P31 - The Impact of Polypharmacy on the Trajectory of Health Outcomes and Physical Function in Older Adults with and without Alzheimer’s Disease and Related Dementias

Background: Older adults are living longer and experiencing multiple chronic conditions requiring medications to improve or maintain their health. Taking multiple medications increases the risk of polypharmacy (PPY) (commonly defined as taking five or more medications daily) which can cause negative health outcomes including falls, hospitalizations, and mortality. Older adults with Alzheimer’s disease and related dementias (ADRD) have more chronic conditions and PPY than those without ADRD. Despite this, little research has been done to understand the key differences in critical health outcomes in older adults with and without ADRD and PPY.

Theoretical framework: not applicable

Methods: This longitudinal case control cohort study utilized round 6-9 (2016-2019) of the National Health and Aging Trends Study (NHATS) data to examine the impact of PPY on health outcomes over time (falls, hospitalizations, physical function, mortality, and transition to a nursing home) in four groups of older adults: those with ADRD+PPY, ADRD only, PPY only, and no ADRD or PPY (N=2,052).

Results: Participants with ADRD+PPY had higher odds of falling in the last year compared to all other groups over time (round 6: OR=3.4, 95% CI [1.8,6.3], round 7: OR=2.3, 95% CI [1.0-5.0], Round 8: OR=3.2, 95% CI [1.4-2.1]). They also experienced more hospitalizations and mortality. Older adults with ADRD+PPY had lower short physical performance battery (SPPB) scores at baseline and over all four timepoints when compared to each of the other groups (p=