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@ARTICLE{Katzke:286665,
author = {V. Katzke$^*$ and R. Bajracharya$^*$ and M. I. Nasser and
B. Schöttker$^*$ and R. Kaaks$^*$},
title = {{N}umber of medically prescribed pharmaceutical agents as
predictor of mortality risk: a longitudinal, time-variable
analysis in the {EPIC}-{H}eidelberg cohort.},
journal = {Scientific reports},
volume = {14},
number = {1},
issn = {2045-2322},
address = {[London]},
publisher = {Macmillan Publishers Limited, part of Springer Nature},
reportid = {DKFZ-2024-00029},
pages = {106},
year = {2024},
note = {#EA:C020#LA:C020#},
abstract = {The number of prescribed medications might be used as proxy
indicator for general health status, in models to predict
mortality risk. To estimate the time-varying association
between active pharmaceutical ingredient (API) count and
all-cause mortality, we analyzed data from a population
cohort in Heidelberg (Germany), including 25,546
participants with information on medication use collected at
3-yearly intervals from baseline recruitment (1994-1998)
until end of 2014. A total of 4548 deaths were recorded
until May 2019. Time-dependent modeling was used to estimate
hazard ratios (HR) and their $95\%$ confidence intervals
(CI) for all-cause mortality in relation to number of APIs
used, within three strata of age (≤ 60, > 60 to ≤ 70 and
> 70 years) and adjusting for lifestyle-related risk
factors. For participants reporting commonly used APIs only
(i.e., API types accounting for up to $80\%$ of medication
time in the population) total API counts showed no
association with mortality risk within any age stratum.
However, when at least one of the APIs was less common, the
total API count showed a strong relationship with all-cause
mortality especially up to age ≤ 60, with HR up to 3.70
$(95\%$ CI 2.30-5.94) with 5 or 6 medications and 8.19
(5.61-11.97) for 7 or more APIs (versus none). Between > 60
and 70 years of age this risk association was weaker, with
HR up to 3.96 (3.14-4.98) for 7 or more APIs, and above 70
years it was weakened further (HR up to 1.54 (1.34-1.79)).
Multiple API-use may predict mortality risk in middle-aged
and women and men ≤ 70 years, but only if it includes at
least one less frequently used API type. With advancing age,
and multiple medication becomes increasingly prevalent, the
association of API count with risk of death progressively
attenuates, suggesting an increasing complexity with age of
underlying mortality determinants.},
cin = {C020 / C070},
ddc = {600},
cid = {I:(DE-He78)C020-20160331 / I:(DE-He78)C070-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38167443},
doi = {10.1038/s41598-023-50487-5},
url = {https://inrepo02.dkfz.de/record/286665},
}