Physical activity to mitigate polypharmacy in multimorbid elderly: a scoping review

Abstract Background Chronic health issues are becoming the primary healthcare burden, leading to a rise in elderly individuals living with multimorbidity (MM). MM nearly always leads to polypharmacy (PPha), with an overall prevalence of 26.3-39.9% in elderly Europeans in 2018. PPha increases healthcare costs and can lead to adverse consequences like falls, readmissions and death. To face this, physical activity (PA) is crucial as a preventive and therapeutic tool. PA has been found to be as effective as medications in preventing diabetes, certain types of cancers, anxiety, depression and coronary heart disease. PA also positively affects adherence to medication regimens and enhances the elderly's quality of life (QoL) and mental well-being. Methods This study follows the methodological steps of Joanna Briggs Institute for scoping reviews. We searched Medline via PubMed, Web of Science and Scopus. The PRISMA Extension for Scoping Reviews was used for reporting. Results Six cross-sectional studies were included; five measured PA by questionnaires and one through accelerometers. MM affected from 33% to 100% of participants; all results were adjusted for confounders. Prevalence of PPha ranged from 25.9% to 57.7%. All of them showed an inverse association between PA and PPha, irrespective of the definition of PPha and the PA assessment method employed. Conclusions Findings revealed a promising inverse association between PA and PPha in multimorbid elders. Here arises a significant opportunity to design and implement specialized PA multicomponent and multilevel programs for multimorbid elders with PPha. Such programs could provide essential education on the benefits of PA, personalized exercise routines, guidance on proper medication management, and regular health monitoring. Such a holistic approach not only addresses the physical aspect of health but also promotes mental well-being, social interaction, and overall QoL for older adults facing the challenges of MM and PPha. Key messages • This study highlights how physical activity can significantly reduce polypharmacy in multimorbid older adults, promoting better health outcomes and QoL while minimizing medication-related risks. • The lack of studies, RCT in particular, shows the necessity of implementing community programs of physical activity to reduce the polypharmacy burden and healthcare costs among multimorbid elders.