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

Anticholinergic Burden and Functional Status in Older People with Cognitive Impairment: Results from the Regal Project



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



The use of drugs with intrinsic anticholinergic properties is widespread among old age persons. A growing body of evidences suggest that a high anticholinergic burden is associated with physical and cognitive impairment. However, the association between anticholinergic drug use and functional status is still poorly investigated, particularly among subjects with initial cognitive impairment. Cross-sectional study examining the association between drug-related anticholinergic burden and functional status in cognitively healthy (CH) (n=691), mild cognitive impairment (MCI) (n=541) or mild Alzheimer's diseases (AD) (n=1127) subjects. Data were gathered from the ReGAl project (Rete Geriatrica Alzheimer-Geriatric Network on Alzheimer's disease), a large longitudinal Italian multicentric clinical-based study, promoted by the Italian Society of Gerontology and Geriatrics (SIGG). 2359 outpatients, older than 65 years, admitted to memory clinics. The total sample size, estimated according to a global effect size of 25% with type I error of 0.05 and a power of 95% is 2010 subjects. Functional status was evaluated by the Katz Index of Independence in Activities of Daily Living (ADL) and the Lawton-Brody Instrumental Activities of Daily Living (IADL) scales. The drug-related anticholinergic burden was estimated by the Anticholinergic Risk Scale (ARS). The 15.9 % (n=375) of total population used at least one drug with anticholinergic properties. Such a drug use was associated with partially dependence in ADL (OR:1.42, CI95%: 1.10-1.83; p=0.006), independently of gender, number of drugs, comorbidity index, presence of clinically relevant neuropsychiatric symptoms and adjusted MMSE. Anticholinergic drug use was associated with un-ability at each IADL task only in male MCI subjects, with significant impairment in shopping (p=0.011), and drug management (p=0.05). The use of medications with anticholinergic properties is common among older persons cognitively health as well as with cognitive impairment. Our results suggest that the use of anticholinergic drugs is associated with functional impairment, especially in old age subjects with initial cognitive impairment. Minimizing anticholinergic burden should result in maintaining daily functioning, especially in a vulnerable population, such as MCI and mild AD.

Please choose payment method:






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

Accession: 059377397

Download citation: RISBibTeXText

PMID: 28346565

DOI: 10.1007/s12603-016-0787-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

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

Influence of comorbidity and cognitive status on instrumental activities of daily living in amnestic mild cognitive impairment: results from the ReGAl project. International Journal of Geriatric Psychiatry 23(5): 523-530, 2007

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, 2013

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 in Older Adults with Mild Cognitive Impairment. Journal of the American Geriatrics Society 64(12): E313-E314, 2016

Prevalence and Correlates of Behavioral Disorders in Old Age Subjects with Cognitive Impairment: Results from the ReGAl Project. Journal of Alzheimer's Disease 60(4): 1275-1283, 2017

Association of Anticholinergic Burden with Cognitive Impairment and Health Care Utilization Among a Diverse Ambulatory Older Adult Population. PharmacoTherapy 36(11): 1123-1131, 2016

The Games for Older Adults Active Life (GOAL) Project for People With Mild Cognitive Impairment and Vascular Cognitive Impairment: A Study Protocol for a Randomized Controlled Trial. Frontiers in Neurology 9: 1040-1040, 2019

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

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

Psychiatric symptom burden in older people living with HIV with and without cognitive impairment: the UCSF HIV over 60 cohort study. Aids Care 29(9): 1178-1185, 2017

Associations of childhood socioeconomic status and adulthood height with functional limitations among Japanese older people: results from the JAGES 2010 Project. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 69(7): 852-859, 2014

Cognitive Functioning in Older People. Results of the First Wave of Cognition of Older People, Education, Recreational Activities, Nutrition, Comorbidities, Functional Capacity Studies (COPERNICUS). Frontiers in Aging Neuroscience 10: 421-421, 2019

Serum Anticholinergic Activity and Cognitive and Functional Adverse Outcomes in Older People: A Systematic Review and Meta-Analysis of the Literature. Plos One 11(3): E0151084, 2016