Medication/supplements

Medication and food supplement use

Medication and food supplement use: LASA152 / LASA352
Food supplement use (extended questions): LASA174 / LASA374 (in wave I)

Contact: Natasja van Schoor

Background
Medicines are often prescribed to older individuals. Of the individuals of 55 years and older, over 50% are taking any prescribed medication (1). The proportion of individuals taking any medication is even up to 80% in individuals of 75 years and older (1).

Polypharmacy is often defined as the use of five of more medicines (2) and this is also prevalent in the older population. Polypharmacy is related to adverse outcomes such as nursing home admission adverse drug reaction, falls and fractures (2,3,4).

In addition to prescribed medication, many older individuals are taking over-the-counter food supplements, which may also affect health.

Measurement instruments in LASA
Medication use was assessed during the medical interviews of each wave. Respondents were asked to show their medication containers to the interviewers. Participants were asked to show only the medicines that were prescribed by a physician and that were used in the past two weeks. The name, dose, frequency of intake, and duration of use of every medicine was recorded. In the I-wave, we additionally asked the respondents what food supplements they had used in the previous year. In the J-wave, we asked the respondents which vitamin D supplements (including combination supplements containing vitamin D) they used in the previous year (J-wave is still in execution). In some earlier waves, information on corticosteroid use in the last three years and multivitamin use was asked.

Questionnaires
LASAB152 / LASAC152 / LASAD152 / LASAE152 / LASA2B152 / LASAF152 / LASAG152 / LASAH152 / LAS3B152 / LASMB152 (in preparation) / LASAI152 (medical interview, in Dutch);

LASAI174 (food supplement use: medical interview, in Dutch)

Variable information
LASAB152 / LASAC152 / LASAD152 / LASAE152 / LASA2B152 / LASAF152 / LASAG152 / LASAH152 / LAS3B152 / LASMB152 (in preparation) / LASAI152;
LASAB352 / LASAC352 / LASAD352 / LASAE352 / LAS2B152 / LASAF352 / LASAG352 / LASAH352 / LAS3B352 / LASMB352 (in preparation) / LASI352 (constructed variables)
(pdf)

LASAI174 (food supplement use);
LASAI374 (information about vitamin D use included)
(pdf)

All medications were recoded into ATC codes, which are official international codes, based on indication and substances. In addition, new variables were created containing the user status of several medication groups (user versus non-user). So far, variables were created for anti-depressants, benzodiazepines, oral antidiabetics, insulin, inotropics, antiarrhytmics, nitrates, anti-hypertensive drugs, diuretics, peripheral vasodilators, anti-lipaemics (for the medicines included in the different groups, syntax is available at LASA.

More information on the ATC codes can be found on the website of the World Health Organisation. This website can be used to create additional groups of medicines.

To calculate the total amount of micronutrients from food supplements as assessed at the I-wave, the Dutch Supplement Database (“Nederlandse Supplementen Database”, NES) of the National Institute for Public Health and the Environment (“Rijksinstituut voor Volksgezondheid en Milieu, RIVM) can be used. We have calculated the total amount of vitamin D according to the following procedures (in Dutch, see data description in LASAI374). These procedures can be followed by researchers to calculate other micronutrients. Note: vitamin D prescribed by the doctor is not yet included in the vitamin D variable (see medication file for prescribed vitamin D). In addition, in some cases, the respondent is using more than 6 supplements. In that case the interview report of that respondent should be checked. For more information, contact LASA.

Availability of information per wave1:

 

B

C

D

E


2B*

F

G

H



3B
*

MB*

I

Medication use (including ATC codes)

Me

Me

Me

Me

Me

Me

Me

Me

Me

Me

Me

Medication use (type & combined)

Me

Me

Me

Me

Me

Me

Me

Me

Me

Me

Me

Vitamin use

Me

Me

Me

- - -

Me**

-

Me

Me

Me***
Food supplements - - - - - - - - - - Me***

Corticosteroid use

-

Me

Me

Me

Me

Me

Me

Me

Me

-

-

Bisphosphonates use in last 10 or 3 years

-

Me

Me

Me

- - - - - - -

Ferro tablets
use

Me

Me

Me

-

-

-

-

-

-

-

-

Calcium tablets use

Me

Me

Me

-

-

-

-

-

Me

-

-

Hormone use after menopause

-

-

Me

-

-

-

-

-

-

-

-

1 More information about the LASA data collection waves is available here

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort (Under Construction)

** asked to a subsample of the individuals. Data can be found in LASAge06 (in preparation)
*** in wave I, extended questions about use of (multi)vitamins and other food supplements were asked

Me=data collected in medical interview


Previous use in LASA

  • De Vries OJ, Peeters GMEE, Elders PJM, Sonnenberg CM, Muller MJ, Deeg DJH, Lips, PTA. (2013). The elimination half-life of benzodiazepines and fall risk: two prospective observational studies. Age and Ageing, 42, 764-770.
  • Sohl E, Van Schoor NM, De Jongh RT, De Vries OJ, Lips PTA. (2012). The impact of medication on vitamin D status in older individuals. Eur J Endocrinol 166, 477-485.
  • Sonnenberg CM, Bierman EJM, Deeg DJH, Comijs HC, Van Tilburg W, Beekman ATF. (2012). Ten-year trends in benzodiazepine use in the Dutch population. Social Psychiatry & Psychiatric Epidemiology, 47, 293-301.
  • Sonnenberg CM, Deeg DJH, Comijs HC, Van Tilburg W, Beekman ATF (2008). Trends in antidepressant use in the older population: Results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 111, 299-305.
  • Bierman EJM, Comijs HC, Gundy CM, Sonnenberg CM, Jonker C, Beekman ATF (2007). The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent? International Journal of Geriatric Psychiatry, 22, 1194-1200.
  • Sonnenberg CM, Beekman ATF, Deeg DJH, Van Tilburg W (2003). Drug treatment in depressed elderly in the Dutch community. International Journal of Geriatric Psychiatry, 18, 99-104.

References

  1. www.cbs.nl.
  2. Richardson et al. Variation over Time in the Association between Polypharmacy and Mortality in the Older Population. Drugs Aging 2011:28 (7): 547-560.
  3. Fulton et al. Polypharmacy in the elderly: a literature review. J Am. Acad. Nurse pract. 2005 Apr: 17 (4): 123-32.
  4. Frazier et al. Healty outcomes and polypharmacy in elderly individuals: an integrated literature review. J Gerontology Nurs 2005 Sep; 31 (9): 4-11.