老年患者衰弱及多重用药、潜在不合理用药的双向关系研究进展  

Advances in research on the bidirectional relationship of frailty with polypharmacy,and potentially inappropriate medications in elderly patients

作　　者：高倩谊 曾运红 GAO Qian-yi;ZENG Yun-hong

机构地区：[1]汕头大学医学院,广东汕头515063 [2]广东省深圳市光明区人民医院健康管理中心,广东深圳518106

出　　处：《中国疗养医学》2025年第4期73-78,共6页Chinese Journal of Convalescent Medicine

摘　　要：随着年龄增长,老年人身体机能逐渐衰退,多种慢性病的发生风险显著增加,如高血压、糖尿病、心脑血管疾病和癌症等。医学诊断和综合治疗的进步发现老年患者中多种慢性病共存的情况愈发普遍,多重用药成为治疗的常见手段。然而,多重用药也带来了潜在不合理用药(PIM)和药物不良事件(ADEs)的风险,这些风险在衰弱患者中更为突出。衰弱是一种与年龄相关的综合征,表现为身体储备能力下降,对外界压力的适应性减弱,是跌倒、住院及死亡风险增加的独立危险因素。衰弱状态不仅会影响药物的代谢和清除过程,还会增加药物相互作用的复杂性,从而加重多重用药带来的不良后果。此外,多重用药可能会通过药物相关的副作用或对功能的负面影响进一步加重衰弱程度。本文旨在探讨老年患者中衰弱、多重用药和潜在不合理用药之间的双向关系,分析这些因素如何相互作用并共同影响患者的健康结局,总结了现有的研究进展,为改善老年患者的药物治疗提供理论支持。Physiological functions gradually decline with aging,leading to a significantly increased risk of multiple chronic diseases like hypertension,diabetes,cardiovascular diseases,and cancer.Advances in medical diagnostics and comprehensive treatments have made multimorbidity increasingly common among older adults,with polypharmacy becoming a prevalent approach to manage them.However,polypharmacy is associated with potential risks,including potentially inappropriate medication(PIM)and adverse drug events(ADEs),which are particularly pronounced in frail patients.Frailty is an age-related syndrome characterized by reduced physiological reserves and diminished adaptability to external stressors,serving as an independent risk factor for falls,hospitalization,and mortality.Frailty not only affects drug metabolism and elimination,but also increases the complexity of drug interactions,thereby exacerbating the adverse outcomes associated with polypharmacy.Additionally,polypharmacy may further aggravate frailty through medication-related side effects and negative impacts on the functional status.We aimed to explore the bidirectional relationship of frailty with polypharmacy,and PIM in older adults.Through analyzing how these factors interact and collectively influence health outcomes,and reviewing current research progress,we provided a theoretical foundation for optimizing medication management in older patients.

关 键 词：衰弱 多重用药 潜在不合理用药 药物不良事件 老年患者 

分 类 号：R969.3[医药卫生—药理学]