Rawle MJ, et al. - Longitudinal links between polypharmacy and cognitive and physical capability were investigated. Researchers also determined if these associations differ with cumulative exposure to polypharmacy. Polypharmacy at age 60 to 64 and age 69 was shown to be related to poorer physical and cognitive capability, even after adjusting for disease burden. In participants with longstanding polypharmacy, the observed stronger negative associations were suggestive of a cumulative, dose-dependent link (where dose is the number of prescribed medications).

• A prospective birth cohort study was carried out in England, Scotland, and Wales.
• Study participants included an eligible sample of men and women from the Medical Research Council National Survey of Health and Development with medication data at age 69 (N=2,122, 79%).
• Using a word learning test, visual search speed task, and the Addenbrooke's Cognitive Examination, Third Edition (ACE-III), cognitive capability was assessed.
• Using chair rise speed, standing balance time, walking speed, and grip strength, physical capability was measured.

• In 18.2% of participants at age 69, presence of polypharmacy (5–8 prescribed medications) was noted.
• In 4.7%, excessive polypharmacy (≥9 prescribed medications) was reported.
• In models adjusted for sex, education, and disease burden, association of both with poorer cognitive and physical capability was shown.
• For excessive polypharmacy, stronger links were documented (e.g., difference in mean ACE-III scores comparing polypharmacy=-2.0, 95% CI=-2.8 to -1.1 and excessive polypharmacy=-2.9, 95% CI=-4.4 to -1.4 with no polypharmacy).
• Findings demonstrated that participants with polypharmacy at age 60 to 64 and at age 69 showed stronger negative associations with cognitive and physical capability were stronger still in participants with polypharmacy at both age 60 to 64 and at age 69 (e.g. difference in mean chair rise speed, comparing polypharmacy with no polypharmacy at both ages=-3.9, 95% CI=-5.2 to -2.6 and at age 60–64 only=-2.5, 95% CI=-4.1 to -0.9).