@article{RN500,
   author = {Elhussein, L. and Williams, R. D. and Man, W. Y. and Burn, E. and Delmestri, A. and Strauss, V. Y. and Prieto-Alhambra, D.},
   title = {Longitudinal trajectories of polypharmacy in older people, and their association with the risk of mortality: a joint latent class model analysis of real-world data from the UK and the Netherlands},
   journal = {Age Ageing},
   volume = {54},
   number = {8},
   note = {1468-2834
Elhussein, Leena
Williams, Ross D
Orcid: 0000-0001-7723-417x
Man, Wai Yi
Burn, Edward
Orcid: 0000-0002-9286-1128
Delmestri, Antonella
Strauss, Victoria Y
Prieto-Alhambra, Daniel
Orcid: 0000-0002-3950-6346
European Health Data and Evidence Network (EHDEN)/
Journal Article
England
2025/08/22
Age Ageing. 2025 Aug 1;54(8):afaf233. doi: 10.1093/ageing/afaf233.},
   abstract = {OBJECTIVE: Polypharmacy is the use of multiple drugs. Many definitions have been established for polypharmacy, often cross-sectionally, despite it naturally changing over time. In this study, we aimed to identify clusters of older people with distinct polypharmacy trajectories over time and associated mortality risks. We then characterised the identified clusters and assessed their generalisability in two external databases. METHODS: Data were extracted from three primary care databases: the UK Clinical Practice Research Datalink (CPRD) GOLD, CPRD Aurum and the Dutch Integrated Primary Care Information (IPCI). People aged ≥65 on 1 January 2015 were included. Polypharmacy, defined as the cumulative number of prescribed ingredients, was calculated at baseline and at the end of each subsequent follow-up year (2015-19). We applied joint latent class modelling, which divides the population into clusters with different trajectories and associated mortality risks. The model was trained in GOLD and validated in Aurum and IPCI. RESULTS: Four clusters were identified and characterised based on polypharmacy baseline and rate of progression: low-steady, intermediate-slow/increasing, intermediate-fast/increasing and high-decreasing. The high-decreasing cluster had the highest average baseline polypharmacy (intercept = 23.4) and prevalence of non-cancer chronic comorbidities, whilst the intermediate-fast/increasing had the steepest polypharmacy rate of progression per year (slope = 6.4), highest baseline and cumulative incidence of cancer, and worst survival outcome. Good validation was found in Aurum and IPCI. CONCLUSION: High baseline levels and increasing levels of polypharmacy were associated with an increased mortality risk in older people. The clusters identified in this study were externally validated in two European databases, confirming their robustness and generalisability.},
   keywords = {Humans
*Polypharmacy
Aged
United Kingdom/epidemiology
Netherlands/epidemiology
Female
Male
Latent Class Analysis
Aged, 80 and over
Risk Factors
Risk Assessment
Databases, Factual
*Mortality/trends
Age Factors
Time Factors
Longitudinal Studies
joint latent class models
longitudinal
mortality
older people
polypharmacy},
   ISSN = {0002-0729 (Print)
0002-0729},
   DOI = {10.1093/ageing/afaf233},
   year = {2025},
   type = {Journal Article}
}

{"_id":"NKxDJ3w3KhNuM4DSS","bibbaseid":"elhussein-williams-man-burn-delmestri-strauss-prietoalhambra-longitudinaltrajectoriesofpolypharmacyinolderpeopleandtheirassociationwiththeriskofmortalityajointlatentclassmodelanalysisofrealworlddatafromtheukandthenetherlands-2025","author_short":["Elhussein, L.","Williams, R. D.","Man, W. Y.","Burn, E.","Delmestri, A.","Strauss, V. Y.","Prieto-Alhambra, D."],"bibdata":{"bibtype":"article","type":"Journal Article","author":[{"propositions":[],"lastnames":["Elhussein"],"firstnames":["L."],"suffixes":[]},{"propositions":[],"lastnames":["Williams"],"firstnames":["R.","D."],"suffixes":[]},{"propositions":[],"lastnames":["Man"],"firstnames":["W.","Y."],"suffixes":[]},{"propositions":[],"lastnames":["Burn"],"firstnames":["E."],"suffixes":[]},{"propositions":[],"lastnames":["Delmestri"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["Strauss"],"firstnames":["V.","Y."],"suffixes":[]},{"propositions":[],"lastnames":["Prieto-Alhambra"],"firstnames":["D."],"suffixes":[]}],"title":"Longitudinal trajectories of polypharmacy in older people, and their association with the risk of mortality: a joint latent class model analysis of real-world data from the UK and the Netherlands","journal":"Age Ageing","volume":"54","number":"8","note":"1468-2834 Elhussein, Leena Williams, Ross D Orcid: 0000-0001-7723-417x Man, Wai Yi Burn, Edward Orcid: 0000-0002-9286-1128 Delmestri, Antonella Strauss, Victoria Y Prieto-Alhambra, Daniel Orcid: 0000-0002-3950-6346 European Health Data and Evidence Network (EHDEN)/ Journal Article England 2025/08/22 Age Ageing. 2025 Aug 1;54(8):afaf233. doi: 10.1093/ageing/afaf233.","abstract":"OBJECTIVE: Polypharmacy is the use of multiple drugs. Many definitions have been established for polypharmacy, often cross-sectionally, despite it naturally changing over time. In this study, we aimed to identify clusters of older people with distinct polypharmacy trajectories over time and associated mortality risks. We then characterised the identified clusters and assessed their generalisability in two external databases. METHODS: Data were extracted from three primary care databases: the UK Clinical Practice Research Datalink (CPRD) GOLD, CPRD Aurum and the Dutch Integrated Primary Care Information (IPCI). People aged ≥65 on 1 January 2015 were included. Polypharmacy, defined as the cumulative number of prescribed ingredients, was calculated at baseline and at the end of each subsequent follow-up year (2015-19). We applied joint latent class modelling, which divides the population into clusters with different trajectories and associated mortality risks. The model was trained in GOLD and validated in Aurum and IPCI. RESULTS: Four clusters were identified and characterised based on polypharmacy baseline and rate of progression: low-steady, intermediate-slow/increasing, intermediate-fast/increasing and high-decreasing. The high-decreasing cluster had the highest average baseline polypharmacy (intercept = 23.4) and prevalence of non-cancer chronic comorbidities, whilst the intermediate-fast/increasing had the steepest polypharmacy rate of progression per year (slope = 6.4), highest baseline and cumulative incidence of cancer, and worst survival outcome. Good validation was found in Aurum and IPCI. CONCLUSION: High baseline levels and increasing levels of polypharmacy were associated with an increased mortality risk in older people. The clusters identified in this study were externally validated in two European databases, confirming their robustness and generalisability.","keywords":"Humans *Polypharmacy Aged United Kingdom/epidemiology Netherlands/epidemiology Female Male Latent Class Analysis Aged, 80 and over Risk Factors Risk Assessment Databases, Factual *Mortality/trends Age Factors Time Factors Longitudinal Studies joint latent class models longitudinal mortality older people polypharmacy","issn":"0002-0729 (Print) 0002-0729","doi":"10.1093/ageing/afaf233","year":"2025","bibtex":"@article{RN500,\r\n author = {Elhussein, L. and Williams, R. D. and Man, W. Y. and Burn, E. and Delmestri, A. and Strauss, V. Y. and Prieto-Alhambra, D.},\r\n title = {Longitudinal trajectories of polypharmacy in older people, and their association with the risk of mortality: a joint latent class model analysis of real-world data from the UK and the Netherlands},\r\n journal = {Age Ageing},\r\n volume = {54},\r\n number = {8},\r\n note = {1468-2834\r\nElhussein, Leena\r\nWilliams, Ross D\r\nOrcid: 0000-0001-7723-417x\r\nMan, Wai Yi\r\nBurn, Edward\r\nOrcid: 0000-0002-9286-1128\r\nDelmestri, Antonella\r\nStrauss, Victoria Y\r\nPrieto-Alhambra, Daniel\r\nOrcid: 0000-0002-3950-6346\r\nEuropean Health Data and Evidence Network (EHDEN)/\r\nJournal Article\r\nEngland\r\n2025/08/22\r\nAge Ageing. 2025 Aug 1;54(8):afaf233. doi: 10.1093/ageing/afaf233.},\r\n abstract = {OBJECTIVE: Polypharmacy is the use of multiple drugs. Many definitions have been established for polypharmacy, often cross-sectionally, despite it naturally changing over time. In this study, we aimed to identify clusters of older people with distinct polypharmacy trajectories over time and associated mortality risks. We then characterised the identified clusters and assessed their generalisability in two external databases. METHODS: Data were extracted from three primary care databases: the UK Clinical Practice Research Datalink (CPRD) GOLD, CPRD Aurum and the Dutch Integrated Primary Care Information (IPCI). People aged ≥65 on 1 January 2015 were included. Polypharmacy, defined as the cumulative number of prescribed ingredients, was calculated at baseline and at the end of each subsequent follow-up year (2015-19). We applied joint latent class modelling, which divides the population into clusters with different trajectories and associated mortality risks. The model was trained in GOLD and validated in Aurum and IPCI. RESULTS: Four clusters were identified and characterised based on polypharmacy baseline and rate of progression: low-steady, intermediate-slow/increasing, intermediate-fast/increasing and high-decreasing. The high-decreasing cluster had the highest average baseline polypharmacy (intercept = 23.4) and prevalence of non-cancer chronic comorbidities, whilst the intermediate-fast/increasing had the steepest polypharmacy rate of progression per year (slope = 6.4), highest baseline and cumulative incidence of cancer, and worst survival outcome. Good validation was found in Aurum and IPCI. CONCLUSION: High baseline levels and increasing levels of polypharmacy were associated with an increased mortality risk in older people. The clusters identified in this study were externally validated in two European databases, confirming their robustness and generalisability.},\r\n keywords = {Humans\r\n*Polypharmacy\r\nAged\r\nUnited Kingdom/epidemiology\r\nNetherlands/epidemiology\r\nFemale\r\nMale\r\nLatent Class Analysis\r\nAged, 80 and over\r\nRisk Factors\r\nRisk Assessment\r\nDatabases, Factual\r\n*Mortality/trends\r\nAge Factors\r\nTime Factors\r\nLongitudinal Studies\r\njoint latent class models\r\nlongitudinal\r\nmortality\r\nolder people\r\npolypharmacy},\r\n ISSN = {0002-0729 (Print)\r\n0002-0729},\r\n DOI = {10.1093/ageing/afaf233},\r\n year = {2025},\r\n type = {Journal Article}\r\n}\r\n\r\n","author_short":["Elhussein, L.","Williams, R. D.","Man, W. Y.","Burn, E.","Delmestri, A.","Strauss, V. Y.","Prieto-Alhambra, D."],"key":"RN500","id":"RN500","bibbaseid":"elhussein-williams-man-burn-delmestri-strauss-prietoalhambra-longitudinaltrajectoriesofpolypharmacyinolderpeopleandtheirassociationwiththeriskofmortalityajointlatentclassmodelanalysisofrealworlddatafromtheukandthenetherlands-2025","role":"author","urls":{},"keyword":["Humans *Polypharmacy Aged United Kingdom/epidemiology Netherlands/epidemiology Female Male Latent Class Analysis Aged","80 and over Risk Factors Risk Assessment Databases","Factual *Mortality/trends Age Factors Time Factors Longitudinal Studies joint latent class models longitudinal mortality older people polypharmacy"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/network/files/qwipow2DJsAxqNp83","dataSources":["PcZMFHooKwpboi2he","jZMXEeHTfokmisJDv"],"keywords":["humans *polypharmacy aged united kingdom/epidemiology netherlands/epidemiology female male latent class analysis aged","80 and over risk factors risk assessment databases","factual *mortality/trends age factors time factors longitudinal studies joint latent class models longitudinal mortality older people polypharmacy"],"search_terms":["longitudinal","trajectories","polypharmacy","older","people","association","risk","mortality","joint","latent","class","model","analysis","real","world","data","netherlands","elhussein","williams","man","burn","delmestri","strauss","prieto-alhambra"],"title":"Longitudinal trajectories of polypharmacy in older people, and their association with the risk of mortality: a joint latent class model analysis of real-world data from the UK and the Netherlands","year":2025}