Researchers: Rachel Dankner^1,2, Angela Chetrit¹

Background: The elderly, whose relative proportion in the population is gradually increasing in Israel and around the world, is characterized by high morbidity, treatment with multiple medications, and risks for adverse events consequent to the medications used.

Objectives: To examine associations of adequacy of medication treatment with long-term morbidity and mortality, and to identify differences in medication treatment adequacy in high risk groups of community-dwelling elderly.

Method: The longitudinal GOH Study (The Israel Study of Glucose Intolerance, Obesity and Hypertension) began in 1969. During the 3rd follow-up (1999-2006) data were collected on health status, lifestyle, detailed use of medications; anthropometric measurements and blood tests were performed. Dates and causes of death were updated through 2019. Survival analysis examined the association between polypharmacy and the use of potentially inappropriate medications (PIMs, according to beers criteria), country of origin and socioeconomic characteristics, adjusting for confounders, and overall/cause-specific mortality risk.

Findings: Findings: Among the 1,210 survivors (mean age 72.9), 38.4% received polypharmacy, and 29.9% took a PIM. After adjusting for age, sex, baseline health status and socioeconomic characteristics, no association was found between PIMs and risk of mortality, whereas polypharmacy was associated with a 1.9 higher mortality risk only among those with 0-1 chronic diseases, i.e. with low morbidity.

Conclusions: Polypharmacy is not necessarily a marker for poor-quality medical treatment, and it is important to consider the health status and

Recommendations: Family physicians should carefully examine the medications list, especially among seemingly healthy elderly. Preventive interventions should focus on the high-risk groups identified.

Research end date: 10/2021