2026 Volume 9 Issue 1 Pages 23-34
To elucidate the effects of adverse drug events on the progression of frailty in elderly outpatients at pharmacies, we analyzed the relationship between frailty status and drugs use by applying statistical methods. From September 202X to October 202X+1, 310 subjects were selected from 3,258 outpatients aged 65 years and older at four pharmacies in Ishikawa Prefecture, Japan, by a purposive selection method. We assessed frailty and depression in the subjects based on the Kihon Check List. We surveyed prescribed drugs from the medication history over the past 8 weeks. Of the total 113 statin users, 25 women and 6 men have used atorvastatin. As compared to 5.3% of atorvastatin users in the non-depression/robust group (6 of 112 participants), 16.5% in the depression/frailty group (13 of 79 participants) was 3.1 times higher (p < 0.05), which is statistically significant. Atorvastatin significantly increased scores of overall and depressed moods, and the prevalence of frailty in a dose-dependent manner. There were significant associations between atorvastatin use and depression (odds ratio (OR) 2.63, 95% confidence interval (CI) 1.18 to 5.87, p < 0.05), and frailty (OR 2.25, 95% CI 1.01 to 5.01, p < 0.05) even after covariate adjustment including sex, age and uses of antithrombotic drugs, and anxiolytics and hypnotics. When depression was added as a covariate, significant association between atorvastatin use and frailty disappeared. Atorvastatin use was significantly associated with depression (OR 3.25, 95% CI 1.31 to 8.09, p < 0.05) in women, but not in men, as adjusted with age. Depression is well known as a side effect of atorvastatin. Therefore, it is considered that frailty may have progressed through worsening depression as the side effect of atorvastatin.
