Medicamentos utilizados por pessoas com 55 anos ou mais na Estratégia Saúde da Família e sua associação com sinais e sintomas de depressão e déficit cognitivo : um estudo populacional

Abstract

This study aims to describe the medications used by people aged 55 years and over enrolled in the “Programa de Envelhecimento Cerebral” (PENCE) of the Family Health Strategy of Porto Alegre. It will also describe among these patients the occurrence of polypharmacy, the use of potentially inappropriate medications and its association with patients’ socioeconomic, lifestyle and health variables, especially the signs and symptoms of depression and cognitive deficit. A cross-sectional population-based study conducted from January 2013 to December 2015, approved by the Research Ethics Committee of PUCRS (nº 826.858). The prevalence of polypharmacy was reported in 35.7% of the population and was the most common drug amount of all age groups, including the younger individuals (55-59 years) (28.1%). After adjustment for socioeconomic and health variables, women (OR 2.46; 95% CI 1.71-3.53), 75-79 years (OR 3.13; 95% CI 1.68-5.83), 1-3 years of study (OR 2.57; 95% CI 1.43-4.59), ex-smokers (OR 1.89; 95% CI 1.29-2.78), poor or very poor self-perceived health (OR 6.43; 95% CI 3.20-12.90), chronic conditions (cardiovascular-related) and depression symptoms were strongly associated with polypharmacy. The prevalence of PIM in the total population was 65.4%, representing a common finding in all age groups, including younger individuals (55-59 years) (60.0%). Former smokers (OR 1.06; 95% CI 1.00-1.12) and current smokers (OR 1.10; 95% CI 1.01-1.18), regular self-perception of health (OR 1.08; 95% CI 1.02-1.15), use three or four medications (OR 1.88; 95% CI 1.65-2.15), and individuals with signs and symptoms of cognitive deficit (OR 1.14; 95% CI 1.03-1.26) and depression (OR 1.12; 95% CI 1.04-1.21) were significantly associated with PIM. Polypharmacy (OR 2.80; 95% CI 2.48-3.16) had the strongest association. Polypharmacy and MPI are prevalent in middle-aged individuals, a population that is poorly researched, and the elderly. The present study proposed an advance in pharmacoepidemiological studies, analyzing some gaps in the literature related to middle-aged adults with unfavorable socioeconomic characteristics, such as low income and schooling.