+ 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

Anticholinergic Medication Burden and 5-Year Risk of Hospitalization and Death in Nursing Home Elderly Residents With Coronary Artery Disease



Anticholinergic Medication Burden and 5-Year Risk of Hospitalization and Death in Nursing Home Elderly Residents With Coronary Artery Disease



Journal of the American Medical Directors Association 17(11): 1056-1059



To assess the association of the anticholinergic medication burden with hospitalization and mortality in nursing home elderly patients and to investigate the role of coronary artery disease (CAD). Longitudinal (5-year) retrospective observational study. Nursing homes in Italy. A total of 3761 nursing home older residents. A comprehensive clinical and functional assessment was carried out through the interRAI long-term care facility instrument. The anticholinergic burden was assessed through the anticholinergic cognitive burden (ACB) scale. Occurrence of hospitalization/all-cause mortality was the primary composite outcome. First hospitalization and all-cause mortality were the secondary outcomes of the study. Hazard ratios (HRs) and subdistribution HRs were obtained through Cox and competing risk (death as competing event for hospitalization) models. Within the sample (mean age 83 ± 7 years; 72% females) the incidence rate of the primary outcome was 10/100 person-year. After adjusting for potential confounders and compared with participants with an ACB of 0, those with an ACB of 1 [HR 1.46; 95% confidence interval (CI) 1.12-1.90] and ABC of 2+ (HR 1.41; 95% CI 1.11-1.79) presented an increased risk of developing the primary outcome. After stratification, the risk for the primary outcome increased along with the anticholinergic burden, only for participants affected by CAD (HR 1.53; 95% CI 0.94-2.50 and HR 1.71; 95% CI 1.09-2.68 for the ACB of 1 and ACB of 2+ groups). An ACB score of 2+ was marginally associated with first hospitalization, considering death as a competing risk, only for those with CAD (subdistribution HR 3.47; 95% CI 0.99-12.3). Anticholinergic medication burden is associated to hospitalization and all-cause mortality in institutionalized older adults. CAD increases such risk. The effectiveness and safety profile of complex drug regimens should be reconsidered in this population.

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

Accession: 057211038

Download citation: RISBibTeXText

PMID: 27590402

DOI: 10.1016/j.jamda.2016.07.012


Related references

Anticholinergic Medication Use and Risk of Dementia Among Elderly Nursing Home Residents with Depression. American Journal of Geriatric Psychiatry 24(6): 485-495, 2018

Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Archives of Internal Medicine 165(1): 68-74, 2005

Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Consultant Pharmacist 20(5): 440-442, 2006

Prevalence and predictors of anticholinergic medication use in elderly nursing home residents with dementia: analysis of data from the 2004 National Nursing Home Survey. Drugs and Aging 27(12): 987-997, 2011

High-risk medication use by nursing home residents before and after hospitalization. Medical Care 52(10): 884-890, 2014

Risk of Mortality Associated with Anticholinergic Use in Elderly Nursing Home Residents with Depression. Drugs and Aging 34(9): 691-700, 2017

Systematic Review of the Prevalence of Medication Errors Resulting in Hospitalization and Death of Nursing Home Residents. Journal of the American Geriatrics Society 65(2): 433-442, 2016

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

Case-control study of exposure to medication and the risk of injurious falls requiring hospitalization among nursing home residents. American Journal of Epidemiology 145(8): 738-745, 1997

Central Nervous System Medication Burden and Risk of Recurrent Serious Falls and Hip Fractures in Veterans Affairs Nursing Home Residents. Journal of the American Geriatrics Society 2018, 2018

A preliminary study of anticholinergic burden and relationship to a quality of life indicator, engagement in activities, in nursing home residents with dementia. Journal of the American Medical Directors Association 10(4): 252-257, 2009

Chronic kidney disease and its association with mortality and hospitalization in Chinese nursing home older residents: a 3-year prospective cohort study. Journal of the American Medical Directors Association 13(9): 782-787, 2013

Central Nervous System Medication Burden and Serious Falls in Older Nursing Home Residents. Journal of the American Geriatrics Society 65(6): 1183-1189, 2017

Medication reviews for nursing home residents to reduce mortality and hospitalization: systematic review and meta-analysis. British Journal of Clinical Pharmacology 78(3): 488-497, 2015

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