Self-Reported Prescription Drug Use for Pain Relief and Sleep Linked to Frailty. Interview with:
Andrew W Bergen, PhD
Senior Scientist
Oregon Research Institute
Eugene, OR 97403

Dr. Bergen  What is the background for this study?

Response: The background to the study is examination of the incident frailty risks of two classes of prescription drugs commonly co-prescribed in response to pain and sleep indications.

The dataset consisted of N=7,201 non-frail, age 65+, community-living individuals from the Health and Retirement Study, a nationally representative longitudinal cohort interviewed every two years.

The drug exposure measures are based on responses to the two questions: “Do you regularly take prescription medications for any of the following common health problems:

For pain in your joints or muscles?” and “Do you regularly take prescription medications for any of the following common health problems: To help you sleep?”.

The outcome measure was the Burden Model of frailty using the conventional threshold of >0.2 for frailty. What are the main findings?

Response: The main findings are that the hazard ratio for incident frailty for those responding yes to both questions versus those responding no to both questions was 1.95 95%CI 1.57-2.43, P<.001.

These results are based on analyses adjusted for demographics and other drug use, and for the competing risk of death.

This corresponds to cumulative incident rates of frailty after 8 years in this non-frail (at baseline) sample for co-use 60.6% versus 34.1% for no use in this sample.

The hazard ratios for regular prescription drug use for pain or for sleep are lower, but still significantly greater than no-use. What should readers take away from your report?

Response: The implications of these findings are that regular use of prescription drug use for pain and for sleep have long term risks to the chronic diseases and to the cognitive and physical functions that make up frailty.

Limitations of the analyses include self-reported prescription drug use and lack of specificity of drug exposures. As single and concomitant prescribing for these prescription drug classes is common in the 65+ population, we recommend further research into both pain and sleep indications and prescription drug risks to frailty. Is there anything else you would like to add?

Response: The Health and Retirement Study is sponsored by the National Institute on Aging (grant U01AG009740) and is conducted by the University of Michigan (

We gratefully acknowledge the Health and Retirement Study for access to its data, the respondents whose data made this study possible, and the many research groups who have performed and published analyses using the HRS. We gratefully acknowledge RAND for access to its easy-to-use RAND HRS Longitudinal File based on the HRS core data. This file was developed at RAND with funding from the National Institute on Aging and the Social Security Administration. We gratefully acknowledge support for data analysis from the Oregon Research Institute (GOPBZ). We are grateful to the deputy editor and to two anonymous reviewers whose helpful and knowledgeable comments and suggestions have improved this analysis.

Conflict of Interest: The authors have declared no conflicts of interest for this article.


J Am Geriatr Soc. 2019 Oct 24. doi: 10.1111/jgs.16214. [Epub ahead of print]
Self-Reported Prescription Drug Use for Pain and for Sleep and Incident Frailty.
Cil G1, Park J2, Bergen AW1.
1.Oregon Research Institute, Eugene.
2 Florida Atlantic University Phyllis and Harvey Sandler School of Social Work, Boca Raton, Florida.

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