Longitudinal Non-interventional Changes of the FORTA Score are Associated with Changes of Cognitive and Physical Function Tests in Community-Dwelling Older People.
Listing tools were found to ameliorate drug treatment in older people; the FORTA (Fit-fOR-The-Aged) list is a clinically validated positive-negative list of medication appropriateness. Here, we retrospectively analyze longitudinal correlations between the FORTA score and key measures of physical and cognitive function in older people.
504 participants of a multi-center cohort study (AgeCoDe/AgeQualiDe) for whom the FORTA score (sum of over- and under-treatment errors) had been assessed were studied at three follow-up (FU) time points (FU 6-8; mean age range 87.9-89.7 years); comparisons between data at these FUs separated by 10 months were available for 292-328 patients.
The univariate analysis of the association between FORTA_Delta_76 (change of FORTA score between FU 6 and 7) and ADL (Activities of Daily Living)_Delta_76 (- 0.155, p < 0.01) and between FORTA_Delta_76 and MMSE (Mini-Mental State Examination)_Delta_76 (- 0.203, p < 0.01) revealed significant correlations. Multivariable analysis (using a forward selection model, p < 0.05) revealed a significant association between FORTA_Delta_76 and MMSE_Delta_76 (p < 0.05). Univariate analyses for other comparisons were only significant for FORTA_Delta_86 and MMSE_Delta_86.
This study indicates that longitudinal non-interventional changes of the FORTA score as an integral index of medication appropriateness are associated with changes in ADL and MMSE: the lower this score the better the functional outcome. These findings are in line with earlier interventional data and underscore the potential of FORTA to improve clinical endpoints in older people.
504 participants of a multi-center cohort study (AgeCoDe/AgeQualiDe) for whom the FORTA score (sum of over- and under-treatment errors) had been assessed were studied at three follow-up (FU) time points (FU 6-8; mean age range 87.9-89.7 years); comparisons between data at these FUs separated by 10 months were available for 292-328 patients.
The univariate analysis of the association between FORTA_Delta_76 (change of FORTA score between FU 6 and 7) and ADL (Activities of Daily Living)_Delta_76 (- 0.155, p < 0.01) and between FORTA_Delta_76 and MMSE (Mini-Mental State Examination)_Delta_76 (- 0.203, p < 0.01) revealed significant correlations. Multivariable analysis (using a forward selection model, p < 0.05) revealed a significant association between FORTA_Delta_76 and MMSE_Delta_76 (p < 0.05). Univariate analyses for other comparisons were only significant for FORTA_Delta_86 and MMSE_Delta_86.
This study indicates that longitudinal non-interventional changes of the FORTA score as an integral index of medication appropriateness are associated with changes in ADL and MMSE: the lower this score the better the functional outcome. These findings are in line with earlier interventional data and underscore the potential of FORTA to improve clinical endpoints in older people.
Authors
Pazan Pazan, Knorr Knorr, Weiss Weiss, Heser Heser, Pabst Pabst, Luppa Luppa, Wiese Wiese, Bickel Bickel, Weyerer Weyerer, Pentzek Pentzek, König König, Brettschneider Brettschneider, Lühmann Lühmann, Eisele Eisele, Maier Maier, Scherer Scherer, Riedel-Heller Riedel-Heller, Wagner Wagner, Wehling Wehling
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