.4274/MMJ.galenos.2023.03063

23. Ramsdale E, Ramsdale E, Mohamed M, Yu V, et al. Polypharmacy, potentially inappropriate medications, and drug-drug interactions in vulnerable older adults with advanced cancer initiating cancer treatment. Oncologist. 2022;27(7):e580-e588. doi:10.1093/oncolo/oyac053

24. Sharma R, Bansal P, Sharma A, et al. Prevalence and predictors of Potentially Inappropriate Psychotropic Medication in older adults with psychiatric illness. Asian J Psychiatr. 2021;66:102872. doi:10.1016/j.ajp.2021.102872

25. Hong CT, Chan L, Wu D, et al. Antiparkinsonism anticholinergics increase dementia risk in patients with Parkinson’s disease. Parkinsonism Relat Disord. 2019;65:224-229. doi:10.1016/j.parkreldis.2019.06.022

26. Lee J, Singh N, Gray SL, et al. Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More. ACR Open Rheumatol. 2022;4(12):1031-1041. doi:10.1002/acr2.11503

27. Séguin DJ, Peschken CA, Dolovich C, et al. Polypharmacy and potentially inappropriate medication use in older adults with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2023;75(2):356-364. doi:10.1002/acr.24766

28. De Alcubierre D, Ferrari D, Mauro G, et al. Glucocorticoids and cognitive function: a walkthrough in endogenous and exogenous alterations. J Endocrinol Invest. 2023;46(10):1961-1982. doi:10.1007/s40618-023-02091-7

29. Khan Z, Mehan S, Saifi MA, et al. Proton Pump Inhibitors and Cognitive Health: Review on Unraveling the Dementia Connection and Co-morbid Risks. Curr Alzheimer Res. 2024;20(11):739-757. doi:10.2174/011567205028994624022-3050737

30. Nevado-Holgado AJ, Kim CH, Winchester L, et al. Commonly prescribed drugs associate with cognitive function: a crosssectional study in UK Biobank. BMJ Open. 2016;6(11):e012177. doi:10.1136/bmjopen-2016-012177

31. Zerah L, Bihan K, Kohler S, et al. Iatrogenesis and neurological manifestations in the elderly. Rev Neurol (Paris). 2020;176(9):710-723. doi:10.1016/j.neurol.2019.11.010

Publicado

2025-12-20

Como Citar

1.
SILVA AM, PANTUZZA LL, REIS AM. Medicamentos potencialmente inapropriados em idosos e que apresentam capacidade de induzir comprometimento cognitivo: prevalência e fatores associados. J Hosp Pharm Health Serv [Internet]. 20º de dezembro de 2025 [citado 15º de fevereiro de 2026];16(4):e1309. Disponível em: https://jhphs.org/sbrafh/article/view/1309

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