{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:46:18Z","timestamp":1791960378804,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K14493"],"award-info":[{"award-number":["25K14493"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Drugs - Real World Outcomes"],"DOI":"10.1007\/s40801-026-00589-z","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:36:34Z","timestamp":1791826594000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Polypharmacy and Activities of Daily Living in Older Patients Undergoing Cerebrovascular Rehabilitation: An Observational Study Using Japanese Real-World Data"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3118-4135","authenticated-orcid":false,"given":"Yukari","family":"Ogawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5465-4531","authenticated-orcid":false,"given":"Takeshi","family":"Horii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9825-6623","authenticated-orcid":false,"given":"Masaharu","family":"Sakoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4092-4344","authenticated-orcid":false,"given":"Kiyoshi","family":"Mihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"589_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107150","author":"T Shimomura","year":"2023","unstructured":"Shimomura T, Kawakami M, Yamada Y, Ito D, Miyazaki Y, Mori N, et al. Impacts of increases and decreases of drugs on rehabilitation outcomes of subacute stroke patients. J Stroke Cerebrovasc Dis. 2023. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2023.107150.","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"589_CR2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.11336\/jjcrs.13.41","volume":"13","author":"A Matsumoto","year":"2022","unstructured":"Matsumoto A, Yoshimura Y, Shimazu S, Nagano F, Bise T, Kido Y, et al. Association of polypharmacy at hospital discharge with nutritional intake, muscle strength, and activities of daily living among older patients undergoing convalescent rehabilitation after stroke. Jpn J Compr Rehabil Sci. 2022;13:41\u20138. https:\/\/doi.org\/10.11336\/jjcrs.13.41.","journal-title":"Jpn J Compr Rehabil Sci"},{"key":"589_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-30331-8","author":"W Chimyaem","year":"2025","unstructured":"Chimyaem W, Choksomngam Y, Buawangpong N, Yingchankul N, Pinyopornpanish K. Prevalence and association of fall-risk-increasing drugs (FRIDs) with fall-related head and non-head injuries in older adults: a retrospective database study. Sci Rep. 2025. https:\/\/doi.org\/10.1038\/s41598-025-30331-8.","journal-title":"Sci Rep"},{"issue":"1","key":"589_CR4","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s40520-015-0359-7","volume":"28","author":"A Collamati","year":"2016","unstructured":"Collamati A, Martone AM, Poscia A, Brandi V, Celi M, Marzetti E, et al. Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence. Aging Clin Exp Res. 2016;28(1):25\u201335. https:\/\/doi.org\/10.1007\/s40520-015-0359-7.","journal-title":"Aging Clin Exp Res"},{"key":"589_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06504-5","author":"A Selcuk","year":"2025","unstructured":"Selcuk A, Atmis V, Sen S, Gemci E, Yurumez B, Yalcin A, et al. Anticholinergic and sedative medications use among community dwelling older adults: risk for polypharmacy and poor physical function. BMC Geriatr. 2025. https:\/\/doi.org\/10.1186\/s12877-025-06504-5.","journal-title":"BMC Geriatr"},{"issue":"5","key":"589_CR6","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/0003-9993(93)90119-u","volume":"74","author":"TA Dodds","year":"1993","unstructured":"Dodds TA, Martin DP, Stolov WC, Deyo RA. A validation of the functional independence measurement and its performance among rehabilitation inpatients. Arch Phys Med Rehabil. 1993;74(5):531\u20136. https:\/\/doi.org\/10.1016\/0003-9993(93)90119-u.","journal-title":"Arch Phys Med Rehabil"},{"key":"589_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2025.105840","author":"J Jerez-Roig","year":"2025","unstructured":"Jerez-Roig J, Bezerra de Souza DL, Baena CP, Bertoldi K, Gomes Dantas AA, Bernardelli RS. Independent functioning among the oldest-old in 27 European countries: a cross-sectional analysis of the SHARE study. J Am Med Dir Assoc. 2025. https:\/\/doi.org\/10.1016\/j.jamda.2025.105840.","journal-title":"J Am Med Dir Assoc"},{"key":"589_CR8","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06606-0","author":"Y Ogawa","year":"2025","unstructured":"Ogawa Y, Sakoh M, Nibe F, Mihara K. Polypharmacy and functional decline in activities of daily living in older rehabilitation inpatients: a retrospective observational study. BMC Geriatr. 2025. https:\/\/doi.org\/10.1186\/s12877-025-06606-0.","journal-title":"BMC Geriatr."},{"issue":"4","key":"589_CR9","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1007\/s40520-020-01591-3","volume":"33","author":"T Tachi","year":"2021","unstructured":"Tachi T, Otsubo M, Toyoshima M, Murayama A, Katsuno H, Ueno A, et al. The association between polypharmacy and the efficiency of the functional independence measure in an acute-stage hospital: a retrospective cohort study. Aging Clin Exp Res. 2021;33(4):983\u201390. https:\/\/doi.org\/10.1007\/s40520-020-01591-3.","journal-title":"Aging Clin Exp Res"},{"issue":"1","key":"589_CR10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/ggi.15001","volume":"25","author":"F Mizokami","year":"2025","unstructured":"Mizokami F, Mizuno T, Taguchi R, Nasu I, Arai S, Higashi K, et al. Development of the Japanese anticholinergic risk scale: English translation of the Japanese article. Geriatr Gerontol Int. 2025;25(1):5\u201313. https:\/\/doi.org\/10.1111\/ggi.15001.","journal-title":"Geriatr Gerontol Int"},{"key":"589_CR11","unstructured":"Ministry of Health, Labour and Welfare. Appendix 1-3: Remuneration Table for Dispensing [Japanese] chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/https:\/\/www.mhlw.go.jp\/content\/12404000\/000894875.pdf Accessed 21 Jan 2026."},{"issue":"4","key":"589_CR12","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1111\/j.1447-0594.2012.00868.x","volume":"12","author":"T Kojima","year":"2012","unstructured":"Kojima T, Akishita M, Kameyama Y, Yamaguchi K, Yamamoto H, Eto M, et al. High risk of adverse drug reactions in elderly patients taking six or more drugs: analysis of inpatient database. Geriatr Gerontol Int. 2012;12(4):761\u20132. https:\/\/doi.org\/10.1111\/j.1447-0594.2012.00868.x.","journal-title":"Geriatr Gerontol Int"},{"issue":"6","key":"589_CR13","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/0003-9993(93)90153-2","volume":"74","author":"AW Heinemann","year":"1993","unstructured":"Heinemann AW, Linacre JM, Wright BD, Hamilton BB, Granger C. Relationships between impairment and physical disability as measured by the functional independence measure. Arch Phys Med Rehabil. 1993;74(6):566\u201373.","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"589_CR14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.3138\/ptc.2017-82","volume":"70","author":"G Bravo","year":"2018","unstructured":"Bravo G, Richards CL, Corriveau H, Trottier L. Converting functional autonomy measurement system scores of patients post-stroke to FIM scores. Physiother Can. 2018;70(4):349\u201355. https:\/\/doi.org\/10.3138\/ptc.2017-82.","journal-title":"Physiother Can"},{"key":"589_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2025.07.010","author":"H Arai","year":"2025","unstructured":"Arai H, Nozoe M, Kamiya K, Fukuoka T, Matsumoto S. Impacts of ACC\/AHA stage A, B, and C heart failure on improvement efficiency in activities of daily living in individuals with disabilities who underwent inpatient rehabilitation. Arch Phys Med Rehabil. 2025. https:\/\/doi.org\/10.1016\/j.apmr.2025.07.010.","journal-title":"Arch Phys Med Rehabil."},{"issue":"36","key":"589_CR16","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599\u2013726. https:\/\/doi.org\/10.1093\/eurheartj\/ehab368.","journal-title":"Eur Heart J"},{"issue":"8","key":"589_CR17","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1253\/circj.CJ-25-0002","volume":"89","author":"T Kitai","year":"2025","unstructured":"Kitai T, Kohsaka S, Kato T, Kato E, Sato K, Teramoto K, et al. JCS\/JHFS 2025 guideline on diagnosis and treatment of heart failure. Circ J. 2025;89(8):1278\u2013444. https:\/\/doi.org\/10.1253\/circj.CJ-25-0002.","journal-title":"Circ J"},{"key":"589_CR18","doi-asserted-by":"publisher","DOI":"10.1155\/srat\/2381790","author":"S Hanaoka","year":"2024","unstructured":"Hanaoka S, Iwabuchi K, Hirai T, Seki T, Hayashi H. Effect of increasing or decreasing use of polypharmacy on recovery of activities of daily living in patients with stroke in the recovery-phase rehabilitation ward: a retrospective cohort study using propensity score matching. Stroke Res Treat. 2024. https:\/\/doi.org\/10.1155\/srat\/2381790.","journal-title":"Stroke Res Treat"},{"key":"589_CR19","doi-asserted-by":"publisher","unstructured":"By the American Geriatrics Society Beers Criteria Update Expert P. American Geriatrics Society 2023 updated AGS Beers Criteria(R) for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052\u201381. https:\/\/doi.org\/10.1111\/jgs.18372.","DOI":"10.1111\/jgs.18372"}],"container-title":["Drugs - Real World Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40801-026-00589-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40801-026-00589-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40801-026-00589-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:02:21Z","timestamp":1791957741000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40801-026-00589-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":19,"alternative-id":["589"],"URL":"https:\/\/doi.org\/10.1007\/s40801-026-00589-z","relation":{},"ISSN":["2199-1154","2198-9788"],"issn-type":[{"value":"2199-1154","type":"print"},{"value":"2198-9788","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"28 September 2026","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Board of Musashino University determined that this study was exempt from ethical review (reference number: R7-8) because all data were fully anonymized and contained no personally identifiable information, consistent with the characteristics of diagnosis procedure combination-based clinical databases.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}