Background Little work to date has quantified the effect of psychotropic medications (antidepressants, benzodiazepines, ‘Z’ drugs, antipsychotics, anticholinergics) on mobility and gait in later life. The aim of this study is to examine the relationship between these medications and mobility/gait parameters in a large cohort of community-dwelling older people. Methods Participants were included if they were ≥60 years at TILDA Wave 1 and underwent gait and mobility assessment (Gaitrite system), with follow-up at Wave 3 (4 years). Medication lists were examined for psychotropic medications. Regression models assessed the relationship between psychotropic medications and mobility, using the following parameters: Timed Up and Go (TUG), gait speed, step length / width, double support phase. Multilevel modelling assessed trajectories of mobility/gait variables over time by psychotropic use. Results Of 2620 patients, 12% were prescribed ≥1 psychotropic medication, 3% prescribed ≥2 psychotropics. Cross-sectionally, psychotropic medication was independently associated with prolonged TUG (β=0.50 (95% CI 0.27–0.73); p<0.001), slower gait speed (β=-5.65 (95% CI -7.92 - -3.38); p<0.001), shorter step length (β=-2.03 (95% CI -2.93 - -1.42); p<0.001) and increased double support phase (β=0.47 (95% CI 0.19-0.75); p=0.001). Longitudinally, psychotropic use was independently associated with transition to abnormal TUG (OR 2.68 (95% CI 1.55–4.64), p<0.001), while using ≥2 psychotropics was associated with transition to slower gait speed (OR 2.59 (95% CI 1.01–6.68); p=0.048). Conclusions Psychotropic use was associated with significantly poorer mobility and gait performance, both cross-sectionally and longitudinally. It is imperative that psychotropic medication use is reviewed as part of comprehensive geriatric assessment.

中文翻译：

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精神药物使用与社区老年人步态和行动障碍之间的关联。数据来自爱尔兰老龄化纵向研究 （TILDA）


背景 迄今为止，很少有工作量化了精神药物（抗抑郁药、苯二氮卓类药物、“Z”药物、抗精神病药、抗胆碱能药）对晚年活动能力和步态的影响。本研究的目的是检查这些药物与大量社区老年人的活动能力/步态参数之间的关系。方法 如果参与者在 TILDA 第 1 波中年龄为 ≥ 60 岁，并接受了步态和活动性评估 （Gaitrite 系统），并在第 3 波 （4 年） 进行随访，则将其纳入。检查了精神药物的药物清单。回归模型使用以下参数评估精神药物与活动能力之间的关系：Timed Up and Go （TUG）、步态速度、步长/宽度、双支撑阶段。多级建模通过精神药物使用评估了活动能力/步态变量随时间变化的轨迹。结果 在 2620 例患者中，12% 的患者开具了 ≥1 种精神药物，3% 的患者开具了 ≥2 种精神药物。横断面研究，精神药物与延长的 TUG （β=0.50 （95% CI 0.27–0.73;p<0.001）、较慢的步态速度 （β=-5.65 （95% CI -7.92 - -3.38）;p<0.001）、较短的步长 （β=-2.03 （95% CI -2.93 - -1.42;p<0.001） 和增加的双支撑期 （β=0.47 （95% CI 0.19-0.75;p=0.001） 独立相关。纵向上，精神药物的使用与向异常 TUG 的转变独立相关 （OR 2.68 （95% CI 1.55–4.64），p<0.001），而使用 ≥2 精神药物与过渡到较慢的步态速度相关 （OR 2.59 （95% CI 1.01–6.68;p=0.048）。结论 精神药物的使用与横截面和纵向活动能力和步态表现显著较差相关。 作为老年综合评估的一部分，必须审查精神药物的使用。