Search

Background: Older adults have the highest drug utilization due to multimorbidity. Although the number of people over age 70 is expected to double within the next decades, population-based data on their medication patterns are scarce especially in combination with polypharmacy and potentially inappropriate medication (PIM). Our objective was to analyse the frequency of polypharmacy, pattern of prescription (PD) and over-the-counter (OTC) drug usage, and PIMs according to age and gender in a population-based cohort of very old adults in Germany., Methods: Cross-sectional baseline data of the Berlin Initiative Study, a prospective cohort study of community-dwelling adults aged ≥70 years with a standardized interview including demographics, lifestyle variables, co-morbidities, and medication assessment were analysed. Medication data were coded using the Anatomical Therapeutic Chemical (ATC) classification. Age- and sex-standardized descriptive analysis of polypharmacy (≥5 drugs, PD and OTC vs. PD only and regular and on demand drugs vs regular only), medication frequency and distribution, including PIMs, was performed by age (

Epidemiologic data on incidence, prevalence and risk factors for chronic kidney disease (CKD) and its progression to kidney failure in people > or =70 years are scarce. This lack may have two reasons: First, the issue has only recently gained importance by the changing demographics characterized by an aging society. Secondly, a validated method for estimating kidney function in terms of glomerular filtration rate (GFR) in the elderly is still lacking. In this paper we describe the methodology of a combined longitudinal and cross-sectional approach of a population based study which will start in January 2010. The aims of the study are to identify prevalent and incident cases of CKD as well as co-morbidities and associated risk factors for progression of disease in this specific age-group. To assess prevalence, a new GFR estimation equation is to be developed. In a longitudinal approach a population based, age stratified sample of 2,000 subjects > or =70 years will be randomly drawn from a data base of a large health insurance company. Interview, physical examination, and preliminary estimation of GFR, based on serum creatinine will be performed. The entire cohort will be followed over the course of 2 years. In a cross-sectional approach a subsample of 600 subjects will be defined based on preliminary GFR values. Kidney function will be determined by measuring plasma clearance of an exogenous filtration marker (Iohexol). A new GFR-equation will be developed and validated using Iohexol clearance as gold standard to estimate GFR accurately and precisely. Data of 2,000 subjects will be used to estimate prevalence of CKD.