Grant: Catalyst Grant: Analysis of CLSA Data

Polypharmacy, defined as daily use of multiple prescribed medications, has been reported in one in four Canadian older adults (aged 65 years and older), and it is linked to poor health outcomes, including hospitalizations and death. Use of medications such as opioids and benzodiazepines in older adults is increasing, and it remains a concern due to the risk of falls and fractures linked with their use. Reasons for such high rates of polypharmacy and opioid and benzodiazepine use (henceforward referred to as adverse medication use) are not entirely known. Loneliness, defined as a perception of being alone and isolated, affects about one in ten community-dwelling adults in Canada. It is associated with substance use disorder and smoking. Our previous work found that loneliness was associated with an increased with 60% odds of daily use of opioids and benzodiazepines and 20% odds of polypharmacy in older adults (aged 65 years and older). This project will build on our prior work by 1) using data as recent as 2018 compared to our previous findings based on data collected in 2008-09, 2) establishing temporality between loneliness and adverse medication use using longitudinal data, and 3) identifying factors associated with adverse medication use among lonely adults to help identify at-risk individuals. The Canadian Longitudinal Study of Aging provides us with the necessary information to answer our research questions, and we have already obtained the necessary approvals to undertake this research. Our team has advanced experience in epidemiological and health services methods. Our work will help healthcare providers to improve screening for loneliness among adults who are on polypharmacy or have high cumulative use of opioids or benzodiazepines. In turn, it will help develop methods to mitigate the effects of loneliness on adverse medication use, along with their attendant health effects.