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. 2017 May 11;5(3):e00310.
doi: 10.1002/prp2.310. eCollection 2017 Jun.

Anticholinergic drug exposure is associated with delirium and postdischarge institutionalization in acutely ill hospitalized older patients

Angelique Egberts  1 , Saskia T van der Craats  1 , Melissa D van Wijk  1 , Shams Alkilabe  1 , Patricia M L A van den Bemt  2 , Francesco U S Mattace-Raso  1
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Anticholinergic drug exposure is associated with delirium and postdischarge institutionalization in acutely ill hospitalized older patients

Angelique Egberts et al. Pharmacol Res Perspect. .

Abstract

Several studies investigated the possible association between anticholinergic drugs and diverse clinical outcomes in older persons, but the results are inconsistent. The aim of this study was to investigate whether anticholinergic drug exposure is associated with delirium on admission, length of hospital stay, postdischarge institutionalization and in-hospital mortality in acutely ill hospitalized older patients. In this observational chart review study, we included acutely ill patients aged 65 and older who were admitted to the geriatric ward of the Erasmus University Medical Center, Rotterdam, The Netherlands, between 2012 and 2015 (n = 905). Anticholinergic drug exposure on admission was defined as the use of anticholinergic drugs, total number of anticholinergic drugs and anticholinergic drug burden score (ADB), quantified with the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden scale (ACB) and the list of Chew et al. (Chew). Logistic regression analyses were performed to investigate possible associations between anticholinergic drug exposure and the aforementioned outcomes. Analyses were adjusted for age, sex, comorbidities, non-anticholinergic drugs and delirium, where appropriate. Moderate and high ADB measured with the ARS were associated with delirium on admission with odds ratios (OR) of 1.70 (95% confidence interval (CI) = 1.16-2.49) and 1.83 (95% CI = 1.06-3.15), respectively. High ADB measured with the ARS was also associated with postdischarge institutionalization (OR = 2.43, 95% CI = 1.24-4.75). No associations were found using the ACB and Chew. Future studies are warranted to investigate the clinical usefulness of the ARS in reducing complications in older persons.

Keywords: Adverse effects; anticholinergic drug scoring systems; delirium; outcomes; physical function; prognosis.

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Figure 1
Flowchart of study sample selection.
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References

    1. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text revision. American Psychiatric Association, Washington, DC.
    1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association, Arlington, VA.
    1. Boustani M, Campbell N, Munger S, Maidment I, Fox C (2008). Impact of anticholinergics on the aging brain: a review and practical application. Aging Health 4: 311–320.
    1. Campbell N, Perkins A, Hui S, Khan B, Boustani M (2011). Association between prescribing of anticholinergic medications and incident delirium: a cohort study. J Am Geriatr Soc 59(Suppl. 2): S277–S281. - PMC - PubMed
    1. Campbell NL, Maidment I, Fox C, Kahn B, Boustani M (2013). The 2012 update to the Anticholinergic Cognitive Burden Scale. J Am Geriatr Soc 61(Suppl. 1): S142–S143.

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