Psychotropic polypharmacy impairs walking independence in post-stroke patients.

Purpose: Psychotropic drugs are associated with adverse outcomes in older adults. However, evidence on the effect of psychotropic use on walking ability in post-stroke patients is lacking. This study examined the association between psychotropic medication use and walking independence in post-stroke...

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Publicado en:European Journal of Clinical Pharmacology Vol. 81; no. 6; pp. 831 - 839
Autores principales: Matsumoto, Ayaka, Yoshimura, Yoshihiro, Nagano, Fumihiko, Shimazu, Sayuri, Bise, Takahiro, Kido, Yoshifumi, Shiraishi, Ai, Kuzuhara, Aomi, Hamada, Takenori, Yoneda, Kouki
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
      vid: 81
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-025-03833-7
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        atl: Psychotropic polypharmacy impairs walking independence in post-stroke patients.
      aug:
        au:
          Matsumoto, Ayaka
          Yoshimura, Yoshihiro
          Nagano, Fumihiko
          Shimazu, Sayuri
          Bise, Takahiro
          Kido, Yoshifumi
          Shiraishi, Ai
          Kuzuhara, Aomi
          Hamada, Takenori
          Yoneda, Kouki
        affil: https://ror.org/00zpddd51 Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuchi-County, 760 Magate, Kikuyo-Town, 869-1106, Kumamoto, Japan
      sug:
        subj:
          Stroke Rehabilitation
          Stroke Patients
          Psychotropic Drugs Therapeutic Use
          Polypharmacy
          Walking Evaluation
          Functional Assessment
          Human
          Female
          Male
          Aged
          Funding Source
          Retrospective Design
          Logistic Regression
          Hypnotics and Sedatives Adverse Effects
          Descriptive Statistics
          Prospective Studies
          Inpatients
          Japan
          Clinical Assessment Tools
          Aged: 65+ years
          Female
          Male
      ab: Purpose: Psychotropic drugs are associated with adverse outcomes in older adults. However, evidence on the effect of psychotropic use on walking ability in post-stroke patients is lacking. This study examined the association between psychotropic medication use and walking independence in post-stroke patients. Methods: This retrospective cohort study included stroke patients admitted for convalescent rehabilitation at a Japanese hospital between 2020 and 2022. Psychotropic medications (benzodiazepines, hypnotics, antipsychotics, and antidepressants) prescribed at admission were recorded. The primary outcome was walking independence at discharge, defined as a Functional Independence Measure (FIM) walk score ≥ 6. Logistic regression analyses examined the association between the number of psychotropic drugs and walking independence, adjusting for potential confounders. Results: Of the 709 patients enrolled, 559 (mean age 75.5 years, 52.8% male) were included in the analysis. At admission, 25.4% of patients used psychotropic drugs. In the adjusted analysis, the number of psychotropic medications was independently associated with lower walking independence at discharge (OR 0.620, 95% CI 0.428–0.897, P = 0.011). Hypnotic use specifically showed a negative impact on walking independence (OR 0.331, 95% CI 0.154–0.708, P = 0.004). However, psychotropic drug use was not significantly associated with improvement in FIM-motor scores. Conclusion: Psychotropic polypharmacy at admission, particularly with hypnotics, was associated with reduced likelihood of achieving walking independence after stroke rehabilitation. Judicious use of psychotropic medications may be warranted when ambulation is a critical goal for older post-stroke patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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