Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 6;5(3):530-41.
doi: 10.1159/000441718. eCollection 2015 Sep-Dec.

The Influence of Patient Characteristics on Anticholinergic Events in Older People

Mohammed Saji Salahudeen  1 , Prasad S Nishtala  1 , Stephen B Duffull  1
Affiliations

The Influence of Patient Characteristics on Anticholinergic Events in Older People

Mohammed Saji Salahudeen et al. Dement Geriatr Cogn Dis Extra. .

Abstract

Aims: To examine patient characteristics that predict adverse anticholinergic-type events in older people.

Methods: This retrospective population-level study included 2,248 hospitalised patients. Individual data on medicines that are commonly associated with anticholinergic events (delirium, constipation and urinary retention) were identified. Patient characteristics examined were medicines with anticholinergic effects (ACh burden), age, sex, non-anticholinergic medicines (non-ACM), Charlson comorbidity index scores and ethnicity. The Akaike information criterion was used for model selection. The data were analysed using logistic regression models for anticholinergic events using the software NONMEM.

Results: ACh burden was found to be a significant independent predictor for developing an anticholinergic event [adjusted odds ratio (aOR): 3.21, 95% CI: 1.23-5.81] for those taking an average of 5 anticholinergic medicines compared to those taking 1. Both non-ACM and age were also independent risk factors (aOR: 1.41, 95% CI: 1.31-1.51 and aOR: 1.08, 95% CI: 1.05-1.10, respectively).

Conclusion: To our knowledge, this is the first study that has examined population-level data in a nonlinear model framework to predict anticholinergic-type adverse events. This study evaluated the relationship between important patient characteristics and the occurrence of anticholinergic-type events. These findings reinforce the clinical significance of reviewing anticholinergic medicines in older people.

Keywords: Adverse events; Anticholinergic burden; Anticholinergic events; Antimuscarinic response; Elderly; Older people; Risk factors.

PubMed Disclaimer

References

    1. Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Mahmoud RA, Kirshner MA, Sorisio DA, Bies RR, Gharabawi G. Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc. 2008;56:1333–1341. - PubMed
    1. Roe CM, Anderson MJ, Spivack B. Use of anticholinergic medications by older adults with dementia. J Am Geriatr Soc. 2002;50:836–842. - PubMed
    1. De Wilde S, Carey IM, Harris T, Richards N, Victor C, Hilton SR, Cook DG. Trends in potentially inappropriate prescribing amongst older UK primary care patients. Pharmacoepidemiol Drug Saf. 2007;16:658–667. - PubMed
    1. Narayan SW, Hilmer SN, Horsburgh S, Nishtala PS. 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 Aging. 2013;30:927–934. - PubMed
    1. Salahudeen MS, Hilmer SN, Nishtala PS. Comparison of anticholinergic risk scales and associations with adverse health outcomes in older people. J Am Geriatr Soc. 2015;63:85–90. - PubMed