{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:36:27Z","timestamp":1791549387590,"version":"4.3.4"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AG080021"],"award-info":[{"award-number":["K24AG080021"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG059183"],"award-info":[{"award-number":["R01AG059183"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK133527"],"award-info":[{"award-number":["R01DK133527"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30DK026743"],"award-info":[{"award-number":["P30DK026743"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32DK060414"],"award-info":[{"award-number":["T32DK060414"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multimorbidity and polypharmacy are common in older adults with cardiometabolic diseases, but their burden in metabolic dysfunction-associated steatotic liver disease (MASLD) is less understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize multimorbidity and polypharmacy among older adults with MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults\u2009\u2265\u200965\u00a0years with transient elastography data in NHANES 2017\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>MASLD was defined as steatosis plus\u2009\u2265\u20091 metabolic risk factor; polypharmacy was\u2009\u2265\u20095 medications. Participants were stratified by age (65\u201369, 70\u201374, and\u2009\u2265\u200975\u00a0years). Survey-weighted analyses evaluated age and polypharmacy in MASLD and non-MASLD adults. Multivariable models adjusted for comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      An estimated 42 million US adults\u2009\u2265\u200965\u00a0years were included, 39.8% had MASLD. The proportion of women with MASLD decreased with age (55.5 to 39.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Diabetes, obesity, and cardiometabolic burden were higher in MASLD across all age groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Polypharmacy was most common in MASLD adults\u2009\u2265\u200975\u00a0years (60.3%), exceeding younger MASLD adults (36.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and non-MASLD peers (42.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). MASLD adults had higher antidiabetic but lower antihypertensive use (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). MASLD adults\u2009\u2265\u200975\u00a0years had over three times the odds of polypharmacy versus those 65\u201369\u00a0years (aOR 3.12, 95%CI 2.21\u20134.42).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older adults with MASLD\u2009\u2265\u200975\u00a0years face a significant and independent burden of polypharmacy. This challenge is especially salient in MASLD, where aggressive management of cardiometabolic comorbidities is essential to preventing disease progression and non-liver mortality, yet the medications used may heighten geriatric vulnerabilities. Age-appropriate medication review, deprescribing, and goal concordant care are critical to navigating this tension in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10624-y","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:27:58Z","timestamp":1784046478000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Polypharmacy Among Older Adults with Metabolic Dysfunction\u2013Associated Steatotic Liver Disease"],"prefix":"10.1007","author":[{"given":"Melinda","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Usman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Covinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"5","key":"10624_CR1","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","volume":"77","author":"ME Rinella","year":"2023","unstructured":"Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, et al. 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Lai receives research support (to institution) from Lipocene and Gore Medical; serves on an advisory board for Boehringer Ingelheim, Cosmo; and consults for Novo Nordisk.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}