Evidence map›Paper›PMID 42266173›Full record

ArticleGeriatrics & gerontology international2026

Nonlinear Associations Between Frailty and Medication Burden in Hospitalized Older Adults.

Hiroyuki Umegaki, Hirotaka Nakashima, Fumihiko Mizokami, Yosuke Yamada, Kazuhisa Watanabe, Chisato Fujisawa, Hitoshi Komiya, Tomihiko Tajima, Shosuke Satake, Yasushi Takeya and 1 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Geriatrics & gerontology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hiroyuki UmegakiDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.ORCID https://orcid.org/0000-0003-2504-4133
Hirotaka NakashimaDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.ORCID https://orcid.org/0000-0003-2564-9204
Fumihiko MizokamiDepartment of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan.
Yosuke YamadaDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Kazuhisa WatanabeDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Chisato FujisawaDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Hitoshi KomiyaDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Tomihiko TajimaDepartment of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Shosuke SatakeDepartment of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.ORCID https://orcid.org/0000-0003-0301-1461
Yasushi TakeyaDivision of Health Science, Graduate School of Medicine, University of Osaka, Osaka, Japan.
Mitsutaka YakabeDepartment of Geriatric Medicine, University of Tokyo Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo examine how medication burden varies across frailty stages in hospitalized older adults, with a focus on potential nonlinear associations:

methodsWe analyzed a multicenter cohort of hospitalized adults aged ≥ 65 years. Frailty was assessed using the preadmission Clinical Frailty Scale (CFS). Associations between CFS and total medication count, potentially inappropriate medication (PIM) count, and anticholinergic burden (Japanese Anticholinergic Risk Scale) were evaluated using restricted cubic spline models adjusted for age, sex, and Charlson Comorbidity Index. Primary analyses were conducted in participants with complete data (n = 1075).

resultsCFS showed significant associations with all medication-related indicators (all overall p < 0.05), with evidence of nonlinearity for medication count (p < 0.0001) and PIM count (p = 0.024). Medication burden increased with worsening frailty, with the steepest rise observed in moderate frailty, followed by attenuation in more severe frailty. Across all indicators, adjusted curves suggested a consistent transition around CFS 5-6. These patterns were independent of age, sex, and comorbidity burden.

conclusionsMedication burden is strongly and nonlinearly associated with frailty in hospitalized older adults. These stage-dependent patterns suggest that moderate frailty may represent a window for targeted medication review and deprescribing, supporting frailty-stratified approaches to medication management in acute care.

Indexed as

Cholinergic AntagonistsFrail ElderlyFrailtyHospitalizationInappropriate PrescribingPolypharmacyPotentially Inappropriate Medication ListAgedAged, 80 and overFemaleGeriatric AssessmentHumansMaleCholinergic Antagonistsanticholinergic burdendeprescribingpolypharmacypotentially inappropriate medications

Identifiers

PMID42266173
PMCPMC13250668

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