Examining the longitudinal associations of polypharmacy and frailty with functional decline in older people with multimorbidity

A self-funded PhD studentship is available under the supervision of Dr Prasad Nishtala at the University of Bath. This is a collaborative project, which will involve working with Dr Hamish Jamieson from the Big Data and Ageing Research Group at Christchurch and Dr Danijela Gnjidic at the University of Sydney. This research project provides an opportunity to combine big data analytics and advance translational research in ageing.
The world population is ageing, and the burden of multiple diseases and medicine consumption is growing. The use of multiple medicines commonly referred to as polypharmacy is increasing in older people.
In this study, we will examine the extent of polypharmacy in frail older people. Given the complex interplay between polypharmacy and frailty, we will examine longitudinal associations of polypharmacy and frailty with functional decline in older people with multimorbidity requiring complex care needs. We have access to interRAI data. The interRAI is a unique, internationally recognised and validated assessment tool for health and disability needs, used for all older people requiring health services in New Zealand. The interRAI assessments used for this study provides a comprehensive overview of the person’s physical, psychological, behavioural and social status. We will analyse a suite of clinical, social and psychological variables from the interRAI assessments to examine the impact of polypharmacy and anticholinergic burden on specific functional outcomes.

1. Bala SS, Jamieson HA, Nishtala PS. Determinants of prescribing potentially inappropriate medications in a nationwide cohort of community dwellers with dementia receiving a comprehensive geriatric assessment. International Journal of Geriatric Psychiatry. Accepted Sept 2018.
2. Bonaga B, Sanchez-Jurado PM, Martinez-Reig M, Ariza G, Rodriguez-Manas L, Gnjidic D, et al. Frailty, Polypharmacy, and Health Outcomes in Older Adults: The Frailty and Dependence in Albacete Study. Journal of the American Medical Directors Association. 2018; 19(1):46-52.