Comorbidities, polypharmacy, functionality and nutritional status in Turkish community-dwelling female elderly

Abstract

Background and aims: Most elderly persons live in developing countries where current geriatric epidemiological data are scarce. We aimed to study major comorbidities, polypharmacy, functional and nutritional status in a Turkish community-dwelling female elderly clinic population.

Methods: Female geriatrics outpatient clinic patients were assessed cross-sectionally. Patients underwent comprehensive geriatric cassessment, including identification of chronic diseases, drugs, functionality, and nutrition. Comorbidities and drugs were defined by the review of patients' self-reports and current medications. Geriatric depression and cognition were assessed by 30-item geriatric depression scale and Folstein mini-mental-state-examination. Functional status was assessed by the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutritional assessment was performed by mini-nutritional-assessment-short form.

Results: Five-hundred and fifteen patients were included in this study over an 8-year period. Mean age was 73.4 ± 6.9 years. Mean number of chronic diseases was 2.8. 61.1 % had >3 chronic diseases. Most common 3 diagnoses were hypertension (75.3 %), depression (45.5 %) and dementia (39.4 %). Mean number of drugs was 4.8. Polypharmacy was noted as 63.2 and 47.6 % by definitions as >4 or >5 chronic drug use, respectively. Subjects with at least one dependency of ADL and IADL were 23.4 and 64.0 %. Prevalence of poor nutrition was 39.1 %. In patients with at least one ADL or IADL dependency, undernutrition (p < 0.001), dementia (p < 0.001), cerebrovascular accident, Parkinson's disease, diabetes were more prevalent (p < 0.05) and were taking higher number of drugs (p < 0.01).

Conclusions: Polypharmacy and functional dependency seem to be prevalent among female elders in our country. Nutritional status was worse than the other reported urban area of Turkey and also than among males of same region but better than among Iranian counterparts. This study illustrates geographical differences in and between the individual countries and supports the continued need for comprehensive geriatric assessment worldwide.