Multimorbidity, Polypharmacy and Cognitive Assessment Among a Sample of Elderly People in Erbil

Background and objectives: As life expectancy increases and the world's population ages, multimorbidity is becoming more widespread globally, the study aims to evaluate the degree of cognitive impairment and the frequency of polypharmacy and multi-morbidity in elderly patients, as well as the association of cognitive impairment with sociodemographic background, adverse drug reactions, with multimorbidity and polypharmacy. Methods: A cross-sectional study was conducted with 165 elderly patients (who visited Rizgari Teaching Hospital and Brayati Family Primary Health Center in Erbil City, from the first of February 2023 till end of September 2023) were enrolled in this study. The questionnaire included basic demographics, medical, and medication history, and a cognitive assessment. The latter was done using the Mini-Mental State Examination. Results: The results demonstrated that with increasing age, cognitive impairment became more severe (p-value = 0.005). There was more severe cognitive impairment among females (20.2%) compared with males (3.7%). (p-value <0.001). The severity of cognitive impairment was improved among those with higher levels of education. Of those with low socioeconomic status, 35% had severe cognitive impairment in comparison to those with medium socioeconomic status which was 4.8% (p-value <0.001). Of the participants, 92.7% had multimorbidity with no significant association with cognitive impairment (P-value = 0.625). Around one-quarter (24.8%) of participants took 5 or more medications. Some commonly observed adverse drug reactions were observed like: constipation, falling, delirium, difficulty sleeping, urine retention, and vertigo with significant association with cognitive impairment (p-value = 0.021). Conclusion: In this study, it was found that severe cognitive impairment increases with age among the elderly in Erbil, with females and illiterate individuals more affected.