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@ARTICLE{Chen:289904,
      author       = {L.-J. Chen$^*$ and S. Sha$^*$ and H. Brenner$^*$ and B.
                      Schöttker$^*$},
      title        = {{L}ongitudinal associations of polypharmacy and frailty
                      with major cardiovascular events and mortality among more
                      than half a million middle-aged participants of the {UK}
                      {B}iobank.},
      journal      = {Maturitas},
      volume       = {185},
      issn         = {0378-5122},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2024-00896},
      pages        = {107998},
      year         = {2024},
      note         = {#EA:C070#LA:C070#},
      abstract     = {Studies of the associations of polypharmacy and frailty
                      with adverse health outcomes in middle-aged adults are
                      limited. Furthermore, a potentially stronger association of
                      polypharmacy with adverse health outcomes in frail than in
                      non-frail adults is of interest.To evaluate associations of
                      frailty (assessed using a frailty index) and polypharmacy
                      (defined as taking five or more drugs) with major
                      cardiovascular events, cancer incidence, all-cause,
                      cardiovascular disease-specific, and cancer-specific
                      mortality.Cox proportional hazards regression models were
                      used to analyze 501,548 participants of the UK Biobank
                      cohort study aged 40-69 years who were followed up for an
                      average of 12 years.The prevalence of pre-frailty and
                      frailty were 43.2 $\%$ and 2.3 $\%,$ respectively, and that
                      of polypharmacy was 18.3 $\%.$ Although strongly associated
                      with each other, frailty and polypharmacy were
                      independently, statistically significantly associated with
                      major cardiovascular events, cardiovascular
                      disease-specific, and all-cause mortality. In addition, the
                      hazard ratios of polypharmacy were stronger among
                      (pre-)frail than non-frail study participants. No profound
                      associations with cancer incidence and cancer mortality were
                      observed. No sex and age differences were observed.This
                      large cohort study showed that polypharmacy and frailty are
                      independent risk factors for major cardiovascular events,
                      cardiovascular disease-specific and all-cause mortality in
                      both middle-aged (40-64 years) and older people (≥ 65
                      years). In addition, the hazard ratios of polypharmacy were
                      stronger among (pre-)frail than non-frail study
                      participants. This underlines the need to avoid polypharmacy
                      as far as possible not only in older but also in middle-aged
                      subjects (40-64 years), especially if they are pre-frail or
                      frail.},
      keywords     = {Cardiovascular disease mortality (Other) / Frailty (Other)
                      / MACE (Other) / Mortality (Other) / Polypharmacy (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {150},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38678818},
      doi          = {10.1016/j.maturitas.2024.107998},
      url          = {https://inrepo02.dkfz.de/record/289904},
}