{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T03:03:19Z","timestamp":1794279799839,"version":"4.9.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"DOI":"10.1186\/s12889-025-25474-2","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:27:41Z","timestamp":1764077261000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The association between polypharmacy and quality of life in elderly population in Southern Iran: Bushehr Elderly Health (BEH) Program"],"prefix":"10.1186","volume":"25","author":[{"given":"Yasaman","family":"Zarinfar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-7043","authenticated-orcid":false,"given":"Nekoo","family":"Panahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razieh","family":"Shojaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Hosseinpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iraj","family":"Nabipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bagher","family":"Larijani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noushin","family":"Fahimfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Ostovar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"25474_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12877-017-0621-2","volume":"17","author":"N Masnoon","year":"2017","unstructured":"Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17:1\u201310.","journal-title":"BMC Geriatr"},{"issue":"9836","key":"25474_CR2","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0140-6736(12)60240-2","volume":"380","author":"K Barnett","year":"2012","unstructured":"Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37\u201343.","journal-title":"Lancet"},{"issue":"4","key":"25474_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics5040085","volume":"5","author":"P Aggarwal","year":"2020","unstructured":"Aggarwal P, Woolford SJ, Patel HP. Multi-morbidity and polypharmacy in older people: challenges and opportunities for clinical practice. Geriatrics. 2020;5(4):85.","journal-title":"Geriatrics"},{"issue":"1","key":"25474_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03279-x","volume":"22","author":"M Delara","year":"2022","unstructured":"Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatr. 2022;22(1):601.","journal-title":"BMC Geriatr"},{"issue":"8","key":"25474_CR5","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5880","volume":"33","author":"Z Wang","year":"2024","unstructured":"Wang Z, Liu T, Su Q, Luo H, Lou L, Zhao L, et al. Prevalence of polypharmacy in elderly population worldwide: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf. 2024;33(8):e5880.","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"1","key":"25474_CR6","first-page":"e131304","volume":"21","author":"R Ebrahimoghli","year":"2022","unstructured":"Ebrahimoghli R, Janati A, Gharaee H, Aghaei MH. Polypharmacy pattern in iran: A comprehensive analysis of a large prescription database. Iran J Pharm Res. 2022;21(1):e131304.","journal-title":"Iran J Pharm Res"},{"issue":"1","key":"25474_CR7","first-page":"112","volume":"8","author":"K Hacker","year":"2024","unstructured":"Hacker K. The burden of chronic disease. Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2024;8(1):112\u20139.","journal-title":"Mayo Clinic Proceedings: Innovations, Quality & Outcomes"},{"issue":"3","key":"25474_CR8","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/0885-3924(94)90129-5","volume":"9","author":"DF Cella","year":"1994","unstructured":"Cella DF. Quality of life: concepts and definition. J Pain Symptom Manage. 1994;9(3):186\u201392.","journal-title":"J Pain Symptom Manage"},{"issue":"3","key":"25474_CR9","first-page":"534","volume":"14","author":"E Jazayeri","year":"2023","unstructured":"Jazayeri E, Kazemipour S, Hosseini SR, Radfar M. Quality of life in the elderly: a community study. Caspian J Intern Med. 2023;14(3):534.","journal-title":"Caspian J Intern Med"},{"key":"25474_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-020-09920-x","volume":"20","author":"P Zaninotto","year":"2020","unstructured":"Zaninotto P, Huang Y-T, Di Gessa G, Abell J, Lassale C, Steptoe A. Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English longitudinal study of ageing. BMC Public Health. 2020;20:1\u20137.","journal-title":"BMC Public Health"},{"key":"25474_CR11","doi-asserted-by":"publisher","unstructured":"Van Wilder L, Devleesschauwer B, Clays E, Pype P, Vandepitte S, De Smedt D. Peer reviewed: polypharmacy and health-related quality of life\/psychological distress among patients with chronic disease. Prev Chronic Dis. 2022;19:E50. https:\/\/doi.org\/10.5888\/pcd19.220062.","DOI":"10.5888\/pcd19.220062"},{"issue":"9","key":"25474_CR12","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1007\/s11136-022-03136-9","volume":"31","author":"MS Aljeaidi","year":"2022","unstructured":"Aljeaidi MS, Haaksma ML, Tan EC. Polypharmacy and trajectories of health-related quality of life in older adults: an Australian cohort study. Qual Life Res. 2022;31(9):2663\u201371.","journal-title":"Qual Life Res"},{"key":"25474_CR13","doi-asserted-by":"publisher","unstructured":"Hung A, Kim YH, Pavon JM. Deprescribing in older adults with polypharmacy. BMJ. 2024;385:e074892.\u00a0https:\/\/doi.org\/10.1136\/bmj-2023-074892.","DOI":"10.1136\/bmj-2023-074892"},{"issue":"8","key":"25474_CR14","doi-asserted-by":"publisher","first-page":"e097863","DOI":"10.1136\/bmjopen-2024-097863","volume":"15","author":"SM-N Ataei","year":"2025","unstructured":"Ataei SM-N, Golestani A, Khosravi S, Tabatabaei-Malazy O, Malekpour M-R, Ebrahimpur M, et al. Medication use patterns and polypharmacy among elderly in iran: a cross-sectional study using National health insurance claims data. BMJ Open. 2025;15(8):e097863.","journal-title":"BMJ Open"},{"issue":"12","key":"25474_CR15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009597","volume":"5","author":"A Ostovar","year":"2015","unstructured":"Ostovar A, Nabipour I, Larijani B, Heshmat R, Darabi H, Vahdat K, et al. Bushehr elderly health (BEH) programme, phase I (cardiovascular system). BMJ Open. 2015;5(12):e009597.","journal-title":"BMJ Open"},{"issue":"8","key":"25474_CR16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013606","volume":"7","author":"G Shafiee","year":"2017","unstructured":"Shafiee G, Ostovar A, Heshmat R, Darabi H, Sharifi F, Raeisi A, et al. Bushehr elderly health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open. 2017;7(8):e013606.","journal-title":"BMJ Open"},{"key":"25474_CR17","volume":"28","author":"AH Mehraban","year":"2014","unstructured":"Mehraban AH, Soltanmohamadi Y, Akbarfahimi M, Taghizadeh G. Validity and reliability of the Persian version of Lawton instrumental activities of daily living scale in patients with dementia. Med J Islamic Repub Iran. 2014;28:25.","journal-title":"Med J Islamic Repub Iran"},{"issue":"6","key":"25474_CR18","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1159\/000313981","volume":"29","author":"M Barekatain","year":"2010","unstructured":"Barekatain M, Walterfang M, Behdad M, Tavakkoli M, Mahvari J, Maracy M, et al. Validity and reliability of the Persian Language version of the neuropsychiatry unit cognitive assessment tool. Dement Geriatr Cogn Disord. 2010;29(6):516\u201322.","journal-title":"Dement Geriatr Cogn Disord"},{"issue":"9","key":"25474_CR19","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1017\/S1368980010000303","volume":"13","author":"B Amirkalali","year":"2010","unstructured":"Amirkalali B, Sharifi F, Fakhrzadeh H, Mirarefin M, Ghaderpanahi M, Larijani B. Evaluation of the mini nutritional assessment in the elderly, Tehran, Iran. Public Health Nutr. 2010;13(9):1373\u20139.","journal-title":"Public Health Nutr"},{"key":"25474_CR20","unstructured":"Kelishadi R, Rabiei K, Khosravi A, Famouri F, Sadeghi M, Rouhafza H, Shirani S. Assessment of physical activity of adolescents in Isfahan. 2001:55\u201366.\u00a0https:\/\/www.sid.ir\/paper\/58480\/en."},{"key":"25474_CR21","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1590\/2237-6089-2017-0116","volume":"40","author":"M Dadfar","year":"2018","unstructured":"Dadfar M, Kalibatseva Z, Lester D. Reliability and validity of the Farsi version of the patient health Questionnaire-9 (PHQ-9) with Iranian psychiatric outpatients. Trends Psychiatry Psychother. 2018;40:144\u201351.","journal-title":"Trends Psychiatry Psychother"},{"key":"25474_CR22","doi-asserted-by":"publisher","unstructured":"Turner-Bowker D, Hogue SJ. Short form 12 health survey (SF-12). In: encyclopedia of quality of life and well-being research. edn. Edited by Michalos AC. Dordrecht: Springer Netherlands; 2014: 5954\u20137. https:\/\/doi.org\/10.1007\/978-94-007-0753-5_2698.","DOI":"10.1007\/978-94-007-0753-5_2698"},{"issue":"3","key":"25474_CR23","first-page":"175","volume":"5","author":"AH Pakpour","year":"2011","unstructured":"Pakpour AH, Nourozi S, Molsted S, Harrison AP, Nourozi K, Fridlund B. Validity and reliability of short form-12 questionnaire in Iranian hemodialysis patients. Iran J Kidney Dis. 2011;5(3):175\u201381.","journal-title":"Iran J Kidney Dis"},{"issue":"7","key":"25474_CR24","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1249\/01.MSS.0000074446.02192.14","volume":"35","author":"M Aadahl","year":"2003","unstructured":"Aadahl M, J\u00f8rgensen T. Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc. 2003;35(7):1196\u2013202.","journal-title":"Med Sci Sports Exerc"},{"issue":"11","key":"25474_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0293912","volume":"18","author":"L Adjeroh","year":"2023","unstructured":"Adjeroh L, Brothers T, Shawwa K, Ikram M, Al-Mamun MA. The association between polypharmacy and health-related quality of life among non-dialysis chronic kidney disease patients. PLoS ONE. 2023;18(11):e0293912.","journal-title":"PLoS ONE"},{"issue":"3","key":"25474_CR26","doi-asserted-by":"publisher","first-page":"246","DOI":"10.21149\/10903","volume":"62","author":"A Salinas-Rodr\u00edguez","year":"2020","unstructured":"Salinas-Rodr\u00edguez A, Manrique-Espinoza B, Rivera-Almaraz A, \u00c1vila-Funes JA. Polypharmacy is associated with multiple health-related outcomes in Mexican community-dwelling older adults. Salud Publica Mex. 2020;62(3):246\u201354.","journal-title":"Salud Publica Mex"},{"issue":"5","key":"25474_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2024.101772","volume":"15","author":"Z Yue","year":"2024","unstructured":"Yue Z, Xue X, Qian J. The association between polypharmacy and health-related quality of life among older adults with prostate cancer. J Geriatr Oncol. 2024;15(5):101772.","journal-title":"J Geriatr Oncol"},{"issue":"1","key":"25474_CR28","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-04878-6","volume":"24","author":"N Panahi","year":"2024","unstructured":"Panahi N, Ahmadi M, Hosseinpour M, Sedokani A, Sanjari M, Khalagi K, et al. The association between quality of life and diabetes: the Bushehr elderly health program. BMC Geriatr. 2024;24(1):267.","journal-title":"BMC Geriatr"},{"issue":"1","key":"25474_CR29","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-05348-9","volume":"24","author":"Y Zarinfar","year":"2024","unstructured":"Zarinfar Y, Panahi N, Hosseinpour M, Sedokani A, Hajivalizadeh S, Nabipour I, et al. The association between osteoporosis and quality of life among older adults in Southern Iran: findings from the Bushehr elderly health program. BMC Geriatr. 2024;24(1):766.","journal-title":"BMC Geriatr"},{"issue":"1","key":"25474_CR30","doi-asserted-by":"publisher","first-page":"e2350963","DOI":"10.1001\/jamanetworkopen.2023.50963","volume":"7","author":"MS Keller","year":"2024","unstructured":"Keller MS, Qureshi N, Mays AM, Sarkisian CA, Pevnick JM. Cumulative update of a systematic overview evaluating interventions addressing polypharmacy. JAMA Netw Open. 2024;7(1):e2350963\u2013e.","journal-title":"JAMA Netw Open"},{"key":"25474_CR31","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2021.104553","volume":"98","author":"S Ozkok","year":"2022","unstructured":"Ozkok S, Aydin CO, Sacar DE, Catikkas NM, Erdogan T, Kilic C, et al. Associations between polypharmacy and physical performance measures in older adults. Arch Gerontol Geriatr. 2022;98:104553.","journal-title":"Arch Gerontol Geriatr"},{"key":"25474_CR32","doi-asserted-by":"crossref","first-page":"E50","DOI":"10.5888\/pcd19.220062","volume":"19","author":"L Van Wilder","year":"2022","unstructured":"Van Wilder L, Devleesschauwer B, Clays E, Pype P, Vandepitte S, De Smedt D. Polypharmacy and health-related quality of life\/psychological distress among patients with chronic disease. Prev Chronic Dis. 2022;19:E50.","journal-title":"Prev Chronic Dis"},{"issue":"1","key":"25474_CR33","doi-asserted-by":"publisher","first-page":"287","DOI":"10.3233\/JAD-231001","volume":"98","author":"I Torres-Atencio","year":"2024","unstructured":"Torres-Atencio I, Carreira MB, M\u00e9ndez A, Quintero M, Broce A, Oviedo DC, et al. Polypharmacy and associated health outcomes in the PARI-HD study. J Alzheimers Dis. 2024;98(1):287\u2013300.","journal-title":"J Alzheimers Dis"},{"key":"25474_CR34","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.16262","volume":"11","author":"YY Chou","year":"2023","unstructured":"Chou YY, Lee YS, Lin CS, Chen JP, Kuo F-H, Lin C-F, et al. Gender-specific linkages: frailty, polypharmacy, anti-cholinergic burden, and 5-year mortality risk\u2014a real-world analysis. PeerJ. 2023;11:e16262.","journal-title":"PeerJ"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25474-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-025-25474-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25474-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:27:44Z","timestamp":1764077264000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-025-25474-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["25474"],"URL":"https:\/\/doi.org\/10.1186\/s12889-025-25474-2","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]},"assertion":[{"value":"29 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and ethical approval for the primary study was obtained from the Ethics Committees at the Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences and Bushehr University of Medical Sciences, marked with the ethical codes IR.TUMS.EMRI.REC.1394.0036 and B-91-14-2, respectively. Informed consent was obtained from all subjects. The Ethical code for the present study is IR.TUMS.MEDICINE.REC.1403.428.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4146"}}