The relationship between functional qualifications and multiple drugs of 65 year-old patients who apply to ADÜ family medicine clinic

Aim Similar to the world population, the elderly population is rapidly increasing in our country and the importance of elderly health is increasing all over the world. The aging period is a process in which the life style and functional capacity of the individual from both physical and psychosocial aspects are negatively affected. Due to aging, increasing chronic diseases and various geriatric syndromes, both functional losses and the number of daily medicines used are increasing. As a result, functional disabilities and the use of multiple medications in the elderly period are two important problems. In this direction; The primary purpose of our study is to examine the association of physical and cognitive functional competences and polyphiles of the elderly we serve. Secondly, it is also aimed to evaluate the functional status of our elderly, to determine the frequency of polypharmacy and to determine the demographic characteristics associated with polypharmacy. Material and Method Our study; Between January 1, 2010 and June 1, 2016, the questionnaires and scales were applied to Adnan Menderes University Medical Faculty Practice and Research Hospital Family Physician Policlinic registered for over 65 years old. It is a single-center, prospective study. 200 people aged 65 years or more who were in accordance with the inclusion criteria were invited to our policlinic and taken to work. Questionnaires were administered using face-to-face interview technique, daily living activity scales and short mental state assessment (MMSE) and Tinetti test. Descriptive analyzes; number, percentage, average, minimum and maximum value; Chi-square and Fisher Exact test were used to analyze categorical data. Multivariate logistic regression analysis was used to determine the effect of age, gender, education level, income level, social security, basic and instrumental activities of daily living, risk of falls, chronic physical disease and cognitive dysfunction on dependent variable polypharmacy. The level of significance was accepted as 0.05. The required ethics committee's work permit was taken from Adnan Menderes University Ethics Committee. Findings The mean age of the study group was 71.1 ± 5.5 years (65-87). Of these, 90 (45%) were female and 110 (55%) were male. 21% of the participants were university graduates while 51% were primary or secondary school graduates. The mean age of chronic physical illnesses of participants in the study was 2,6 ± 1,2 (0-6). It was found that 94% of the participants had at least one chronic physical illness. The medication used by the participants was 3.4 ± 1.6 varieties (0-8). The propensity to use home remedies was preliminary. Only 48.5% of the group had polypharmacy. In the Basic and the Instrumental daily life activity scale, the majority of the participants were fully functional. The most common continental problems were found in the basic daily activities (32.5%), whereas in the instrümental daily life activities, the most frequent minor repairs and laundry problems were encountered (33%). The most affected cognitive function according to MMSE test was the ability to record with a rate of 38% and the least affected function with a rate of 1.5%. In the Tinetti test, 19.5% of the participants were in the high risk group while 42% were in the low risk group. Findings of our study are; (p: 0,005), increased risk of falling (p: 0,000), increased incidence of chronic disease (p: 0,001) and higher cognitive deficits (p: 0,008) in the presence of polypharmacy. Results Polypharmacy; it is confronted as one of the important geriatric syndromes which increase both morbidity and mortality and impair the quality of life and cause functional deficiencies. Multidrug use which is quite common in the elderly; It was associated with functional and cognitive impairment with the risk of falling. We think that it will be possible for the elderly to be better protected from the negative consequences of the polypharmacy when they are informed by the family physicians. Key words: polypharmacy, daily life activities, Tinetti, MMSE