The study's objective is to determine the impact of inappropriate prescribing on health-related outcomes for community dwelling elderly. Inappropriate prescribing is defined by two different criteria: 1) inappropriate medication use as defined by Beers et. al. (1991); 2) inappropriate medication use criteria developed under contract to HCFA in response to the Medicare Catastrophic Coverage Act of 1988. Outcomes measured include functional status (as measured by basic and instrumental activities of daily living, and mobility), health services utilization (hospitalization, institutionalization, emergency room and physician office visits) and associated costs, and mortality. Investigators plan to examine whether the relationship between inappropriate prescribing and outcomes are affected by factors such as age, gender, race, urban/rural residence and comorbidities. A longitudinal design that is population based will be used. The specific hypotheses to be tested are that, compared with elders not receiving inappropriate prescriptions, elderly participants with inappropriate prescribing will have greater functional decline, increased utilization of health services, higher costs and increased likelihood of death after controlling for important covarites (e.g. comorbidities). The study will analyze a pre-existing data set from the National Institute on Aging (NIA)-funded Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE).
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