ArticlePloS one2022
Polypharmacy occurrence and the related risk of premature death among older adults in Denmark: A nationwide register-based cohort study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 38 citations in OpenAlex.
- Evaluation of polypharmacy and potentially inappropriate medication use among geriatric individuals aged 80 years and older.BMC geriatrics · 2026Article
- Polypharmacy and anticholinergic burden are common but not independently associated with outcomes after emergency laparotomy in older adults.Langenbeck's archives of surgery · 2026Observational
- Patients' Attitudes Towards Deprescribing and Associations With Patient-Related Factors Across Two Hospital Settings.Basic & clinical pharmacology & toxicology · 2026Article
- Polypharmacy, multimorbidity, and socioeconomic inequalities in a Spanish region: a population-based cross-sectional study.Frontiers in public health · 2026Article
- Association between polypharmacy and hypertension in the Iranian population aged 50 years or older: Iranian Multicenter Osteoporosis Study (IMOS-2021).BMC primary care · 2025Article
- Balancing polypharmacy and comorbidity management: cardiovascular health.Current opinion in HIV and AIDS · 2025Review
- Association between polypharmacy and 2-year outcomes among Chinese older inpatients: a multi-center cohort study.BMC geriatrics · 2024Article
- Impact of polypharmacy on 3-year mortality in patients with heart failure: a retrospective study.Journal of pharmaceutical health care and sciences · 2024Article
- Article
- Article
- Incidence and risk factors for polypharmacy among elderly people assisted by primary health care in Brazil.BMC geriatrics · 2023Article
- Observational
- Is shared decision-making a determinant of polypharmacy in older patients with chronic disease? A cross-sectional study in Hubei Province, China.BMC geriatrics · 2023Article
- Polypharmacy among older adults in Brazil: Association with sociodemographic factors and access to health services.Dialogues in health · 2022Article
- Redefining polypharmacy: Shifting from drug counts to patient-centered clinical appropriateness.Perspectives in clinical researchReview
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Authors and funding
4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPolypharmacy, defined as the concurrent use of ≥5 medications, increases the risk of drug-drug and drug-disease interactions as well as non-adherence to drug therapy. This may have negative health consequences particularly among older adults due to age-related pharmacokinetic and pharmacodynamic changes. This study aims to uncover the occurrence of polypharmacy among older adults in Denmark and investigate how polypharmacy relates to mortality.
methodThis nationwide register-based study included 1,338,058 adults aged 65+ years between January 2013 and December 2017 in Denmark. Polypharmacy prevalence was measured at time of inclusion while incidence and the association between polypharmacy and mortality were measured over the five-year follow-up using Cox regression. In an attempt to adjust for confounding by indication, propensity scores with overlap weighting were introduced to the regression model.
resultsAt time of inclusion, polypharmacy prevalence was 29% and over the five years follow-up, 47% of the remaining adults transitioned into polypharmacy. Identified risk factors included multimorbidity (2+ morbidities: HR = 3.51; 95% CI = 3.48-3.53), age (95+ years: HR = 2.85; 95% CI = 2.74-2.96), socioeconomic factors (Highest income quartile: HR = 0.81; 95% CI = 0.80-0.81), region of birth region (Non-western migrants: HR = 0.77; 95% CI = 0.75-0.79), marital status (Divorced: HR = 1.10; 95% CI = 1.10-1.12) and year of inclusion (2017: HR = 1.19; 95% CI = 1.19-1.22). Further analyses showed that polypharmacy involves many different drug cocktails with medication for the cardiovascular system (95%), blood and blood-forming organs (69%), alimentary tract and metabolism (61%) and nervous system (54%) contributing the most. After adjustment for propensity scores with OW, both polypharmacy (HR = 3.48, CI95% = 3.41-3.54) and excessive polypharmacy (HR = 3.48, CI95% = 3.43-3.53) increased the risk of death substantially.
conclusionA considerable proportion of older adults in Denmark were exposed to polypharmacy dependent on health status, socio-economic status, and societal factors. The associated three- to four-fold mortality risk indicate a need for further exploration of the appropriateness of polypharmacy among older adults.
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