ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicOptimizing Medication Management in Older Adults: Addressing Polypharmacy, Deprescribing and Represcribing ChallengesView all 8 articles
The Association of Polypharmacy with Intrinsic Capacity: An Analysis of the WHO ICOPE Pilot Data from Lianyungang, China
Provisionally accepted
- 1The Second Hospital of Shandong University, Jinan, China
- 2Lanzhou University First Hospital, Lanzhou, China
- 3Lianyungang Oriental Hospital, Lianyungang, China
- 4Lianyungang No 1 People's Hospital, Lianyungang, China
- 5Ganyun County Traditional Chinese Medicine Hospital, Lian yun gang, China
- 6Haizhou District Puxi Community Health Service Center, Lian yun gang, China
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Objective: As a core indicator of healthy aging, intrinsic capacity (IC) may be adversely impacted by polypharmacy. Leveraging data from the WHO Integrated Care for Older People (ICOPE) pilot in China, this study examines the association between polypharmacy and IC decline in older adults, aiming to provide evidence-based insights for optimizing geriatric pharmacotherapy. Methods: A cross-sectional analysis was conducted using data from community-dwelling and institutionalized adults aged ≥60 years enrolled at the Lianyungang (LYG) pilot site of the WHO ICOPE China program.Medication histories, demographic characteristics, lifestyle factors, and chronic disease profiles were collected via structured questionnaires. The WHO ICOPE screening tool was employed to assess five IC domains: cognition, mobility, sensory function, nutrition, and psychology. Polypharmacy was defined as concurrent use of ≥5 medications. Multivariable logistic regression models evaluated the polypharmacy-IC decline association, with stratification analyses assessing subgroup heterogeneity. Results: The study enrolled 467 participants, comprising a polypharmacy cohort (≥5 medications, n=33) and a non-polypharmacy cohort (n=434). Mean IC score was 3.5±1.5. In unadjusted analyses, polypharmacy is associated with greater odds of IC decline(OR=2.81, 95% CI: 1.06–7.43, p=0.037). This association persisted in Model 1 (demographic-adjusted: OR=2.82, 95% CI: 1.05–7.56, p=0.039), Model 2 (socioeconomic-adjusted: OR=3.65, 95% CI: 1.33–9.98, p=0.012), and Model 3 (functional/geriatric-adjusted: OR=3.23, 95% CI: 1.13–9.28, p=0.029). However, in the fully adjusted Model 4 (including comorbidities), the OR attenuated to 2.31 (95% CI: 0.77–6.88, p=0.134), retaining a positive but non-significant association. After full covariate adjustment, each additional medication was associated with a 22% increase in the likelihood of IC decline (OR=1.22, 95% CI: 1.01–1.47, p=0.04). Patients with IC decline demonstrated significantly higher medication counts than those with preserved IC (p<0.05). Stratified analyses confirmed stable associations across subgroups (all interaction p>0.05). Conclusion: An increase in the number of medications used by older adults may be positively associated with a decline in intrinsic capacity (IC). The prevalence of IC decline is significantly higher among individuals taking ≥5 medications compared to those using fewer medications. These findings suggest that polypharmacy is associated with IC decline and could serve as a potential indicator for IC decline.
Keywords: Polypharmacy, Intrinsic capacity (IC), older adults, ICOPE, Integrated Care
Received: 26 Jul 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Yun, wang, Gao, Gu, Sun, Xia, Jiang, Zhang and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jia Ming Xia, 1304870813@qq.com
Yan Dong, dylzu_lnyx@163.com
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