2019 年 45 巻 7 号 p. 365-375
The associations between polypharmacy, potentially inappropriate medications' (PIMs) use or anticholinergic load, and rehabilitation outcomes in Japan are unclear. This review evaluated whether polypharmacy, PIMs' use, or anticholinergic load during hospitalization affected the basic activities of daily living (ADL) Functional Independence Measure (FIM) among geriatric patients with stroke in a convalescent setting. First, we evaluated 144 consecutive geriatric stroke patients with chronic kidney disease to establish the association between polypharmacy and FIM-motor (FIM-M). Multiple logistic regression analysis for polypharmacy, adjusting for confounding factors, revealed that polypharmacy was independently and negatively correlated with FIM-M efficiency. Second, we evaluated 272 consecutive geriatric patients with stroke with low ADL to establish the association between PIMs' use and FIM-M. Multiple linear regression analysis for FIM-M gain, adjusting for confounding factors, revealed that increased PIMs' use was independently and negatively correlated with FIM-M gain. Finally, we aimed to establish whether anticholinergic load was associated with FIM-cognitive (FIM-C) among 418 geriatric patients convalescing after stroke. Multiple linear regression analysis for FIM-C gain, adjusting for confounding factors, revealed that increased anticholinergic load during hospitalization was independently and negatively correlated with FIM-C gain. These results may be useful to ensure the proper use of drugs in the convalescent setting.