Anticholinergic burden and frailty in older inpatients: insights from analysis of admission and discharge medicines using four anticholinergic scales DOI Creative Commons

Mohammed Adem Mohammed,

Amy Hai Yan Chan, Nasir Wabe

et al.

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 20, 2024

Abstract Background Exposure to high anticholinergic burden is associated with adverse outcomes in older adults. Older adults frailty have greater vulnerability effects. There limited data on hospitalised particularly, New Zealand. This study aimed (i) examine exposure medicines inpatients using multiple scales, and (ii) describe the association of patient factors such as exposure. Methods We reviewed admission discharge 222 patients (≥ 65 years) a Zealand hospital. Sociodemographic, diagnostic medication were collected from electronic health records. Anticholinergic was quantified Burden Classification (ABC), Cognitive Scale (ACB), Risk (ARS), Drug Index (DBI). Frailty assessed index (FI) Hospital score (HFRS); higher scores indicate frailty. Multivariable logistic regression analysis used determine burden. Results Depending scale used, mean ranged 0.65 1.83 0.59 1.40 at discharge, 32–74% 25–65% prescribed least one medicine. About 1 3 had discharge. On admission, being frail (adjusted odds ratio [AOR] 5.16, 95% confidence interval [95% CI] 1.57, 16.97), having history readmission (AOR 4.96, CI 1.58, 15.59), number [AOR range 1.18 1.10, 1.26 (ARS scale) 1.25 1.15, 1.36 (DBI scale)] At pre-frail scale: AOR = 6.58, 1.71–25.32) (ACB 5.73, 1.66, 19.70) those 1.09, 1.29 1.33 1.20, 1.49 Conclusion A reduction observed population yet, one-third cohort discharged medicines. Enhancing hospital prescribers’ pharmacists’ awareness about targeted interventions in-hospital deprescribing are needed reduce acute setting.

Language: Английский

Prevalence of delirium in German nursing homes: protocol for a cross-sectional study DOI Creative Commons
Jonas Dörner,

Alexandre Houdelet-Oertel,

Zafer Arslan

et al.

BMJ Open, Journal Year: 2025, Volume and Issue: 15(1), P. e087482 - e087482

Published: Jan. 1, 2025

Introduction Delirium is a neuropathological syndrome that associated with several negative outcomes. Nursing home residents are vulnerable to developing delirium. Valid prevalence data and factors not yet available for Germany. Therefore, the aim of study DeliA project (Delirium in Homes) assess delirium its 750 nursing residents. Methods analysis Trained registered nurses from each participating will collect multicentre cross-sectional study. The inclusion criteria valid informed consent, age ≥65 years sufficient language skills. exclusion aphasia, coma, deafness or end-of-life status. 4 ‘A’s Test be used as primary measurement. motor subtypes determined using Motor Subtype Scale. Covariables factors, including functional impairments, pain, cognitive status nutritional status, assessed through standardised measurements. Moreover, such prescribed drugs medical diagnosis, hearing impairment falls records. Furthermore, Drug Burden Index calculated, logistic regression model. period collection homes planned 2 consecutive weeks April 2024. Ethics dissemination This was approved by Committee Witten/Herdecke University (no. 82/2023). Findings published peer-reviewed journals presented at conferences. Registration https://osf.io/xkfvh/ (DOI 10.17605/OSF.IO/XKFVH).

Language: Английский

Citations

0
Association between dizziness and future falls and fall-related injuries in older adults: a systematic review and meta-analysis DOI Creative Commons
Yuxiao Li, Rebecca Smith, Susan L. Whitney

et al.

Age and Ageing, Journal Year: 2024, Volume and Issue: 53(9)

Published: Sept. 1, 2024

Dizziness is common in older adults, especially those attending falls services. Yet, the extent to which dizziness associated with future has not been reviewed. This systematic review and meta-analysis assessed association between related injuries adults.

Language: Английский

Citations

2
Anticholinergic Exposure, Drug Dose and Postoperative Delirium: Comparison of Dose-Related and Non-Dose-Related Anticholinergic Burden Scores in a Retrospective Cohort Study of Older Orthopaedic and Trauma Surgery Patients DOI Creative Commons
Carolin Geßele, Constanze Rémi,

Vera Smolka

et al.

Drugs & Aging, Journal Year: 2024, Volume and Issue: 41(12), P. 1003 - 1013

Published: Nov. 28, 2024

Postoperative delirium (POD) is a common complication in older adult patients after surgery. A patient's preoperative anticholinergic (AC) burden potentially modifiable risk factor for POD. As the influence of drug dose remains unknown, we aimed to compare three AC scores relation POD, two which were dose-related. This retrospective cohort study (03/22–10/22) included orthopaedic and trauma surgery > 65 years. POD was assessed using four A's test (4AT), diagnosis, chart review. The determined non-dose-related German Anticholinergic Burden score (GerACB), an extension dose-related Muscarinic Acetylcholinergic Receptor ANTagonist Exposure scale (extMARANTE), Drug Index (GerDBI). Multivariable logistic regression analysis association between Scores compared kappa statistics, sensitivity, specificity, positive predictive value (PPV), negative (NPV). observed 71 385 (18.4%). For all scores, high significantly associated with adjusting age, sex, dementia, physical status, number prescribed drugs (p < 0.001). overall agreement among classifications substantial (no POD: κ = 0.645, 0.632). GerACB had lowest sensitivity 23.9% (extMARANTE: 42.3%, GerDBI: 40.8%), but highest PPV 48.6% 38.5%, 43.3%). Both have limited modest screening medication However, given additional effort required consideration, sufficient clinical practice, PPV.

Language: Английский

Citations

0
Anticholinergic burden and frailty in older inpatients: insights from analysis of admission and discharge medicines using four anticholinergic scales DOI Creative Commons

Mohammed Adem Mohammed,

Amy Hai Yan Chan, Nasir Wabe

et al.

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 20, 2024

Abstract Background Exposure to high anticholinergic burden is associated with adverse outcomes in older adults. Older adults frailty have greater vulnerability effects. There limited data on hospitalised particularly, New Zealand. This study aimed (i) examine exposure medicines inpatients using multiple scales, and (ii) describe the association of patient factors such as exposure. Methods We reviewed admission discharge 222 patients (≥ 65 years) a Zealand hospital. Sociodemographic, diagnostic medication were collected from electronic health records. Anticholinergic was quantified Burden Classification (ABC), Cognitive Scale (ACB), Risk (ARS), Drug Index (DBI). Frailty assessed index (FI) Hospital score (HFRS); higher scores indicate frailty. Multivariable logistic regression analysis used determine burden. Results Depending scale used, mean ranged 0.65 1.83 0.59 1.40 at discharge, 32–74% 25–65% prescribed least one medicine. About 1 3 had discharge. On admission, being frail (adjusted odds ratio [AOR] 5.16, 95% confidence interval [95% CI] 1.57, 16.97), having history readmission (AOR 4.96, CI 1.58, 15.59), number [AOR range 1.18 1.10, 1.26 (ARS scale) 1.25 1.15, 1.36 (DBI scale)] At pre-frail scale: AOR = 6.58, 1.71–25.32) (ACB 5.73, 1.66, 19.70) those 1.09, 1.29 1.33 1.20, 1.49 Conclusion A reduction observed population yet, one-third cohort discharged medicines. Enhancing hospital prescribers’ pharmacists’ awareness about targeted interventions in-hospital deprescribing are needed reduce acute setting.

Language: Английский

Citations

0