+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Association of Anticholinergic Burden with Cognitive and Functional Status in a Cohort of Hospitalized Elderly Comparison of the Anticholinergic Cognitive Burden Scale and Anticholinergic Risk Scale



Association of Anticholinergic Burden with Cognitive and Functional Status in a Cohort of Hospitalized Elderly Comparison of the Anticholinergic Cognitive Burden Scale and Anticholinergic Risk Scale



Drugs & Aging 30(2): 103-112



Drugs with anticholinergic effects are associated with adverse events such as delirium and falls as well as cognitive decline and loss of independence.The aim of the study was to evaluate the association between anticholinergic burden and both cognitive and functional status, according to the hypothesis that the cumulative anticholinergic burden, as measured by the Anticholinergic Cognitive Burden (ACB) Scale and Anticholinergic Risk Scale (ARS), increases the risk of cognitive decline and impairs activities of daily living.This cross-sectional, prospective study (3-month telephone follow-up) was conducted in 66 Italian internal medicine and geriatric wards participating in the Registry of Polytherapies SIMI (Societ Italiana di Medicina Interna) (REPOSI) study during 2010. The sample included 1,380 inpatients aged 65 years or older. Cognitive status was rated with the Short Blessed Test (SBT) and physical function with the Barthel Index. Each patient s anticholinergic burden was evaluated using the ACB and ARS scores.The mean SBT score for patients treated with anticholinergic drugs was higher than that for patients receiving no anticholinergic medications as also indicated by the ACB scale, even after adjustment for age, sex, education, stroke and transient ischaemic attack [9.2 (95 % CI 8.6 9.9) vs. 8.5 (95 % CI 7.8 9.2); p = 0.05]. There was a dose response relationship between total ACB score and cognitive impairment. Patients identified by the ARS had more severe cognitive and physical impairment than patients identified by the ACB scale, and the dose response relationship between this score and ability to perform activities of daily living was clear. No correlation was found with length of hospital stay.Drugs with anticholinergic properties identified by the ACB scale and ARS are associated with worse cognitive and functional performance in elderly patients. The ACB scale might permit a rapid identification of drugs potentially associated with cognitive impairment in a dose response pattern, but the ARS is better at rating activities of daily living.

(PDF emailed within 0-6 h: $19.90)

Accession: 036657432

Download citation: RISBibTeXText

DOI: 10.1007/s40266-012-0044-x


Related references

Association of anticholinergic burden with cognitive and functional status in a cohort of hospitalized elderly: comparison of the anticholinergic cognitive burden scale and anticholinergic risk scale: results from the REPOSI study. Drugs and Aging 30(2): 103-112, 2013

Anticholinergic component of the Drug Burden Index and the Anticholinergic Drug Scale as measures of anticholinergic exposure in older people in New Zealand: a population-level study. Drugs and Aging 30(11): 927-934, 2014

The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. Journal of Clinical Pharmacology 46(12): 1481-1486, 2006

Anticholinergic medications in patients admitted with cognitive impairment or falls (AMiCI). The impact of hospital admission on anticholinergic cognitive medication burden. Results of a multicentre observational study. Journal of Clinical Pharmacy and Therapeutics 43(5): 682-694, 2018

Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients. Plos One 12(2): E0171353, 2017

Anticholinergic Burden and Functional Status in Older People with Cognitive Impairment: Results from the Regal Project. Journal of Nutrition, Health and Aging 21(4): 389-396, 2017

Anticholinergic delirium: Assessing the role of anticholinergic burden in the elderly. Current Psychosis and Therapeutics Reports 2(1): 33-36, 2004

Association of Anticholinergic Drug Burden with Cognitive and Functional Decline Over Time in Older Inpatients: Results from the CRIME Project. Drugs and Aging 35(10): 917-924, 2018

Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. Bmc Geriatrics 15: 31, 2016

The relationship of an anticholinergic rating scale with serum anticholinergic activity in elderly nursing home residents. Psychopharmacology Bulletin 36(4): 14-19, 2003

The interaction between medical burden and anticholinergic cognitive burden on neuropsychological function in a geriatric primary care sample. Archives of Clinical Neuropsychology 30(2): 105-113, 2015

The anticholinergic risk scale and anticholinergic adverse effects in older persons. Archives of Internal Medicine 168(5): 508-513, 2008

Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 68(3): 271-278, 2013

The cognitive cost of anticholinergic burden: decreased response to cognitive training in schizophrenia. American Journal of Psychiatry 166(9): 1055-1062, 2009

Drug Burden Index score and anticholinergic risk scale as predictors of readmission to the hospital. Consultant Pharmacist 29(3): 158-168, 2014