The association between polypharmacy and malnutrition(risk) in older people: A systematic review
Open accessAbstract
Background & aim Malnutrition adversely influences a broad range of physical and psychological symptoms. Although polypharmacy is often mentioned to be associated with malnutrition, especially in older people it is unclear to what extent. The aim of this systematic review was to investigate the extent of the association between polypharmacy and malnutrition in older people. Methods The methodology followed the guidelines of the Cochrane Collaboration. Literature search was performed in PubMed, CINAHL and Embase. The population of interest for this systematic review were people of 65 years and older with polypharmacy. Because there is ambiguity with regard to the actual definition of malnutrition and polypharmacy, in this systematic review all articles describing malnutrition prevalence rates were included, regardless of the criteria used. Both observational and intervention studies were screened for eligibility. Selection and quality assessment of the included full text studies was assessed by two reviewers independently. A level of evidence and methodological quality score was adjudged to each article based on this assessment. Results A total of 3126 studies were retrieved by the literature search, of which seven studies were included in this systematic review. There was considerable variation in the definition of polypharmacy between studies. Two studies defined polypharmacy as the use of five or more drugs, two studies as the use of six or more drugs, two studies provided…
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A systematic review found that polypharmacy defined as ≥5 medicines in subjects ≥65 years of age was significantly associated with malnutrition.
“For example, a systematic review of polypharmacy defined as !5 medicines in subjects !65 years of age was significantly associated with malnutrition [172], and polypharmacy when defined as >10 medicines was associated with an increased risk of malnutrition after three years in those >75 years [173].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [172]
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Cites
Polypharmacy Among Adults Aged 65 Years and Older in the United States: 1988–2010
Charlesworth, C. J., Smit, E., Lee, D. S. H., Alramadhan, F., & Odden, M. C. (2015) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glv013 · Cited by 570 · see citing works
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Research works printed but not linked: 6
- [1][1] [Bardel A, Wallander MA, Sv € ardsudd K. Reported current use of prescription drugs and some of its determinants among 35 to 65-year-old women in midSweden. A population-based study. J Clin Epidemiol 2000;53(6):637 e 43.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref1) -
- [3][3] [Cusack BJ. Pharmacokinetics in older persons. Elsevier 2004;2(4):274 e 302.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref3) -
- [4][4] [Hajjar E, Ca fi ero A, Hanlon J. Polypharmacy in elderly patients. Elsevier 2007;5(4):345 e 51.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref4) -
- [5][5] [Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995-2010. BMC Med 2015;13(1):1 e 10.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref5) -
- [6][6] [Morin L, Johnell K, Laroche ML, Fastbom J, Wastesson JW. The epidemiology of polypharmacy in older adults: register-based prospective cohort study. Clin Epidemiol 2018;10:289 e 98.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref6) -
- [7][7] [Van Der Linden CMJ. Polyharmacy in older people. Nederland Tijdschr Dermatol Venereol 2017;27(9):479 e 81.](http://refhub.elsevier.com/S2405-4577(22)00181-4/sref7) Clinical Nutrition ESPEN xxx (xxxx) xxx
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ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“65 years of age was signi fi cantly associated with malnutrition [172], and polypharmacy when de fi ned as > 10 medicines was associated with an increased risk of malnutrition after three years in those > 75 years [173].”
- Authors
- Kok, W. E., Haverkort, E. B., Algra, Y. A., Mollema, J., Hollaar, V. R. Y., Naumann, E., de van der Schueren, M. A. E., & Jerković-Ćosić, K.
- Affiliations
- University of Applied Sciences Utrecht (NL)
- HAN University of Applied Sciences (NL)
- Corresponding author
- Kok, W.E.
- Haverkort, E.B.
- Algra, Y.A.
- Mollema, J.
- Hollaar, V.R.Y.
- Naumann, E.
- Venue
- Clinical Nutrition ESPEN
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 49
- Pages
- 163-171
- ISSN
- 2405-4577 (ISSN-L)
- OpenAlex
- W4220865672
- Cited by
- 55
- References
- 1
- Citations by year
- 2026: 8 · 2025: 20 · 2024: 15 · 2023: 8 · 2022: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Nutrition ESPEN (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion, public-domain)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- polypharmacy, malnutrition, older adults, malnutrition risk, drug use, excessive polypharmacy, malnutrition prevalence
- MeSH terms
- Aged, Humans, Prevalence, Polypharmacy, Malnutrition
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