Research Article
Year 2025,
, 197 - 205, 17.06.2025
Abstract
Amaç: Bu çalışmanın amacı yaşlılarda polifarmasi ile depresyon, anksiyete ve stres arasındaki ilişkiyi incelemektir.
Yöntemler: Bu kesitsel çalışma, Türkiye'nin doğusundaki bir ilde iki farklı hastaneye başvuran 396 yaşlı ile gerçekleştirilmiştir. Veri toplamak için Bilgi Formu ve Depresyon Anksiyete Stres Ölçeği-21 kullanıldı. Veriler Ağustos ve Eylül 2023 tarihleri arasında elde edilmiştir.
Bulgular: Yaşlıların %43,7'sinde polifarmasi mevcuttu. Çalışmada gelir durumu (OR=0,385; %95 GA=0,163-0,909, P=,029), hipertansiyon (OR=3,899; %95 GA=1,606-9,466, P=,003), koroner arter hastalığı (OR=6,677; %95 CI=2,620-17,020, P<,001), diyabet (OR=3,924; %95 CI=1,543-9,981, P=,004), akciğer hastalığı (OR=8,893; %95 CI=2,909-27,180, P<,001), hiperlipidemi (OR=20,023; %95 CI=5,737-69,887, P<,001), böbrek hastalığı (OR=16,514; %95 CI=5,873-46,431, P<,001), tiroid hastalığı (OR=7,213; %95 CI=2,255-23,079, P<,001), kanser (OR=24,783; %95 GA=6,755-90,933, P<,001) ve çok fazla ilaç kullandığını düşünme (OR=0,484; %95 GA=0,233-1,005, P=,052) polifarmasi için anlamlı risk faktörleriydi. Yaşlılarda depresyon, anksiyete ve stres varlığının polifarmasi için anlamlı bir risk faktörü olmadığı görülmüştür (P>,05).
Sonuç: Yaşlılarda polifarmasi ile depresyon, anksiyete ve stres arasındaki ilişki üzerine daha fazla çalışma yapılması gereklidir. Gelecekteki çalışmalarda daha kapsamlı ölçüm araçlarının kullanılması, yaşlıların kullandıkları ilaçların hangi gruba ait olduğunun değerlendirilmesi ve nedenselliğin test edilmesi önerilmektedir.
Keywords
Ethical Statement
“Yaşlılarda Polifarmasi ile Depresyon, Anksiyete ve Stres Arasındaki İlişki: Kesitsel Bir Çalışma” başlıklı makalemizin derginizde makale olarak değerlendirilmesini rica ederim. Bu makalenin daha önce yayınlanmadığını ve başka bir yerde yayınlanmak üzere değerlendirilmediğini beyan ederim. Herhangi bir finansal destek veya çıkar çatışması oluşturabilecek bir ilişkim olmadığını beyan ederim.
Supporting Institution
Yok.
Thanks
Bu çalışmaya katılan tüm yaşlılara içtenlikle teşekkür ederiz.
References
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- 2. Sofulu F, Karadakovan A. Evaluation of knowledge and practices on polypharmacy and drug use of geriatric individuals. Izmir Kâtip Celebi University Faculty of Health Sciences Journal. 2022;7(3):529-533. https://dergipark.org.tr/en/pub/ikcusbfd/issue/72902/1065640.
- 3. Dangerfield HJ, Scott JM, Zohn JH, Segal DL, Benton MJ. Relationship between anxiety and quality of life among older adults with self‐reported polypharmacy in long‐term care: A cross‐sectional study. J Adv Nurs. 2023;79(9):3559-3568. https://doi.org/10.1111/jan.15691.
- 4. Gumustakim RS, Baser DA. Multiple drug use in elderly in primary care: An example of rural field. Turk J Fam Pract. 2019;23(1):2-8. https://dx.doi.org/10.15511/tahd.19.00102.
- 5. Assari S, Bazargan M. Polypharmacy and psychological distress may be associated in African American adults. Pharmacy. 2019;7(1):14. https://doi.org/10.3390/pharmacy7010014.
- 6. Kizmaz M, Kumtepe KB, Cetin KN, Doner E. Investigation of polypharmacy prevalence and affecting factors in patients over 65 years presenting to family medicine polyclinic of rural district hospital. Ankara Med J. 2020;20(1):123-134. https://dx.doi.org/10.5505/amj.2020.46548.
- 7. Karahan FS, Hamarta E. The effect of chronic diseases and polypharmacy on anxiety and death anxiety in geriatric patients. Aegean J Med Sci. 2019;2(1):8-13. https://doi.org/10.33713/egetbd.463608.
- 8. Korkmaz EA, Yalcin Gursoy M. Polypharmacy prevalence in rural-living older adults: A cross-sectional study. Turkiye Klinikleri J Health Sci. 2023;8(2):300-307. https://doi.org/10.5336/healthsci.2022-94098.
- 9. Ozturk E, Ganidaglı S, Ozturk Z. Polypharmacy in the elderly: A double-edged sword. Med Records. 2023;5(2):255-261. https://doi.org/10.37990/medr.1183707.
- 10. Assari S, Wisseh C, Saqib M, Helmi H, Bazargan M. Polypharmacy and depressive symptoms in US-born mexican american older adults. Psych. 2019;1(1):491-503. https://doi.org/10.3390/psych1010038.
- 11. Sari NPWP, Manungkalit M. The best predictor of anxiety, stress, and depression among institutionalized elderly. Int J Environ Res Public Health. 2019;8(4):419-426. https://dx.doi.org/10.11591/ijphs.v8i4.20359.
- 12. World Health Organization. Mental health of older adults. Updated October 20, 2023. Accessed April 16, 2024. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults.
- 13. Gameiro GR, Minguini IP, Alves TCTF. The role of stress and life events in the onset of depression in the elderly. Rev Med (São Paulo). 2014;93(1):31-40. http://dx.doi.org/10.11606/issn.1679-9836.v93i1p31-40.
- 14. Färber F, Rosendahl J. Trait resilience and mental health in older adults: A meta‐analytic review. Personal Ment Health. 2020;14(4):361-375. https://doi.org/10.1002/pmh.1490.
- 15. National Council on Aging. Stress and how to reduce it: A guide for older adults. Updated March 24, 2023. Accessed April 22, 2024. https://www.ncoa.org/article/stress-and-how-to-reduce-it-a-guide-for-older-adults.
- 16. Bazargan M, Smith J, Saqib M, Helmi H, Assari S. Associations between polypharmacy, self-rated health, and depression in African American older adults; mediators and moderators. Int J Environ Res Public Health. 2019;16(9):1574. https://doi.org/10.3390/ijerph16091574.
- 17. Cheng C, Bai J. Association between polypharmacy, anxiety, and depression among Chinese older adults: evidence from the Chinese longitudinal healthy longevity survey. Clin Interv Aging. 2022;17:235-244. https://doi.org/10.2147%2FCIA.S351731.
- 18. Cigiloglu A, Efendioglu EM, Ozturk ZA. Polypharmacy and depression among older individuals. Eur J Ther. 2022;28(3):226-229. http://dx.doi.org/10.5152/EurJTher.2022.21040.
- 19. Ozturk Y, Comertoglu EO, Hafizoglu M, et al. The relationship between polypharmacy and geropsychiatric assessment scales in geriatric outpatients. Eur J Geriatr Gerontol. 2023;5(3):225-230. http://doi.org/10.4274/ejgg.galenos.2023.2023-5-1.
- 20. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. J Cogn Behav Psychother Res. 2018;7:19-30. https://doi.org/10.5455/JCBPR.274847.
- 21. Gutiérrez-Valencia M, Herce PA, Lacalle-Fabo E, Escámez BC, Cedeno-Veloz B, Martínez-Velilla N. Prevalence of polypharmacy and associated factors in older adults in Spain: Data from the National Health Survey 2017. Med Clín (English Edition). 2019;153(4):141-150. https://doi.org/10.1016/j.medcle.2019.06.009.
- 22. Iqbal A, Richardson C, Iqbal Z, et al. Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis. BMC Geriatr. 2023;23(1):149. https://doi.org/10.1186/s12877-023-03835-z.
- 23. Nwadiugwu MC. Multi-morbidity in the older person: an examination of polypharmacy and socioeconomic status. Front Public Health. 2021;8:582234. https://doi.org/10.3389/fpubh.2020.582234.
- 24. Galazzi A, Lusignani M, Chiarelli MT, et al. Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy. Int J Clin Pharm. 2016;38:454-461. https://doi.org/10.1007/s11096-016-0279-4.
- 25. Clyne B, Cooper JA, Boland F, Hughes CM, Fahey T, Smith SM. Beliefs about prescribed medication among older patients with polypharmacy: a mixed methods study in primary care. Br J Gen Prac. 2017;67(660):e507-e18. https://doi.org/10.3399/bjgp17X691073.
- 26. Mortelmans L, Goossens E, Dilles T. Beliefs about medication after hospital discharge in geriatric patients with polypharmacy. Geriatr Nurs. 2022;43:280-287. https://doi.org/10.1016/j.gerinurse.2021.12.007.
- 27. Palapinyo S, Methaneethorn J, Leelakanok N. Association between polypharmacy and depression: A systematic review and meta‐analysis. J Pharm Pract Res. 2021;51(4):280-299. https://doi.org/10.1002/jppr.1749.
- 28. Van Wilder L, Devleesschauwer B, Clays E, Pype P, Vandepitte S, De Smedt D. Peer reviewed: polypharmacy and health-related quality of life/psychological distress among patients with chronic disease. Prev Chronic Dis. 2022;19:e50. https://doi.org/10.5888%2Fpcd19.220062.
- 29. Yanardag MZ, Sahin DS. An examination on trait anxiety and trait depression in the elderly individuals. Society and Social Work. 2019;30(1):37-55.
- 30. Rațıu MI. Social influences on mental health of the elderly. Revista Universitară de Sociologie. 2023;3(2023):313-318. https://www.researchgate.net/publication/378274426_SOCIAL_INFLUENCES_ON_MENTAL_HEALTH_OF_THE_ELDERLY.
- 31. Erkekoglu P, Baydar T, Sahin G. Drugs that induce depression as their side effect in the elderly: Review. Turkiye Klinikleri J Pharm Sci. 2012;1(1): 31-45.
- 32. Dantas EHM, Figueira OA, Figueira AA, et al. The association between physical activity and anxiety in aging: a comparative analysis. Healthcare. 2023;11(15):2164. https://doi.org/10.3390/healthcare11152164.
- 33. Issalillah F, Aisyah N. The elderly and the determinants of stress. Journal of Social Science Studies (JOS3). 2022;2(1):9-12. https://doi.org/10.56348/jos3.v2i1.19.
- 34. Xiao S, Shi L, Dong F, et al. The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support. Aging Ment Health. 2022;26(9):1798-1804. https://doi.org/10.1080/13607863.2021.1947965.
- 35. Yang H, Deng Q, Geng Q, et al. Association of self-rated health with chronic disease, mental health symptom and social relationship in older people. Sci Rep. 2021;11(1):14653. https://doi.org/10.1038/s41598-021-94318-x.
- 36. Huang LJ, Du WT, Liu YC, et al. Loneliness, stress, and depressive symptoms among the Chinese rural empty nest elderly: A moderated mediation analysis. Issues Ment Health Nurs. 2019;40(1):73-78. https://doi.org/10.1080/01612840.2018.1437856.
- 37. Son H, Cho HJ, Cho S, et al. The moderating effect of social support between loneliness and depression: differences between the young-old and the old-old. Int J Environ Res Public Health. 2022;19(4):2322. https://doi.org/10.3390/ijerph19042322.
Association between Polypharmacy and Depression, Anxiety and Stress in Elderly: A Cross-Sectional Study
Abstract
Objective: This study aimed to examine the association between polypharmacy and depression, anxiety and stress in elderly.
Methods: This cross-sectional study was conducted with 396 elderly admitted to two different hospitals in a province in eastern Türkiye. Information Form and Depression Anxiety Stress Scale-21 were used to collect data. The data were obtained between August and September 2023.
Results: Polypharmacy was present in 43.7% of the elderly. In the study, it was determined that income status (OR=0.385; %95 GA=0.163-0.909, P=.029), hypertension (OR=3.899; 95% CI=1.606-9.466, P=.003), coronary artery disease (OR=6.677; 95% CI=2.620-17.020, P=.001), diabetes (OR=3.924; 95% CI=1.543-9.981, P=.004), lung disease (OR=8.893; 95% CI=2.909-27.180, P<.001), hyperlipidemia (OR=20.023; 95% CI=5.737-69.887, P<.001), kidney disease (OR=16.514; 95% CI=5.873-46.431, P<.001), thyroid disease (OR=7.213; 95% CI=2.255-23.079, P<.001), cancer (OR=24.783; 95% CI=6.755-90.933, P<.001) and thinking that they were using too much drug (OR=0.484; 95% CI=0.233-1.005, P=.052) were significant risk factors for polypharmacy. It was observed that the presence of depression, anxiety and stress was not a significant risk factor for polypharmacy in the elderly (P>.05).
Conclusion: Further study on association between polypharmacy and depression, anxiety and stress in elderly is necessary. In future studies, it is recommended to use more comprehensive measurement tools, to evaluate which group the medicines used by the elderly belong to and to test causality.
Keywords
Ethical Statement
Please find our manuscript “Association between Polypharmacy and Depression, Anxiety and Stress in Elderly: A Cross-Sectional Study” for consideration as an article in your journal. I hereby declare that the manuscript has not been published before and is not being considered for publication elsewhere. I declare that no financial support or relationships that may pose conflict of interest.
Supporting Institution
None
Thanks
We sincerely thank all the elderly who participated in this study.
References
- 1. Pusuroglu M, Pusuroglu G, Hocaoglu C. The relationship of chronic diseases with anxiety and depression in patients over 65 years of age. Duzce Med J. 2023;25(2):135-140. https://doi.org/10.18678/dtfd.1258000.
- 2. Sofulu F, Karadakovan A. Evaluation of knowledge and practices on polypharmacy and drug use of geriatric individuals. Izmir Kâtip Celebi University Faculty of Health Sciences Journal. 2022;7(3):529-533. https://dergipark.org.tr/en/pub/ikcusbfd/issue/72902/1065640.
- 3. Dangerfield HJ, Scott JM, Zohn JH, Segal DL, Benton MJ. Relationship between anxiety and quality of life among older adults with self‐reported polypharmacy in long‐term care: A cross‐sectional study. J Adv Nurs. 2023;79(9):3559-3568. https://doi.org/10.1111/jan.15691.
- 4. Gumustakim RS, Baser DA. Multiple drug use in elderly in primary care: An example of rural field. Turk J Fam Pract. 2019;23(1):2-8. https://dx.doi.org/10.15511/tahd.19.00102.
- 5. Assari S, Bazargan M. Polypharmacy and psychological distress may be associated in African American adults. Pharmacy. 2019;7(1):14. https://doi.org/10.3390/pharmacy7010014.
- 6. Kizmaz M, Kumtepe KB, Cetin KN, Doner E. Investigation of polypharmacy prevalence and affecting factors in patients over 65 years presenting to family medicine polyclinic of rural district hospital. Ankara Med J. 2020;20(1):123-134. https://dx.doi.org/10.5505/amj.2020.46548.
- 7. Karahan FS, Hamarta E. The effect of chronic diseases and polypharmacy on anxiety and death anxiety in geriatric patients. Aegean J Med Sci. 2019;2(1):8-13. https://doi.org/10.33713/egetbd.463608.
- 8. Korkmaz EA, Yalcin Gursoy M. Polypharmacy prevalence in rural-living older adults: A cross-sectional study. Turkiye Klinikleri J Health Sci. 2023;8(2):300-307. https://doi.org/10.5336/healthsci.2022-94098.
- 9. Ozturk E, Ganidaglı S, Ozturk Z. Polypharmacy in the elderly: A double-edged sword. Med Records. 2023;5(2):255-261. https://doi.org/10.37990/medr.1183707.
- 10. Assari S, Wisseh C, Saqib M, Helmi H, Bazargan M. Polypharmacy and depressive symptoms in US-born mexican american older adults. Psych. 2019;1(1):491-503. https://doi.org/10.3390/psych1010038.
- 11. Sari NPWP, Manungkalit M. The best predictor of anxiety, stress, and depression among institutionalized elderly. Int J Environ Res Public Health. 2019;8(4):419-426. https://dx.doi.org/10.11591/ijphs.v8i4.20359.
- 12. World Health Organization. Mental health of older adults. Updated October 20, 2023. Accessed April 16, 2024. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults.
- 13. Gameiro GR, Minguini IP, Alves TCTF. The role of stress and life events in the onset of depression in the elderly. Rev Med (São Paulo). 2014;93(1):31-40. http://dx.doi.org/10.11606/issn.1679-9836.v93i1p31-40.
- 14. Färber F, Rosendahl J. Trait resilience and mental health in older adults: A meta‐analytic review. Personal Ment Health. 2020;14(4):361-375. https://doi.org/10.1002/pmh.1490.
- 15. National Council on Aging. Stress and how to reduce it: A guide for older adults. Updated March 24, 2023. Accessed April 22, 2024. https://www.ncoa.org/article/stress-and-how-to-reduce-it-a-guide-for-older-adults.
- 16. Bazargan M, Smith J, Saqib M, Helmi H, Assari S. Associations between polypharmacy, self-rated health, and depression in African American older adults; mediators and moderators. Int J Environ Res Public Health. 2019;16(9):1574. https://doi.org/10.3390/ijerph16091574.
- 17. Cheng C, Bai J. Association between polypharmacy, anxiety, and depression among Chinese older adults: evidence from the Chinese longitudinal healthy longevity survey. Clin Interv Aging. 2022;17:235-244. https://doi.org/10.2147%2FCIA.S351731.
- 18. Cigiloglu A, Efendioglu EM, Ozturk ZA. Polypharmacy and depression among older individuals. Eur J Ther. 2022;28(3):226-229. http://dx.doi.org/10.5152/EurJTher.2022.21040.
- 19. Ozturk Y, Comertoglu EO, Hafizoglu M, et al. The relationship between polypharmacy and geropsychiatric assessment scales in geriatric outpatients. Eur J Geriatr Gerontol. 2023;5(3):225-230. http://doi.org/10.4274/ejgg.galenos.2023.2023-5-1.
- 20. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. J Cogn Behav Psychother Res. 2018;7:19-30. https://doi.org/10.5455/JCBPR.274847.
- 21. Gutiérrez-Valencia M, Herce PA, Lacalle-Fabo E, Escámez BC, Cedeno-Veloz B, Martínez-Velilla N. Prevalence of polypharmacy and associated factors in older adults in Spain: Data from the National Health Survey 2017. Med Clín (English Edition). 2019;153(4):141-150. https://doi.org/10.1016/j.medcle.2019.06.009.
- 22. Iqbal A, Richardson C, Iqbal Z, et al. Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis. BMC Geriatr. 2023;23(1):149. https://doi.org/10.1186/s12877-023-03835-z.
- 23. Nwadiugwu MC. Multi-morbidity in the older person: an examination of polypharmacy and socioeconomic status. Front Public Health. 2021;8:582234. https://doi.org/10.3389/fpubh.2020.582234.
- 24. Galazzi A, Lusignani M, Chiarelli MT, et al. Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy. Int J Clin Pharm. 2016;38:454-461. https://doi.org/10.1007/s11096-016-0279-4.
- 25. Clyne B, Cooper JA, Boland F, Hughes CM, Fahey T, Smith SM. Beliefs about prescribed medication among older patients with polypharmacy: a mixed methods study in primary care. Br J Gen Prac. 2017;67(660):e507-e18. https://doi.org/10.3399/bjgp17X691073.
- 26. Mortelmans L, Goossens E, Dilles T. Beliefs about medication after hospital discharge in geriatric patients with polypharmacy. Geriatr Nurs. 2022;43:280-287. https://doi.org/10.1016/j.gerinurse.2021.12.007.
- 27. Palapinyo S, Methaneethorn J, Leelakanok N. Association between polypharmacy and depression: A systematic review and meta‐analysis. J Pharm Pract Res. 2021;51(4):280-299. https://doi.org/10.1002/jppr.1749.
- 28. Van Wilder L, Devleesschauwer B, Clays E, Pype P, Vandepitte S, De Smedt D. Peer reviewed: polypharmacy and health-related quality of life/psychological distress among patients with chronic disease. Prev Chronic Dis. 2022;19:e50. https://doi.org/10.5888%2Fpcd19.220062.
- 29. Yanardag MZ, Sahin DS. An examination on trait anxiety and trait depression in the elderly individuals. Society and Social Work. 2019;30(1):37-55.
- 30. Rațıu MI. Social influences on mental health of the elderly. Revista Universitară de Sociologie. 2023;3(2023):313-318. https://www.researchgate.net/publication/378274426_SOCIAL_INFLUENCES_ON_MENTAL_HEALTH_OF_THE_ELDERLY.
- 31. Erkekoglu P, Baydar T, Sahin G. Drugs that induce depression as their side effect in the elderly: Review. Turkiye Klinikleri J Pharm Sci. 2012;1(1): 31-45.
- 32. Dantas EHM, Figueira OA, Figueira AA, et al. The association between physical activity and anxiety in aging: a comparative analysis. Healthcare. 2023;11(15):2164. https://doi.org/10.3390/healthcare11152164.
- 33. Issalillah F, Aisyah N. The elderly and the determinants of stress. Journal of Social Science Studies (JOS3). 2022;2(1):9-12. https://doi.org/10.56348/jos3.v2i1.19.
- 34. Xiao S, Shi L, Dong F, et al. The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support. Aging Ment Health. 2022;26(9):1798-1804. https://doi.org/10.1080/13607863.2021.1947965.
- 35. Yang H, Deng Q, Geng Q, et al. Association of self-rated health with chronic disease, mental health symptom and social relationship in older people. Sci Rep. 2021;11(1):14653. https://doi.org/10.1038/s41598-021-94318-x.
- 36. Huang LJ, Du WT, Liu YC, et al. Loneliness, stress, and depressive symptoms among the Chinese rural empty nest elderly: A moderated mediation analysis. Issues Ment Health Nurs. 2019;40(1):73-78. https://doi.org/10.1080/01612840.2018.1437856.
- 37. Son H, Cho HJ, Cho S, et al. The moderating effect of social support between loneliness and depression: differences between the young-old and the old-old. Int J Environ Res Public Health. 2022;19(4):2322. https://doi.org/10.3390/ijerph19042322.
There are 37 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Mental Health Nursing, Aged Care Nursing |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | May 31, 2025 |
| Publication Date | June 17, 2025 |
| Submission Date | November 17, 2024 |
| Acceptance Date | March 13, 2025 |
| Published in Issue | Year 2025 |