Association of systemic anticholinergic medication use and accelerated decrease in lung function in older adults

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Feb. 22, 2024

Abstract Older adults are frequently exposed to medicines with systemic anticholinergic properties, which linked increased risk of negative health outcomes. The association between anticholinergics and lung function has not been reported. aim this study was investigate if exposure influences in older adults. Participants the southernmost centres Swedish National on Aging Care (SNAC) were followed from 2001 2021. In total, 2936 subjects (2253 Good Skåne 683 SNAC-B) included. An extensive medical examination including spirometry assessments performed during visits. burden described using cognitive scale. effect new use annual change forced expiratory volume (FEV1s) estimated mixed models. During follow-up, 802 (27.3%) participants at least one medicine. On average, FEV1s without decreased 37.2 ml/year (95% CI [33.8; 40.6]) while low high lose 47.2 [42.4; 52.0]) 43.7 [25.4; 62.0]). A novel properties accelerated decrease found. is comparable that observed smokers. Studies needed further explore potential side anticholinergics.

Language: Английский

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The association between medication use and health-related quality of life in multimorbid older patients with polypharmacy

European Geriatric Medicine, Journal Year: 2024, Volume and Issue: 15(6), P. 1713 - 1723

Published: Aug. 20, 2024

To explore the association between medication use-related factors and health-related quality of life (HRQoL) in older hospitalised multimorbid patients with polypharmacy.

Language: Английский

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Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex

PLoS ONE, Journal Year: 2021, Volume and Issue: 16(6), P. e0253336 - e0253336

Published: June 30, 2021

The cumulative effect of medication inhibiting acetylcholine activity-also known as anticholinergic burden (AB)-can lead to functional and cognitive decline, falls, death. Given that studies on the population prevalence AB are rare, we aimed describe it in a large unselected sample.Using German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% analyzed outpatient drug dispensations 2016. Based Anticholinergic Cognitive Burden (ACB) scale, classified persons into four categories determined continuous variable.Among 16,470,946 (54% female), clinically relevant (ACB≥3) was 10% (women) 7% (men). Below age 40 highest ≤18 years (6% both sexes). At older ages (50-59 vs. 90-99 years), ACB≥3 increased 26% (men) 32% (women). Medication classes contributing differed by age: antihistamines, antibiotics, glucocorticoids (≤19 antidepressants (20-49 antidepressants, cardiovascular medication, antidiabetics (50-64 additionally for urinary incontinence/overactive bladder (≥65 years). dispensed general physicians contributed most AB.Although is particularly common persons, younger groups up 7%. risks associated targeted interventions at prescriber level needed. Furthermore, should be explored.

Language: Английский

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Using the Drug Burden Index to identify older adults at highest risk for medication-related falls

BMC Geriatrics, Journal Year: 2020, Volume and Issue: 20(1)

Published: June 12, 2020

Abstract Background The Drug Burden Index (DBI) was developed to assess patient exposure medications associated with an increased risk of falling. objective this study examine the association between DBI and medication-related fall risk. Methods used a retrospective cohort design, 1-year observation period. Participants ( n = 1562) were identified from 31 community pharmacies. We examined scores four outcomes. Our primary outcome, which limited participants who received medication review, indexed whether review resulted in at least one recommendation (e.g., discontinue medication) being communicated participant’s health care provider. Secondary outcomes full sample: (1) screened positive for risk, (2) reported 1+ falls past year, (3) injurious year. All outcome variables dichotomous (yes/no). Results Among those 387), percentage patients receiving ranged 10.2% among 0 compared 60.2% ≥1.0 (Chi-square (4)=42.4, p < 0.0001). 1058), higher did not (Means 0.98 (SD 1.00) versus 0.59 0.74), respectively, Conclusion findings suggest that is useful tool could be improve future research practice by focusing resources on individuals greatest falls.

Language: Английский

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Anticholinergic Burden, Sleep Quality and Health Outcomes in Malaysian Aged Care Home Residents

Pharmacy, Journal Year: 2019, Volume and Issue: 7(4), P. 143 - 143

Published: Oct. 23, 2019

The use of anticholinergic medications by residents in aged care homes is associated with increased risk adverse effects. These include cognitive impairment, sleep disturbances, and falls, necessitate healthcare visits the burden on systems. objective this study was to investigate associations between health outcomes such as independence activities for daily living, frailty, quality life, quality. conducted among Malaysian homes, 60 years above. Anticholinergic calculated using Cognitive Burden (ACB) scale. Health outcome measures included independence, assessed Katz Activities Daily Living scale (Katz ADL); Older People's Quality Life Questionnaire (OPQOL); Groningen Frailty Index (GFI); quality, measured Pittsburg Sleep (PSQI). Just over one-third (36%) population exposed at least one medication effect. An frailty (p = 0.031), latency 0.007), disturbances 0.015). Further studies are required assess effect prolonged exposure outcomes.

Language: Английский

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Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA

Frontiers in Pharmacology, Journal Year: 2023, Volume and Issue: 14

Published: March 3, 2023

Introduction: Anticholinergic and sedative medication is prescribed for various conditions in older patients. While the general association between anticholinergic impaired functioning well established, its specific role individuals with vertigo, dizziness, balance disorders (VDB) still incompletely understood. The objective of this study was to investigate, whether an exposure associated lower generic vertigo-specific patients VDB. Methods: Data originates from longitudinal multicenter MobilE-TRA two follow-ups, conducted 2017 2019 German federal states. Exposure quantified using drug burden index (DBI). Generic assessed by Health Assessment Questionnaire Disability Index, appraising amount difficulties performing activities daily living (ADL). Vertigo-specific measured Vestibular Activities Participation (VAP) questionnaire, assessing patient-reported regarding that are difficult perform because their propensity provoke VDB (Scale 1) as immediate consequences on participation related mobility 2). Longitudinal linear mixed models were applied assess at baseline level status over time. Results: An overall 19 (7 Bavaria) primary care physicians (mean age = 54 years, 29% female) recruited 158 (59% (median 78 70% female). present 56 (35%) significantly [Beta 0.40, 95%-CI (0.18; 0.61)] [VAP Scale 1: Beta 2.47, (0.92; 4.02)], VAP 2: 3.74, [2.23; 5.24]). Conclusion: Our results highlight importance a close monitoring use When feasible, should be replaced equivalent alternative therapies order potentially reduce

Language: Английский

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Effects of anticholinergic and sedative medication use on fractures: A self‐controlled design study

Journal of the American Geriatrics Society, Journal Year: 2021, Volume and Issue: 69(11), P. 3212 - 3224

Published: July 22, 2021

Abstract Background/Objectives Unintentional falls are a leading cause of injury for older adults, and evidence is needed to understand modifiable risk factors. We evaluated 1‐year fall‐related fracture whether dispensing medications with anticholinergic/sedating properties temporally associated an increased odds these fractures. Design A retrospective cohort study nested self‐controlled analyses conducted between January 1, 2014, December 31, 2016. Setting Twenty percent nationwide, random sample US Medicare beneficiaries. Participants New users who were 66+ years old had Parts A, B, D coverage but no claims in the year before initiation eligible. Measurements followed new until first non‐vertebral, (primary outcome), disenrollment, death, or end data. estimated corresponding 95% confidence intervals (CIs) after use. applied case‐crossover case‐time‐control designs estimate ratios (ORs) CIs by comparing anticholinergic and/or sedating medication exposure (any vs. none) during 14‐day hazard period preceding earlier control period. Results total 1,097,989 beneficiaries initiated The cumulative incidence fracture, accounting death as competing risk, was 5.0% (95% CI: 5.0%–5.0%). Using design (n = 41,889), adjusted OR association fractures 1.03 0.99, 1.08). Accounting noted temporal trend using 209,395), 1.60 1.52, 1.69). Conclusion Use Patients their healthcare providers should consider pharmacologic non‐pharmacologic treatments target condition that safer.

Language: Английский

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Quantifying cumulative anticholinergic and sedative drug load among US Medicare Beneficiaries

Pharmacoepidemiology and Drug Safety, Journal Year: 2020, Volume and Issue: 30(2), P. 144 - 156

Published: Oct. 1, 2020

Medications with anticholinergic and sedative properties are widely used among older adults despite strong evidence of harm. The drug burden index (DBI), a pharmacological screening tool, measures these across classes, higher DBI exposure (DBI > 1) has been associated certain physical function-related adverse events. Our aim was to quantify mean daily in the United States (US).We screened medications for operationalized US Medicare claims. We then conducted retrospective cohort study 20% random, nationwide sample 4 137 384 fee-for-service beneficiaries aged 66+ years (134 757 039 person-months) from January 2013 December 2016. measured monthly distribution based on DBI, categorized as (a) >0 vs 0 (any use) (b) 0, < ≤ 1, 1 2, examined temporal trends. described patient-level factors (eg, demographics, healthcare high (>2) low (0 DBI≤1) exposure.The aggregated at month-level, was: 58.1% = 29.0% DBI≤1, 9.3% DBI≤2, 3.7% 2. Predictors 2) included indicators increased use number claims), white race, younger age, frailty, psychosis diagnosis code.The predictors can inform discussions between patients providers about medication appropriateness potential de-prescribing. Future Medicare-based studies should assess association

Language: Английский

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HIV-positive women have higher prevalence of comorbidities and anticholinergic burden: assessment of the HIV-positive population from Menorca (Balearic Islands)

AIDS Care, Journal Year: 2022, Volume and Issue: 35(6), P. 800 - 809

Published: April 27, 2022

Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to HIV population from Menorca (Illes Balears). Adult HIV-positive individuals antiretroviral treatment attending pharmacy service Hospital Mateu Orfila (Menorca) were included. In single visit, demographical clinical characteristics, cotreatments collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) symptoms associated (HIV-SI index) assessed. A total 223 included, 68.2% men, median age 53.00 (44.50–58.00) years, BMI 24.07, 47.73% smokers 9.90% drug consumers. Women had more advanced stages disease significantly (cough anxiety) versus men (p = .033 p .048, respectively). Moreover higher exposures anticholinergic drugs (DBI 0.51 vs. 0.27) reported, together frequency (57.7% 37.5%; .005) that increased age. Red frequently reported PI (2.69%), NNRTIs (1.92%) booster (1.92%). These results support need implement specific measures for women tools assess risk interactions.

Language: Английский

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The association between anticholinergic/sedative burden and physical frailty in people aging with HIV

AIDS, Journal Year: 2023, Volume and Issue: 38(4), P. 509 - 519

Published: Dec. 1, 2023

Objective: This study aimed to estimate the strength of association between anticholinergic/sedative burden and concurrent physical frailty in people aging with HIV. Design: cross-sectional analysis examined baseline data from 824 adults a mean age 53 enrolled Positive Brain Health Now study. Methods: Anticholinergic medications were identified using four methods: Cognitive Burden (ACB) Scale, Risk Scale (ARS), Drug (ADS), anticholinergic list Sedative Catalog (ACSBC). Sedatives Load Model (SLM) sedative ACSBC. Physical was assessed modified Fried Frailty Phenotype (FFP) based on self-report items. Multivariable logistic regression models, adjusted for sociodemographic factors, lifestyle considerations, HIV-related variables, comorbidities, co-medication use, used odds ratios (ORs). Results: demonstrated associations across various total (OR range: 1.22–1.32; 95% confidence interval (CI) 1.03–1.66), 1.18–1.24; CI 1.02–1.45), high 2.12–2.74; 1.03–6.19), 1.94–2.18; CI: 1.01–4.34). Conclusion: The burdens may represent modifiable risk factors Future studies should evaluate effects reducing outcomes explore prognostic value diverse scoring methods.

Language: Английский

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