Dr Jackie Buck RN, BSc (Hons), MSc, PhD & Dr Jane Fleming BA(Hons), RGN, MPhil, PhD
University of East Anglia and Cambridge University
Investigating multimorbidity in a population-based study of older old age: the Cambridge City over-75s Cohort (CC75C)
More of us are living into ‘older old age’: the number of people aged 90 or older has almost tripled in three decades. Many diseases develop with age but modern healthcare has improved survival, so growing numbers of very old people are living many years with health conditions. Recent guidelines stress the importance of taking account of their needs, but because living so long is quite new, there is little information about very old age.
This project aims to use information already gathered through a long-running study of ageing (CC75C) from people who were already aged at least 75 when this began in 1985. Their generous willingness to help research, answering interview questions every few years in repeated surveys until the last person had died, has created a unique resource that can help plan for our ageing population by answering some of the questions health and care services are asking: How commonly are very old people living with various different conditions and especially with more than one condition (known as ‘multimorbidity’)? What support are they relying on from medication, health/care services and family? What are their experiences of living with multiple conditions and their priorities? What factors affect older old age multimorbidity?
Dr Oladapo Joseph Ogunbayo
Polypharmacy associated with non-prescription medication use among older adults with multi-morbidity.
As life expectancy increases, the number of people with chronic health conditions that require treatment with medicines is also on the increase. Multimorbidity, the co-occurrence of two or more chronic conditions, is increasingly common among older adults (≥65 years). Most older people will require one or more medicines to manage and live well with their chronic condition(s). Polypharmacy, which is the concurrent use of multiple medicines (usually five or more) can be problematic, especially among older adults with multimorbidity as it increases the risks of non‐adherence to treatment, toxicity, interactions, poor quality of life, hospitalisations and death.
The use of prescribed medicines is the main predictor of polypharmacy but there are increasing concerns about self-medication with over-the-counter, herbal and other medicines (e.g. those bought over the internet) that have not been prescribed. The adverse consequences of polypharmacy associated with these non-prescribed medicines may be even greater for older, frail adults who are already on numerous prescribed medicines and may be experiencing cognitive and functional impairments and other geriatric syndromes.
The proposed project will systematically review current evidence (qualitative and quantitative literature) to understand and describe the burden of non-prescribed medicines use among older adults. The project will also involve data analyses of population level data to explore factors and patterns associated with non‐prescribed medicines use and variables such as sociodemographic, disease and health status and health service use. The findings will provide evidence for clinicians and policymakers and help to develop strategies that go beyond review of prescribed medicines.