Physical Function and Drugs in the Elderly a Scoping Review
Author(s): ,
Jonathon Thomson
Affiliations:
BSc
,
Allyson Jones
Affiliations:
PhD
Christina Shaw
,
Christina Shaw
Affiliations:
Adrian Wagg
Affiliations:
MB BS FRCP FRCP(E) FHEA (M
Canadian Pharmacists Conference ePoster Library. Sadowski C. Jun 4, 2017; 174256
Dr. Cheryl Sadowski
Dr. Cheryl Sadowski
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Abstract
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Objectives
Over half of older adults use medications long-term to treat a chronic condition. Although side effect profiles are well known, evidence has not been synthesized regarding medications impacting physical function. This evidence gap poses a challenge for clinicians making decisions about medication use in older adults at risk of functional impairment. The purpose of this scoping review was to evaluate the literature regarding medication and function in older adults.

Methods
Databases searched were MEDINE, EMBASE, and CINAHL. Study restrictions included English language, subjects mean age >64 years, medications from top 10 drug classes used by older adults, and having a validated physical function test. The titles/abstracts were screened by 2 individuals, and the full text articles were abstracted by 2 individuals, with consensus used for discrepancies.

Results
We screened 11,375 titles/abstracts, with 41 articles meeting our inclusion criteria. The studies were divided into two categories, with 21 focusing on physical function, and 20 focusing on falls. For physical function, antihypertensive medications lead to motor decline. Most cardiovascular medications (statins, ACE inhibitors (ACE-I), thiazides) showed no impairment with grip strength or overall muscle strength. Findings of functional status with statins and ACE-I were mixed. Although risk of falling was increased within the first 3 weeks of initiating most cardiovascular medications (ACE-I, beta-blockers, nifedipine, candesartan, and thiazides), no risk was seen with chronic users (> 12-month use).

Conclusion
There is limited literature available regarding how medications impact physical function in seniors. Most studies did not include functional measures as primary outcomes.

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