Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

OBJECTIVES Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to qua...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of the American Geriatrics Society (JAGS) Vol. 67; no. 12; pp. 2482 - 2489
Main Authors:	Shmuel, Shahar, Lund, Jennifer L., Alvarez, Carolina, Hsu, Christine D., Palta, Priya, Kucharska‐Newton, Anna, Jordan, Joanne M., Nelson, Amanda E., Golightly, Yvonne M.
Format:	Journal Article
Language:	English
Published:	Hoboken, USA John Wiley & Sons, Inc 01.12.2019 Wiley Subscription Services, Inc
Subjects:	Adults African Americans Aged Aged, 80 and over Aging aging health Attainment Attrition Cohort analysis cohort study Drug Prescriptions - statistics & numerical data Drugs Educational attainment epidemiology Ethnic groups Female Frail Frailty Frailty - epidemiology Health risk assessment Humans Incidence Independent Living Intervention Longitudinal Studies Male Middle Aged Minority groups North Carolina - epidemiology Older people Phenotypes Polypharmacy Prescription drugs Prevalence Prospective Studies Women North Carolina aging health epidemiology frailty cohort study polypharmacy
ISSN:	0002-8614, 1532-5415, 1532-5415
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Abstract	OBJECTIVES Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty. DESIGN Prospective cohort study. SETTING A community‐based cohort study of adults residing in Johnston County, North Carolina. PARTICIPANTS White and African American adults aged 50 to 95 years (n=1697). MEASUREMENTS At each study visit, all prescription and over‐the‐counter medications were recorded. We calculated annual polypharmacy (5‐9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006‐2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006‐2010 and 2013‐2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log‐binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively. RESULTS At the 2006‐2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006‐2010 and 2013‐2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013‐2015 visit was 15% (mean follow‐up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9‐2.0), yet estimates are imprecise and should be interpreted with caution. CONCLUSION Consistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482–2489, 2019 See related editorial by Paula Rochon.
AbstractList	Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty.OBJECTIVESPolypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty.Prospective cohort study.DESIGNProspective cohort study.A community-based cohort study of adults residing in Johnston County, North Carolina.SETTINGA community-based cohort study of adults residing in Johnston County, North Carolina.White and African American adults aged 50 to 95 years (n=1697).PARTICIPANTSWhite and African American adults aged 50 to 95 years (n=1697).At each study visit, all prescription and over-the-counter medications were recorded. We calculated annual polypharmacy (5-9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006-2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006-2010 and 2013-2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log-binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively.MEASUREMENTSAt each study visit, all prescription and over-the-counter medications were recorded. We calculated annual polypharmacy (5-9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006-2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006-2010 and 2013-2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log-binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively.At the 2006-2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006-2010 and 2013-2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013-2015 visit was 15% (mean follow-up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9-2.0), yet estimates are imprecise and should be interpreted with caution.RESULTSAt the 2006-2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006-2010 and 2013-2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013-2015 visit was 15% (mean follow-up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9-2.0), yet estimates are imprecise and should be interpreted with caution.Consistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482-2489, 2019.CONCLUSIONConsistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482-2489, 2019. Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty. Prospective cohort study. A community-based cohort study of adults residing in Johnston County, North Carolina. White and African American adults aged 50 to 95 years (n=1697). At each study visit, all prescription and over-the-counter medications were recorded. We calculated annual polypharmacy (5-9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006-2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006-2010 and 2013-2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log-binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively. At the 2006-2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006-2010 and 2013-2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013-2015 visit was 15% (mean follow-up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9-2.0), yet estimates are imprecise and should be interpreted with caution. Consistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482-2489, 2019. OBJECTIVESPolypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty.DESIGNProspective cohort study.SETTINGA community‐based cohort study of adults residing in Johnston County, North Carolina.PARTICIPANTSWhite and African American adults aged 50 to 95 years (n=1697).MEASUREMENTSAt each study visit, all prescription and over‐the‐counter medications were recorded. We calculated annual polypharmacy (5‐9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006‐2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006‐2010 and 2013‐2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log‐binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively.RESULTSAt the 2006‐2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006‐2010 and 2013‐2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013‐2015 visit was 15% (mean follow‐up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9‐2.0), yet estimates are imprecise and should be interpreted with caution.CONCLUSIONConsistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482–2489, 2019 See related editorial by Paula Rochon . OBJECTIVES Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty. DESIGN Prospective cohort study. SETTING A community‐based cohort study of adults residing in Johnston County, North Carolina. PARTICIPANTS White and African American adults aged 50 to 95 years (n=1697). MEASUREMENTS At each study visit, all prescription and over‐the‐counter medications were recorded. We calculated annual polypharmacy (5‐9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006‐2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006‐2010 and 2013‐2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log‐binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively. RESULTS At the 2006‐2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006‐2010 and 2013‐2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013‐2015 visit was 15% (mean follow‐up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9‐2.0), yet estimates are imprecise and should be interpreted with caution. CONCLUSION Consistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482–2489, 2019 See related editorial by Paula Rochon.
Author	Lund, Jennifer L. Hsu, Christine D. Jordan, Joanne M. Alvarez, Carolina Kucharska‐Newton, Anna Nelson, Amanda E. Palta, Priya Shmuel, Shahar Golightly, Yvonne M.
Author_xml	– sequence: 1 givenname: Shahar orcidid: 0000-0003-1726-1875 surname: Shmuel fullname: Shmuel, Shahar email: shmuel@unc.edu organization: University of North Carolina at Chapel Hill – sequence: 2 givenname: Jennifer L. surname: Lund fullname: Lund, Jennifer L. organization: University of North Carolina at Chapel Hill – sequence: 3 givenname: Carolina surname: Alvarez fullname: Alvarez, Carolina organization: University of North Carolina at Chapel Hill – sequence: 4 givenname: Christine D. surname: Hsu fullname: Hsu, Christine D. organization: University of North Carolina at Chapel Hill – sequence: 5 givenname: Priya surname: Palta fullname: Palta, Priya organization: University of North Carolina at Chapel Hill – sequence: 6 givenname: Anna surname: Kucharska‐Newton fullname: Kucharska‐Newton, Anna organization: University of Kentucky – sequence: 7 givenname: Joanne M. surname: Jordan fullname: Jordan, Joanne M. organization: University of North Carolina – sequence: 8 givenname: Amanda E. surname: Nelson fullname: Nelson, Amanda E. organization: University of North Carolina – sequence: 9 givenname: Yvonne M. surname: Golightly fullname: Golightly, Yvonne M. organization: University of North Carolina at Chapel Hill
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/31648378$$D View this record in MEDLINE/PubMed
BookMark	eNp90c1KJDEQB_Agis64e_AFpMGLHkZT6Y90H3XwaxlY0d1zU51kNEN3MiZppG8-gs_ok5hxXA-Cm0sg_KpI_WtMNo01ipA9oMcQz8ni3h9DwYBtkBHkKZvkGeSbZEQpZZOygGyHjL1fUAqMluU22UmhyMqUlyNye2PbYfmArkMxJGhkcm2ElsqE5MKhbsOQaJNgMrPmXodeaoNtMrVd1xsdhtfnlzP0SsaXB-tCchfF8INszbH16ufHvUv-Xpz_mV5NZr8vr6ens4nIoIr_qoSkMBcUESCvaMEUQjVveJOnyBvBGBaNzAXkGW8kNGlVctFAjsgZCMnSXXK47rt09rFXPtSd9kK1LRple1-zlFYZp5ylkR58oQvbuzjKSrEYXFXxMqr9D9U3nZL10ukO3VD_SyuCozUQznrv1PyTAK1Xm6jjJur3TUR78sUKHTBoa8Iq1_9VPOlWDd-3rn9d3q0r3gAATZlp
CitedBy_id	crossref_primary_10_1080_17512433_2020_1829467 crossref_primary_10_1186_s12877_023_03878_2 crossref_primary_10_1016_j_ctim_2021_102782 crossref_primary_10_1007_s40471_020_00226_5 crossref_primary_10_1186_s12877_024_04887_5 crossref_primary_10_1111_jgs_16394 crossref_primary_10_1186_s12877_021_02491_5 crossref_primary_10_1186_s12911_022_01766_0 crossref_primary_10_1016_j_archger_2024_105521 crossref_primary_10_1016_j_jamda_2025_105621 crossref_primary_10_1111_jgs_16213 crossref_primary_10_1186_s12877_023_04147_y crossref_primary_10_1136_bmjopen_2021_052057 crossref_primary_10_1016_j_ijcard_2023_02_021 crossref_primary_10_1007_s00228_023_03481_9 crossref_primary_10_1007_s40520_021_01797_z crossref_primary_10_3390_antiox10121975 crossref_primary_10_1111_jgs_19476 crossref_primary_10_3233_JAD_200122 crossref_primary_10_1016_j_mad_2023_111788 crossref_primary_10_1007_s40618_023_02181_6 crossref_primary_10_1111_ggi_14708 crossref_primary_10_1186_s12877_023_03968_1 crossref_primary_10_1007_s12603_020_1451_z crossref_primary_10_1016_j_archger_2023_104928
Cites_doi	10.1371/journal.pone.0142123 10.1007/s00228-017-2276-5 10.1093/gerona/56.3.M146 10.1111/bcp.13590 10.1002/pds.3772 10.7861/clinmedicine.11-1-72 10.1093/gerona/glv133 10.1053/j.ajkd.2016.08.034 10.1093/gerona/61.3.262 10.1016/j.jamda.2014.11.016 10.3389/fnagi.2015.00056 10.1016/j.jamda.2017.02.009 10.1007/s11357-013-9590-3 10.1016/j.jamda.2016.05.017 10.1016/j.jclinepi.2012.02.018 10.1111/jgs.14718 10.1517/14740338.2013.827660 10.1016/j.jamda.2015.01.087 10.1016/j.cger.2017.02.002 10.1093/ageing/afn293 10.1001/jama.2015.13766 10.1080/00273171.2011.568786 10.1016/S0929-6646(11)60037-5 10.1097/EDE.0b013e318230e861 10.1111/jgs.14515 10.1093/aje/kwn164 10.1111/j.1365-2125.2010.03825.x 10.1016/j.jamda.2017.07.008 10.1007/s40266-013-0151-3 10.3904/kjim.2014.331 10.1161/CIRCOUTCOMES.116.003350 10.1007/s40266-015-0302-9 10.1001/jamainternmed.2018.4720 10.14283/jfa.2018.5 10.1159/000274804 10.1111/jgs.14135 10.5811/westjem.2017.5.33615 10.1016/S0140-6736(12)62167-9 10.1093/gerona/59.3.M255 10.1038/clpt.2011.258 10.1111/j.1532-5415.2008.01939.x 10.1111/jgs.13877 10.1016/S0140-6736(12)60240-2 10.1016/j.amjopharm.2010.06.003 10.1186/s12913-016-1360-3 10.1016/j.arr.2010.09.001 10.1111/j.1532-5415.2012.04054.x
ContentType	Journal Article
Copyright	2019 The American Geriatrics Society 2019 The American Geriatrics Society. 2019 American Geriatrics Society and Wiley Periodicals, Inc.
Copyright_xml	– notice: 2019 The American Geriatrics Society – notice: 2019 The American Geriatrics Society. – notice: 2019 American Geriatrics Society and Wiley Periodicals, Inc.
DBID	AAYXX CITATION CGR CUY CVF ECM EIF NPM 7QP 7TK K9. NAPCQ 7X8
DOI	10.1111/jgs.16212
DatabaseName	CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed Calcium & Calcified Tissue Abstracts Neurosciences Abstracts ProQuest Health & Medical Complete (Alumni) ProQuest Nursing and Allied Health Premium MEDLINE - Academic
DatabaseTitle	CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) ProQuest Health & Medical Complete (Alumni) Nursing & Allied Health Premium Calcium & Calcified Tissue Abstracts Neurosciences Abstracts MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic MEDLINE ProQuest Health & Medical Complete (Alumni) CrossRef
Database_xml	– sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Medicine
EISSN	1532-5415
EndPage	2489
ExternalDocumentID	31648378 10_1111_jgs_16212 JGS16212
Genre	article Research Support, U.S. Gov't, P.H.S Journal Article Research Support, N.I.H., Extramural
GeographicLocations	North Carolina
GeographicLocations_xml	– name: North Carolina
GrantInformation_xml	– fundername: National Institute on Aging funderid: K99 AG052830; R01 AG056479 – fundername: Centers for Disease Control and Prevention funderid: CDC U01DP003206; CDC U01DP006266 – fundername: Centers for Disease Control and Prevention (CDC)/Association of Schools of Public Health Cooperative agreements funderid: S043; S1734; S3486 – fundername: National Institute of Arthritis and Musculoskeletal and Skin Diseases funderid: Grant 5 ‐P60‐AR49465‐03; Grant 5‐P60‐AR3070 – fundername: NIAMS NIH HHS grantid: Grant 5-P60-AR3070 – fundername: CDC HHS grantid: CDC U01DP003206 – fundername: CDC HHS grantid: CDC U01DP006266 – fundername: NIA NIH HHS grantid: R01 AG056479 – fundername: NIAMS NIH HHS grantid: Grant 5 -P60-AR49465-03 – fundername: Centers for Disease Control and Prevention (CDC)/Association of Schools of Public Health Cooperative agreements grantid: S3486 – fundername: Centers for Disease Control and Prevention (CDC)/Association of Schools of Public Health Cooperative agreements grantid: S1734 – fundername: NIAMS NIH HHS grantid: P60 AR049465 – fundername: Centers for Disease Control and Prevention (CDC)/Association of Schools of Public Health Cooperative agreements grantid: S043 – fundername: NCCDPHP CDC HHS grantid: U01 DP006266
GroupedDBID	--- --Z -~X ..I .3N .55 .GA .GJ .Y3 05W 0R~ 10A 1CY 1KJ 1OB 1OC 29L 31~ 33P 36B 3O- 3SF 4.4 50Y 50Z 51W 51X 52M 52N 52O 52P 52R 52S 52T 52U 52V 52W 52X 53G 5GY 5HH 5LA 5RE 5VS 66C 6PF 702 7PT 8-0 8-1 8-3 8-4 8-5 8F7 8UM 930 A01 A03 AAESR AAEVG AAHHS AAHQN AAIPD AAMNL AANHP AANLZ AAONW AAQQT AARRQ AASGY AAWTL AAXRX AAYCA AAYJJ AAZKR ABCQN ABCUV ABDPE ABEML ABIVO ABJNI ABLJU ABOCM ABPPZ ABPVW ABQWH ABXGK ACAHQ ACBWZ ACCFJ ACCZN ACGFO ACGFS ACGOF ACHQT ACMXC ACNCT ACPOU ACPRK ACRPL ACSCC ACXBN ACXQS ACYXJ ADBBV ADBTR ADEOM ADIZJ ADKYN ADMGS ADNMO ADOZA ADXAS ADZMN AEEZP AEGXH AEIGN AEIMD AENEX AEQDE AEUQT AEUYR AFBPY AFEBI AFFNX AFFPM AFGKR AFPWT AFWVQ AFZJQ AHBTC AHMBA AI. AIACR AIAGR AITYG AIURR AIWBW AJBDE ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN ALVPJ AMBMR AMYDB ASPBG ATUGU AVWKF AZBYB AZFZN AZVAB BAFTC BDRZF BFHJK BHBCM BKOMP BMXJE BROTX BRXPI BY8 C45 CAG COF CS3 D-6 D-7 D-E D-F DCZOG DPXWK DR2 DRFUL DRMAN DRSTM DU5 DUUFO EBS EJD EMOBN ESX EX3 F00 F01 F04 F5P FEDTE FUBAC G-S G.N GODZA H.X HF~ HGLYW HVGLF HZI HZ~ H~9 IHE IX1 J0M J5H K48 KBYEO L7B LATKE LC2 LC3 LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES MEWTI MK4 MRFUL MRMAN MRSTM MSFUL MSMAN MSSTM MXFUL MXMAN MXSTM N04 N05 N4W N9A NF~ NHB O66 O9- OHT OIG OVD P2P P2W P2X P2Z P4B P4D PALCI PQQKQ Q.N Q11 QB0 QN7 R.K RIWAO RJQFR ROL RX1 SAMSI SUPJJ TAE TEORI TN5 TWZ UB1 UKR UPT V9Y VH1 W8V W99 WBKPD WH7 WHWMO WIH WIJ WIK WOHZO WOW WQ9 WQJ WRC WVDHM WXI WXSBR X7M XG1 XOL YCJ YF5 YFH YOC YQJ YQT YUY YZZ ZGI ZHY ZXP ZY1 ZZTAW ~IA ~S- ~WT AAMMB AAYXX AEFGJ AEYWJ AGHNM AGQPQ AGXDD AGYGG AIDQK AIDYY AIQQE CITATION O8X CGR CUY CVF ECM EIF NPM PKN YIN Z5M 7QP 7TK K9. NAPCQ 7X8
ID	FETCH-LOGICAL-c4192-89cd01fc0aa1159062ea19fb7b53a7bc22a6bd5c1547bd1b3987cb15aa721cd23
IEDL.DBID	DRFUL
ISICitedReferencesCount	26
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000492097900001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	0002-8614 1532-5415
IngestDate	Sun Sep 28 02:06:56 EDT 2025 Fri Nov 14 19:17:53 EST 2025 Wed Feb 19 02:30:50 EST 2025 Tue Nov 18 21:16:38 EST 2025 Sat Nov 29 06:58:52 EST 2025 Wed Jan 22 16:41:02 EST 2025
IsDoiOpenAccess	false
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	12
Keywords	aging health epidemiology frailty cohort study polypharmacy
Language	English
License	2019 The American Geriatrics Society.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c4192-89cd01fc0aa1159062ea19fb7b53a7bc22a6bd5c1547bd1b3987cb15aa721cd23
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ORCID	0000-0003-1726-1875
PMID	31648378
PQID	2322129978
PQPubID	41968
PageCount	8
ParticipantIDs	proquest_miscellaneous_2309470723 proquest_journals_2322129978 pubmed_primary_31648378 crossref_primary_10_1111_jgs_16212 crossref_citationtrail_10_1111_jgs_16212 wiley_primary_10_1111_jgs_16212_JGS16212
PublicationCentury	2000
PublicationDate	December 2019
PublicationDateYYYYMMDD	2019-12-01
PublicationDate_xml	– month: 12 year: 2019 text: December 2019
PublicationDecade	2010
PublicationPlace	Hoboken, USA
PublicationPlace_xml	– name: Hoboken, USA – name: United States – name: New York
PublicationTitle	Journal of the American Geriatrics Society (JAGS)
PublicationTitleAlternate	J Am Geriatr Soc
PublicationYear	2019
Publisher	John Wiley & Sons, Inc Wiley Subscription Services, Inc
Publisher_xml	– name: John Wiley & Sons, Inc – name: Wiley Subscription Services, Inc
References	2010; 34 2012; 60 2015; 16 2015; 70 2017; 69 2017; 65 2008; 38 2012; 380 2015; 32 2015; 10 2016; 31 2011; 11 2008; 56 2011; 10 2016; 72 2018; 84 2008; 168 2016; 17 2013; 381 2016; 16 2015; 7 2007; 34 2011; 110 2017; 73 2015; 24 2018; 7 2018; 19 2012; 91 2006; 61 2015; 314 2017; 33 2011; 71 2004; 59 2017; 10 2018; 178 2016; 64 2014; 36 2014; 13 2011; 46 2017; 18 2001; 56 2012; 23 2012; 65 2010; 8 2014; 31 e_1_2_6_51_1 e_1_2_6_32_1 e_1_2_6_30_1 e_1_2_6_19_1 Kucharska‐Newton AM (e_1_2_6_46_1) 2016; 72 e_1_2_6_13_1 e_1_2_6_36_1 e_1_2_6_11_1 e_1_2_6_34_1 e_1_2_6_17_1 e_1_2_6_15_1 e_1_2_6_38_1 Jordan JM (e_1_2_6_44_1) 2007; 34 e_1_2_6_43_1 e_1_2_6_20_1 e_1_2_6_41_1 e_1_2_6_9_1 e_1_2_6_5_1 e_1_2_6_7_1 e_1_2_6_24_1 e_1_2_6_49_1 e_1_2_6_3_1 e_1_2_6_22_1 e_1_2_6_45_1 e_1_2_6_26_1 e_1_2_6_47_1 e_1_2_6_10_1 e_1_2_6_31_1 e_1_2_6_50_1 e_1_2_6_14_1 e_1_2_6_35_1 e_1_2_6_12_1 e_1_2_6_33_1 e_1_2_6_18_1 e_1_2_6_39_1 e_1_2_6_16_1 e_1_2_6_37_1 e_1_2_6_42_1 e_1_2_6_21_1 Aprahamian I (e_1_2_6_28_1) 2018; 7 e_1_2_6_40_1 e_1_2_6_8_1 e_1_2_6_4_1 e_1_2_6_6_1 e_1_2_6_25_1 e_1_2_6_48_1 e_1_2_6_23_1 e_1_2_6_2_1 e_1_2_6_29_1 e_1_2_6_27_1 31648366 - J Am Geriatr Soc. 2019 Dec;67(12):2441-2443
References_xml	– volume: 36 start-page: 923 issue: 2 year: 2014 end-page: 931 article-title: Multi‐morbidity, dependency, and frailty singly or in combination have different impact on health outcomes publication-title: Age (Dordr). – volume: 168 start-page: 656 issue: 6 year: 2008 end-page: 664 article-title: Constructing inverse probability weights for marginal structural models publication-title: Am J Epidemiol. – volume: 110 start-page: 247 issue: 4 year: 2011 end-page: 257 article-title: Prevalence and correlates of geriatric frailty in a northern Taiwan Community publication-title: J Formos Med Assoc. – volume: 13 start-page: 57 issue: 1 year: 2014 end-page: 65 article-title: Clinical consequences of polypharmacy in elderly publication-title: Expert Opin Drug Saf. – volume: 65 start-page: 989 issue: 9 year: 2012 end-page: 995 article-title: Polypharmacy cutoff and outcomes: five or more medicines were used to identify community‐dwelling older men at risk of different adverse outcomes publication-title: J Clin Epidemiol. – volume: 10 issue: 11 year: 2015 article-title: Incidence and effects of polypharmacy on clinical outcome among patients aged 80+: a five‐year follow‐up study publication-title: PLoS One. – volume: 65 start-page: 179 issue: 1 year: 2017 end-page: 184 article-title: Factors influencing transitions between frailty states in elderly adults: the Progetto Veneto Anziani Longitudinal Study publication-title: J Am Geriatr Soc – volume: 59 start-page: 255 issue: 3 year: 2004 end-page: 263 article-title: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care publication-title: J Gerontol A Biol Sci Med Sci. – volume: 24 start-page: 637 issue: 6 year: 2015 end-page: 646 article-title: Polypharmacy and frailty: prevalence, relationship, and impact on mortality in a French sample of 2350 old people publication-title: Pharmacoepidemiol Drug Saf. – volume: 56 start-page: 1791 issue: 10 year: 2008 end-page: 1795 article-title: Editorial: leading on behalf of an aging society publication-title: J Am Geriatr Soc – volume: 60 start-page: 1487 issue: 8 year: 2012 end-page: 1492 article-title: Prevalence of frailty in community‐dwelling older persons: a systematic review publication-title: J Am Geriatr Soc. – volume: 61 start-page: 262 issue: 3 year: 2006 end-page: 266 article-title: Phenotype of frailty: characterization in the women's health and aging studies publication-title: J Gerontol A Biol Sci Med Sci – volume: 178 start-page: 1673 issue: 12 year: 2018 end-page: 1680 article-title: Assessment of attitudes toward deprescribing in older Medicare beneficiaries in the United States publication-title: JAMA Intern Med – volume: 16 start-page: 259 issue: 3 year: 2015 end-page: 261 article-title: Searching for a polypharmacy threshold associated with frailty publication-title: J Am Med Dir Assoc. – volume: 7 start-page: 108 issue: 2 year: 2018 end-page: 112 article-title: Polypharmacy but not potential inappropriate prescription was associated with frailty in older adults from a middle‐income country outpatient clinic publication-title: J Frailty Aging. – volume: 10 start-page: 104 issue: 1 year: 2011 end-page: 114 article-title: Outcome instruments to measure frailty: a systematic review publication-title: Ageing Res Rev. – volume: 16 start-page: 412 issue: 5 year: 2015 end-page: 419 article-title: Frailty screening in the community using the FRAIL scale publication-title: J Am Med Dir Assoc. – volume: 56 start-page: M146 issue: 3 year: 2001 end-page: M156 article-title: Frailty in older adults: evidence for a phenotype publication-title: J Gerontol A Biol Sci Med Sci. – volume: 8 start-page: 215 issue: 3 year: 2010 end-page: 224 article-title: A pharmacoepidemiologic study of community‐dwelling, disabled older women: factors associated with medication use publication-title: Am J Geriatr Pharmacother. – volume: 72 issue: 3 year: 2016 article-title: Operationalizing frailty in the atherosclerosis risk in communities study cohort publication-title: J Gerontol Ser A Biol Sci Med Sci. – volume: 31 start-page: 225 issue: 3 year: 2014 end-page: 232 article-title: Prevalence and impact of fall‐risk‐increasing drugs, polypharmacy, and drug‐drug interactions in robust versus frail hospitalised falls patients: a prospective cohort study publication-title: Drugs Aging. – volume: 64 start-page: 89 issue: 1 year: 2016 end-page: 95 article-title: Effects of changes in number of medications and drug burden index exposure on transitions between frailty states and death: the Concord Health and Ageing in Men Project cohort study publication-title: J Am Geriatr Soc – volume: 31 start-page: 594 issue: 3 year: 2016 end-page: 600 article-title: The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly publication-title: Korean J Intern Med – volume: 69 start-page: 228 issue: 2 year: 2017 end-page: 236 article-title: Frailty, kidney function, and polypharmacy: the Atherosclerosis Risk in Communities (ARIC) study publication-title: Am J Kidney Dis. – volume: 34 start-page: 123 issue: 2 year: 2010 end-page: 129 article-title: Geographic variation in one‐year recurrent ischemic stroke rates for elderly Medicare beneficiaries in the USA publication-title: Neuroepidemiology – volume: 16 start-page: 128 issue: 1 year: 2016 article-title: Associations of frailty with health care costs—results of the ESTHER cohort study publication-title: BMC Health Serv Res. – volume: 38 start-page: 156 issue: 2 year: 2008 end-page: 162 article-title: The impact of frailty on the utilisation of antithrombotic therapy in older patients with atrial fibrillation publication-title: Age Ageing – volume: 91 start-page: 521 issue: 3 year: 2012 end-page: 528 article-title: High‐risk prescribing and incidence of frailty among older community‐dwelling men publication-title: Clin Pharmacol Ther. – volume: 314 start-page: 1818 issue: 17 year: 2015 end-page: 1831 article-title: Trends in prescription drug use among adults in the United States from 1999‐2012 publication-title: JAMA. – volume: 23 start-page: 119 issue: 1 year: 2012 end-page: 128 article-title: Accounting for bias due to selective attrition: the example of smoking and cognitive decline publication-title: Epidemiology. – volume: 32 start-page: 849 issue: 10 year: 2015 end-page: 856 article-title: Prevalence of potential and clinically relevant statin‐drug interactions in frail and robust older inpatients publication-title: Drugs Aging – volume: 33 start-page: 293 issue: 3 year: 2017 end-page: 303 article-title: Frailty in older persons publication-title: Clin Geriatr Med. – volume: 70 start-page: 1427 issue: 11 year: 2015 end-page: 1434 article-title: Frailty in older adults: a nationally representative profile in the United States publication-title: J Gerontol Ser A Biol Sci Med Sci. – volume: 64 start-page: 1281 issue: 6 year: 2016 end-page: 1286 article-title: Prevalence and incidence of frailty in community‐dwelling older people: Beijing longitudinal study of aging II publication-title: J Am Geriatr Soc. – volume: 7 start-page: 56 year: 2015 article-title: Determinants of frailty: the added value of assessing medication publication-title: Front Aging Neurosci – volume: 10 issue: 1 year: 2017 article-title: Heat maps of hypertension, diabetes mellitus, and smoking in the continental United States publication-title: Circ Cardiovasc Qual Outcomes – volume: 18 start-page: 624 issue: 7 year: 2017 end-page: 628 article-title: Polypharmacy is associated with higher frailty risk in older people: an 8‐year longitudinal cohort study publication-title: J Am Med Dir Assoc. – volume: 46 start-page: 399 issue: 3 year: 2011 end-page: 424 article-title: An introduction to propensity score methods for reducing the effects of confounding in observational studies publication-title: Multivariate Behav Res. – volume: 73 start-page: 1165 issue: 9 year: 2017 end-page: 1172 article-title: Frailty, polypharmacy, and potentially inappropriate medications in old people: findings in a representative sample of the French population publication-title: Eur J Clin Pharmacol – volume: 17 start-page: 767.e9 issue: 8 year: 2016 end-page: 767.e13 article-title: Adverse outcomes in relation to polypharmacy in robust and frail older hospital patients publication-title: J Am Med Dir Assoc – volume: 34 start-page: 172 issue: 1 year: 2007 end-page: 180 article-title: Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project publication-title: J Rheumatol – volume: 11 start-page: 72 issue: 1 year: 2011 end-page: 75 article-title: The frailty syndrome publication-title: Clin Med. – volume: 65 issue: 2 year: 2017 article-title: Is polypharmacy associated with frailty in older people? Results from the ESTHER cohort study publication-title: J Am Geriatr Soc – volume: 19 start-page: 46 issue: 1 year: 2018 end-page: 52 article-title: Frailty, polypharmacy, and health outcomes in older adults: the frailty and dependence in albacete study publication-title: J Am Med Dir Assoc – volume: 381 start-page: 752 issue: 9868 year: 2013 end-page: 762 article-title: Frailty in elderly people publication-title: Lancet – volume: 71 start-page: 224 issue: 2 year: 2011 end-page: 231 article-title: Gentamicin pharmacokinetics in old age and frailty publication-title: Br J Clin Pharmacol. – volume: 380 start-page: 37 issue: 9836 year: 2012 end-page: 43 article-title: Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross‐sectional study publication-title: Lancet. – volume: 18 start-page: 785 issue: 5 year: 2017 end-page: 793 article-title: Trends and characteristics of emergency department visits for fall‐related injuries in older adults, 2003‐2010 publication-title: West J Emerg Med. – volume: 84 start-page: 1432 issue: 7 year: 2018 end-page: 1444 article-title: The relationship between frailty and polypharmacy in older people: a systematic review publication-title: Br J Clin Pharmacol. – ident: e_1_2_6_38_1 doi: 10.1371/journal.pone.0142123 – ident: e_1_2_6_20_1 doi: 10.1007/s00228-017-2276-5 – ident: e_1_2_6_2_1 doi: 10.1093/gerona/56.3.M146 – ident: e_1_2_6_15_1 doi: 10.1111/bcp.13590 – ident: e_1_2_6_26_1 doi: 10.1002/pds.3772 – ident: e_1_2_6_5_1 doi: 10.7861/clinmedicine.11-1-72 – ident: e_1_2_6_11_1 doi: 10.1093/gerona/glv133 – ident: e_1_2_6_14_1 – ident: e_1_2_6_30_1 doi: 10.1053/j.ajkd.2016.08.034 – ident: e_1_2_6_3_1 doi: 10.1093/gerona/61.3.262 – ident: e_1_2_6_18_1 doi: 10.1016/j.jamda.2014.11.016 – ident: e_1_2_6_33_1 doi: 10.3389/fnagi.2015.00056 – ident: e_1_2_6_35_1 doi: 10.1016/j.jamda.2017.02.009 – ident: e_1_2_6_50_1 doi: 10.1007/s11357-013-9590-3 – ident: e_1_2_6_29_1 doi: 10.1016/j.jamda.2016.05.017 – ident: e_1_2_6_17_1 doi: 10.1016/j.jclinepi.2012.02.018 – ident: e_1_2_6_34_1 doi: 10.1111/jgs.14718 – volume: 72 issue: 3 year: 2016 ident: e_1_2_6_46_1 article-title: Operationalizing frailty in the atherosclerosis risk in communities study cohort publication-title: J Gerontol Ser A Biol Sci Med Sci. – ident: e_1_2_6_16_1 doi: 10.1517/14740338.2013.827660 – ident: e_1_2_6_22_1 doi: 10.1016/j.jamda.2015.01.087 – ident: e_1_2_6_12_1 doi: 10.1016/j.cger.2017.02.002 – ident: e_1_2_6_25_1 doi: 10.1093/ageing/afn293 – ident: e_1_2_6_45_1 doi: 10.1001/jama.2015.13766 – ident: e_1_2_6_47_1 doi: 10.1080/00273171.2011.568786 – ident: e_1_2_6_27_1 doi: 10.1016/S0929-6646(11)60037-5 – ident: e_1_2_6_49_1 doi: 10.1097/EDE.0b013e318230e861 – ident: e_1_2_6_40_1 doi: 10.1111/jgs.14515 – ident: e_1_2_6_48_1 doi: 10.1093/aje/kwn164 – ident: e_1_2_6_24_1 doi: 10.1111/j.1365-2125.2010.03825.x – ident: e_1_2_6_32_1 doi: 10.1016/j.jamda.2017.07.008 – ident: e_1_2_6_23_1 doi: 10.1007/s40266-013-0151-3 – ident: e_1_2_6_31_1 doi: 10.3904/kjim.2014.331 – volume: 34 start-page: 172 issue: 1 year: 2007 ident: e_1_2_6_44_1 article-title: Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project publication-title: J Rheumatol – ident: e_1_2_6_42_1 doi: 10.1161/CIRCOUTCOMES.116.003350 – ident: e_1_2_6_21_1 doi: 10.1007/s40266-015-0302-9 – ident: e_1_2_6_51_1 doi: 10.1001/jamainternmed.2018.4720 – volume: 7 start-page: 108 issue: 2 year: 2018 ident: e_1_2_6_28_1 article-title: Polypharmacy but not potential inappropriate prescription was associated with frailty in older adults from a middle‐income country outpatient clinic publication-title: J Frailty Aging. doi: 10.14283/jfa.2018.5 – ident: e_1_2_6_41_1 doi: 10.1159/000274804 – ident: e_1_2_6_39_1 doi: 10.1111/jgs.14135 – ident: e_1_2_6_43_1 doi: 10.5811/westjem.2017.5.33615 – ident: e_1_2_6_4_1 doi: 10.1016/S0140-6736(12)62167-9 – ident: e_1_2_6_7_1 doi: 10.1093/gerona/59.3.M255 – ident: e_1_2_6_36_1 doi: 10.1038/clpt.2011.258 – ident: e_1_2_6_13_1 doi: 10.1111/j.1532-5415.2008.01939.x – ident: e_1_2_6_37_1 doi: 10.1111/jgs.13877 – ident: e_1_2_6_8_1 doi: 10.1016/S0140-6736(12)60240-2 – ident: e_1_2_6_19_1 doi: 10.1016/j.amjopharm.2010.06.003 – ident: e_1_2_6_10_1 doi: 10.1186/s12913-016-1360-3 – ident: e_1_2_6_6_1 doi: 10.1016/j.arr.2010.09.001 – ident: e_1_2_6_9_1 doi: 10.1111/j.1532-5415.2012.04054.x – reference: 31648366 - J Am Geriatr Soc. 2019 Dec;67(12):2441-2443
SSID	ssj0012088
Score	2.4412315
Snippet	OBJECTIVES Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and... See related editorial by Paula Rochon . Polypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons... OBJECTIVESPolypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and...
SourceID	proquest pubmed crossref wiley
SourceType	Aggregation Database Index Database Enrichment Source Publisher
StartPage	2482
SubjectTerms	Adults African Americans Aged Aged, 80 and over Aging aging health Attainment Attrition Cohort analysis cohort study Drug Prescriptions - statistics & numerical data Drugs Educational attainment epidemiology Ethnic groups Female Frail Frailty Frailty - epidemiology Health risk assessment Humans Incidence Independent Living Intervention Longitudinal Studies Male Middle Aged Minority groups North Carolina - epidemiology Older people Phenotypes Polypharmacy Prescription drugs Prevalence Prospective Studies Women
Title	Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study
URI	https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fjgs.16212 https://www.ncbi.nlm.nih.gov/pubmed/31648378 https://www.proquest.com/docview/2322129978 https://www.proquest.com/docview/2309470723
Volume	67
WOSCitedRecordID	wos000492097900001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVWIB databaseName: Wiley Online Library Full Collection 2020 customDbUrl: eissn: 1532-5415 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0012088 issn: 0002-8614 databaseCode: DRFUL dateStart: 19970101 isFulltext: true titleUrlDefault: https://onlinelibrary.wiley.com providerName: Wiley-Blackwell
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT9wwEB7BglAvlPIoSwG5VQ-9BCX2Jo7FqQ8WVFGEaJH2FvkJK62yiGSRcuMn9Df2l3ScZKOigoTELUrGsuXxeL7J2N8AfJRGWJM41ABlKhjETgQKUWvAGNMMgzfGnauLTfCzs3Q0EucLcDi_C9PwQ3Q_3Lxl1Pu1N3Cpin-N_Ko4iBLqKwwvUVy3gx4sfbsYXp52SQQapmmHftENtcRC9UGeeeOH7ug_jPkQstY-Z_j6RaNdg9UWapLPzdp4Aws2X4eVH20yfQMuzqeT6qahrq6IzA3BzcLXGC0JwtnxpKzIOCeSnE59TaOZ8fWzSHuhpKz-3P_-gh7Q4JtrhPDEH0isNuFyePTr60nQllgItE__BqnQJoycDqVEaOg5i62MhFNcxUxypSmViTKxRqDFlYkUEynXKoqlxMhRG8q2oJdPc7sNREtqlRDOMO0G2EamCafSxgNqeeJY2IdP85nOdMs_7stgTLIuDrkqsnqO-vChE71pSDceE9qdqytr7a7IEB_iJ4GhcR_ed5_RYnwaROZ2OvMyGNLykFPWh7eNmrteGEaPnmIfB1tr8-nus-_HP-uHneeLvoNXiLdEcxpmF3rl7czuwbK-K8fF7T4s8lG63y7iv2Bd9Ec
linkProvider	Wiley-Blackwell
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1fT9swED-hMo297A8brFvHzMTDXoISu4ljaS_A1rGtVIiBxFvkv6xSlaI2nZQ3PgKfcZ-Ec5JGQwxpEm9RfJYtn8_3O9_5DmBHGmFN4pADlKmgHzsRKEStAWNMMzTeGHeuKjbBR6P0_Fwcr8Cn5VuYOj9Ee-HmJaM6r72A-wvpv6X8Yr4bJdSXGF7t4zaKO7D6-WRwNmy9CDRM0xb-oh5qMgtVkTzLzrf10R2QeRuzVkpn8Oxh030OTxuwSfbq3fECVmy-Do-PGnf6Szg5nk7Kyzp5dUlkbggeF77KaEEQ0I4nRUnGOZFkOPVVjRbGV9AizZOSovxzdb2POtDgn18I4okPSSxfwdngy-nBYdAUWQi0dwAHqdAmjJwOpURw6LMWWxkJp7iKmeRKUyoTZWKNUIsrEykmUq5VFEuJtqM2lG1AJ5_m9jUQLalVQjjDtOtjH5kmnEob96nliWNhFz4ulzrTTQZyXwhjkrWWyMU8q9aoCx9a0ss67ca_iHpLfmWN5M0zRIjYJNA47sJ224wy4x0hMrfThadBo5aHnLIubNZ8bkdhaD_6JPs42Yqd9w-fff_6s_p48_-k72Ht8PRomA2_jX68hSeIvkQdG9ODTjFb2HfwSP8uxvPZVrOXbwA8nPdP
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT9wwEB4hqBCXvqB0CxSDOPSSKrE3cSz1QqFb2i6rFQ-JW-QnXWmVXbHZSrnxE_ob-SWMk2wEaitV4hYlY9nyeDzfZOxvAA6kEdYkDjVAmQq6sROBQtQaMMY0w-CNceeqYhN8MEivrsRwCT4t7sLU_BDtDzdvGdV-7Q3cTo17aOXXs49RQn2J4ZVuLBI0y5Xjs95lv80i0DBNW_iLfqhhFqpO8iwaP_ZHf4DMx5i1cjq9F08b7kt43oBNclivjlewZPPXsHrapNPX4Ww4GZfTmry6JDI3BLcLX2W0IAhoR-OiJKOcSNKf-KpGc-MraJHmSklR3t3-_ow-0OCbnwjiiT-SWG7AZe_LxdFJ0BRZCLRPAAep0CaMnA6lRHDoWYutjIRTXMVMcqUplYkysUaoxZWJFBMp1yqKpcTYURvK3sByPsntWyBaUquEcIZp18U2Mk04lTbuUssTx8IOfFhMdaYbBnJfCGOctZHI9Syr5qgD-63otKbd-JvQ9kJfWWN5swwRIn4SGBx3YK_9jDbjEyEyt5O5l8Ggloecsg5s1npue2EYP3qSfRxspc5_d599_3pePbz7f9FdWB0e97L-t8GPLVhD8CXqozHbsFzczO0OPNO_itHs5n2zlO8B1RP2yg
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Polypharmacy+and+Incident+Frailty+in+a+Longitudinal+Community%E2%80%90Based+Cohort+Study&rft.jtitle=Journal+of+the+American+Geriatrics+Society+%28JAGS%29&rft.au=Shmuel%2C+Shahar&rft.au=Lund%2C+Jennifer+L.&rft.au=Alvarez%2C+Carolina&rft.au=Hsu%2C+Christine+D.&rft.date=2019-12-01&rft.issn=0002-8614&rft.eissn=1532-5415&rft.volume=67&rft.issue=12&rft.spage=2482&rft.epage=2489&rft_id=info:doi/10.1111%2Fjgs.16212&rft.externalDBID=n%2Fa&rft.externalDocID=10_1111_jgs_16212
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0002-8614&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0002-8614&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0002-8614&client=summon