Proton Pump Inhibitors and Functional Decline in Older Adults Discharged From Acute Care Hospitals

• Autores: Andrea Corsonello, Marcello Maggio, Sergio Fusco, Bakhita Adamo, Diana Amantea, Claudio Pedone, Sabrina Garasto, Gian Paolo Ceda, Francesco Corica, Fabrizia Lattanzio, Raffaele Antonelli Incalzi
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 6, 2014, págs. 1110-1115
• Idioma: inglés
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• Resumen

  • Objectives: To investigate the relationship between use of proton pump inhibitors (PPIs) and incident dependency in older adults discharged from acute care hospitals.

    Design: Prospective observational study.

    Setting: Eleven geriatric and internal medicine acute care wards located throughout Italy.

    Participants: Individuals (mean age 79.2 ± 5.5) who were not completely dependent at the time of discharge from participating wards (N = 401).

    Measurements: The outcome of interest was the loss of at least one basic activity of daily living (ADL) from discharge to the end of follow-up (12 months). The relationship between PPI use and functional decline was investigated using logistic regression analysis before and after propensity score matching.

    Results: Use of PPIs was significantly associated with functional decline before (odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.17�2.60) and after propensity score matching (OR = 2.44; 95% CI = 1.36�4.41). Other predictors of functional decline were hypoalbuminemia (OR = 3.10, 95% CI = 1.36�7.10 before matching, OR = 2.81, 95% CI = 1.09�7.77 after matching) and cognitive impairment (OR = 4.08, 95% CI = 1.63�10.2 before matching, OR = 6.35, 95% CI = 1.70�24.0 after matching).

    Conclusion: Use of PPIs is associated with functional decline during 12 months of follow-up in older adults discharged from acute care hospitals.