The number of medications people take increases with age. By the age of 80, a third of adults are taking 8 or more medications. Taking a greater number of medication increases the risk of side effects, and this is known as problematic polypharmacy. Older people, especially those living with frailty, are at greater risk of problematic polypharmacy. The consequences of this, for some people, can be an increased risk of hospital admission, move into a residential home and even death. As such, GPs and other primary care professionals, are encouraged only to prescribe medications which are necessary, and remove those where risk of harms may outweigh potential benefits.  

Anti-hypertensives and statins are the most commonly prescribed medications, and are ‘cardioprotective medications’, i.e. prescribed to reduce the risk of cardiovascular disease such as heart attacks and strokes, rather than to control symptoms. At present there is very little information available as to what the risks and benefits of continuing these medications are as a person ages. One important consideration is how these medications could affect a person’s mobility, as we know that older people value their physical independence highly. Antihypertensives are known to cause falls, but little is known about how they impact wider mobility problems. Research around statins is conflicting as they may be linked to muscle pain and weakness in a small number of people, but a few small studies have also shown that statins could strengthen muscle fibres. The degree to which anti-hypertensives and statins could affect a person’s mobility may also depend on how frail a person is, as they be more vulnerable to the adverse effects.  

The proposed study will use data from the Oxford Pain Activity and Lifestyle (OPAL) study to give new insights into how antihypertensives and statins may affect mobility in older adults. For the OPAL study 5409 adults aged 65 and older were recruited from general practices around the country. Each participant completed a detailed questionnaire at the start of the study, and then annually. Data collection, at present is complete for the first two years of follow-up, and this will be used for the present study. Questionnaires included detailed information about physical ability and activity, and lifestyle. Nearly all participants (5367/5409, 99.2%)  gave consent for the research team to access their primary care records. In this study we will link OPAL participants to primary care records held in the Oxford-RCGP Research Surveillance Centre repository (ORCHID), most importantly to access their prescription records over the study period. We will then look to understand how medications, particularly anti-hypertensives and statins, are linked to mobility decline over the first 2 years of the study. We will also investigate if the relationship between these medications and mobility is any different in participants living with frailty, as these people may have different vulnerabilities to the effects of medication.