Highlights
- •The majority of elderly psychiatric patients in this study were receiving at least one anticholinergic drug
- •A higher anticholinergic burden (ACB score ≥ 3) was observed among patients on polypharmacy and those having schizophrenia
- •An increase in anticholinergic burden was associated with a worsened cognition and two times increased incidence of anemia
Abstract
Objectives
We aimed in this study to determine the extent of exposure to anticholinergic drugs
in older adults with psychiatric illnesses using the anticholinergic cognitive burden
(ACB) scale and to identify the factors associated with anticholinergic drugs use
and higher ACB scores.
Methods
A cross-sectional study was conducted in the psychogeriatric division of an elderly
care hospital. The study sample comprised all inpatients, aged ≥65 years, and diagnosed
with psychiatric illness.
Results
Anticholinergic drugs use was reported in 117 (79.6 %) patients, 76 (51.7 %) had an
ACB score ≥ 3. Schizophrenia [OR = 5.4 (95 % CI 1.1–10.2), p = 0.02], anemia [OR = 2.2
(95 % CI 1.54–7.89), p = 0.01], and anticholinergic adverse effects [OR = 2.8 (95 %
CI 1.12–7.07), p = 0.04] were significantly associated with a higher likelihood of
using anticholinergic drugs. The odds of having an ACB score ≥ 3 over an ACB score = 0
were significantly increased by schizophrenia [OR = 4.9 (95 % CI 1.65–8.02), p = 0.01],
anemia [OR = 1.32 (95 % CI 1.90–6.90), p = 0.02], and polypharmacy [OR = 1.74 (95 %
CI 1.10–2.40), p = 0.04], while they were significantly decreased by age [OR = 0.86
(95 % CI 0.78–0.96), p < 0.001]. Patients with cognitive impairment were less likely
than those without cognitive impairment to have an ACB score ≥ 3 over an ACB score = 0.
Conclusions
Our study revealed that older adults with psychiatric illnesses were exposed to high
anticholinergic burden.
Keywords
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Article info
Publication history
Published online: March 27, 2023
Accepted:
March 19,
2023
Received:
November 12,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
