Analyse of Polypharmacy and its Consequences on Nutritional Status in Elderly People Living in Nursing Home in Auvergne

Purpose: Malnutrition and polypharmacy are two public health problems due to their high prevalence in the elderly and their serious consequences, including reduced functional ability, hospitalization and mortality. Methods: Our study concerns 4,363 residents in 104 nursing homes in Auvergne (based on the sample of the RIDE study). The number of drugs is collected by a pharmacist from the resident’s file. The polypharmacy threshold is arbitrarily set at 5 drugs or more. A Mini Nutritional Assessment (MNA) is performed for each resident and the malnutrition threshold is 17. Results: Our population is aged on average 86.4 ± 7.9 years. There is 27% of undernourished and 71.65% at risk for malnutrition. The mean number of drug is at 8.3 ± 3.6 with 79.9% of polymedicated. We found no relationship between malnutrition and polypharmacy. Polypharmacy is inversely proportional to the functional dependency measured by the French GIR index. Age and functional dependency are two risk factors for malnutrition. Conclusion: Chronic diseases cause dependence and anorexia, sources of malnutrition. The appropriate treatment of these chronic diseases would make it possible to fight against the weakening of functional capacity. The polypharmacy, if appropriate, does not result in malnutrition. The management of malnutrition must add at the same time nutritional cares including human aids, and tailored drug treatment of the chronic diseases. Keywords: Malnutrition; Polypharmacy; Elderly; Physical dependency; Nursing home; Inappropriate medication; Key Points: Very old age and reduced functional capacity are two risk factors of malnutrition in nursing home residents. -There is no relationship between polypharmacy and malnutrition in nursing home residents. - The management of the malnutrition with only nutritional measures is not optimum. - Appropriate drug management of chronic diseases may reduce under nutrition. -There is a lot of inappropriate polypharmacy with an unfavorable benefit-risk ratio or a doubtful effectiveness to a therapeutic alternative