Prevalence of Sarcopenia-Promoting Medicines in Patients With Sarcopenia and Falls

Официальное название

Exploratory Study on the Prevalence of Sarcopenia-Promoting Medicines in Patients With Sarcopenia and Falls

Обзор

Sarcopenia, characterised by the loss of muscle mass and function, is a common condition among the elderly and is often associated with increased risk of falls. Certain medications, such as glucocorticoids, statins, and some antipsychotics, may exacerbate sarcopenia, leading to a higher incidence of falls. This study aims to explore the prevalence of such medicines in patients diagnosed with sarcopenia who have experienced falls. Understanding the impact of these medications on sarcopenia and fall risk can inform clinical guidelines and improve patient outcomes.

Подробное описание

Sarcopenia, the age-related loss of muscle mass and strength, is a recognised contributor to frailty, disability, and increased fall risk in older adults. While physical inactivity and comorbidities are known risk factors, increasing evidence suggests that certain medications - including corticosteroids, sedatives and statins - may also contribute to muscle decline. These medicines are frequently prescribed to older adults, but the extent of their use in patients with sarcopenia and falls remains poorly defined.

Falls clinics manage high-risk patients, yet there is currently limited research examining the prevalence of sarcopenia-promoting medications in this specific setting. This study addresses an important knowledge gap by estimating the prevalence of these medicines in older adults attending a secondary care falls clinic, and by exploring associations with sarcopenia and fall history.

The findings will support a better understanding of medication-related risk factors for sarcopenia and may help guide future deprescribing and medication review strategies. This aligns with current priorities in geriatric medicine to reduce inappropriate polypharmacy and improve outcomes for older adults through targeted, evidence-based prescribing.

Вмешательства

• Диагностический тест Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire
  Self-administered screening tool for sarcopenia
• Диагностический тест Hand grip strength
  Used to assess sarcopenia
• Диагностический тест Timed Up and Go test
  Screening test for falls in elderly
• Диагностический тест Gait speed
  Assessment to check for functional mobility and risk of falls.
• Диагностический тест Clinical Frailty Scale (CFS)
  Used to assess level of frailty.

Первичные конечные точки

• Prevalence of exposure to one or more sarcopenia-promoting medication [Срок оценки: 6 months]

Вторичные конечные точки (7)

• Distribution of sarcopenia-promoting medication classes [Срок оценки: 6 months]
• Number of sarcopenia-promoting medications per participant [Срок оценки: 6 months]
• Handgrip strength [Срок оценки: 6 months]
• Gait speed [Срок оценки: 6 months]
• SARC-F score [Срок оценки: 6 months]
• Timed Up and Go Test [Срок оценки: 6 months]
• Association between medication burden and functional performance [Срок оценки: 6 months]

Критерии участия

Критерии включения

• Aged ≥65 years
• Attendance at the falls clinic for a new assessment
• Diagnosed with sarcopenia (based on the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria)
• History of falls in the past 12 months

Критерии исключения

• Cognitive impairment preventing consent
• Acute medical instability
• Enrolled in on other clinical trials.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Только случаи

Центры проведения

Великобритания · 1 центр

• Medway NHS Foundation Trust — Gillingham

Публикации

• Zia A, Kamaruzzaman SB, Tan MP. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk. Postgrad Med. 2015 Apr;127(3):330-7. doi: 10.1080/00325481.2014.996112. Epub 2014 Dec 24. PMID 25539567
• Veronese N, Stubbs B, Noale M, Solmi M, Pilotto A, Vaona A, Demurtas J, Mueller C, Huntley J, Crepaldi G, Maggi S. Polypharmacy Is Associated With Higher Frailty Risk in Older People: An 8-Year Longitudinal Cohort Study. J Am Med Dir Assoc. 2017 Jul 1;18(7):624-628. doi: 10.1016/j.jamda.2017.02.009. Epub 2017 Apr 7. PMID 28396180
• Tanskanen, A., et al. (2015). Anticholinergic burden and physical functioning in older people: A systematic review. Drugs & Aging, 32(10), 741-750.
• Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. J Diabetes Metab Disord. 2017 May 16;16:21. doi: 10.1186/s40200-017-0302-x. eCollection 2017. PMID 28523252
• Scott, D., et al. (2016). Sarcopenia and statin use: A potential link? Drugs & Aging, 33(1), 1-9.
• Reeve E, Wiese MD, Hendrix I, et al. (2014). The impact of deprescribing interventions on polypharmacy and clinical outcomes: a systematic review and meta-analysis. J Am Med Dir Assoc. 15(3):131-6. https://doi.org/10.1016/j.jamda.2013.11.008
• Rawle MJ, Westbury LD, Russell S, et al (2018). Anticholinergic drug burden and cognitive function in people aged 50 years and older: the English Longitudinal Study of Ageing. Age Ageing; 47(4):505-11 https://doi.org/10.1093/ageing/afy026
• Landi, F., et al. (2019). Polypharmacy and sarcopenia in older adults: A population-based study. Journal of the American Medical Directors Association, 20(5), 600-604.e7.

Идентификаторы

NCT: NCT07127692 · 354863

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗