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POLYPHARMACY WAS ASSOCIATED WITH MORTALITY IN THE ELDERLY HISPANIC POPULATION: HOW STRONG WAS THE ASSOCIATION?

Columbia University Medical Center New York, New York

Address correspondence to Huai Yong Cheng, MD, MPH, The Allen Pavilion, Columbia University Medical Center, 5141 Broadway, New York, NY 10034-1159. E-mail: hyc2105{at}columbia.edu

To the Editor:

Using the data of the Hispanic Established Population for Epidemiologic Studies of the Elderly (EPESE), Dr. Espino and his colleagues found that the taking of more than four medications by elderly Hispanic persons was independently associated with high mortality after adjusting several confounders (1). However, the absolute contribution of polypharmacy to mortality in the elderly Hispanic population is still unknown. In addition, an adjusted hazard ratio of 1.27 with a low limit of 95% confidence interval close to 1 for polypharmacy (1) indicated that the association between polypharmacy and mortality was not strong. Interestingly enough, cardiovascular disease, hypertension, and stroke were not associated with mortality (1), which means that polypharmacy could be a marker of cardiovascular disease, hypertension, or stroke, or a combination of all of these. Taken together, it is unclear whether reducing polypharmacy to achieve mortality benefit in the elderly Hispanic population should be recommended based on the study in the Journal. As the authors suggested, further study is needed.

Reference

1. Espino DV, Bazaldua OV, Palmer RF, et al. Suboptimal medication use and mortality in an older adult community-based cohort: results from the Hispanic EPESE study. J Gerontol Med Sci. 2006;61A:170-175.[Abstract/Free Full Text]

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