Anticholinergic exposure and its association with dementia/Alzheimer's disease and mortality in older adults

被引:4
|
作者
Poonawalla, Insiya B. [1 ]
Xu, Yihua [1 ]
Gaddy, Rainelle [2 ]
James, Alex [2 ]
Ruble, Matt [2 ]
Burns, Salina [2 ]
Dixon, Suzanne W. [1 ]
Suehs, Brandon T. [1 ]
机构
[1] Humana Inc, Humana Healthcare Res, 500 W Main St, Louisville, KY 40202 USA
[2] Humana Inc, Humana Pharm Solut, 500 W Main St, Louisville, KY 40202 USA
关键词
Anticholinergic; Dementia; Alzheimer's disease; Mortality; Beers criteria; COGNITIVE IMPAIRMENT; RISK ADJUSTMENT; MEDICATION USE; DRUG BURDEN; DELIRIUM; INDEXES;
D O I
10.1186/s12877-023-04095-7
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
BackgroundUse of anticholinergic (ACH) medications is associated with increased risk of cognitive decline in the elderly. However, little is known about this association from a health plan perspective.MethodsThis retrospective cohort study used the Humana Research Database to identify individuals with at least one ACH medication dispensed in 2015. Patients were followed until incidence of dementia/Alzheimer's disease, death, disenrollment or end of December 2019. Multivariate Cox regression models were used to assess the association between ACH exposure and study outcomes, adjusting for demographics and clinical characteristics.ResultsA total of 12,209 individuals with no prior ACH use or dementia/Alzheimer's disease diagnosis were included. As ACH polypharmacy increased (i.e., from no ACH exposure, to one, two, three, and four or more ACH medications), there was a stair-step increase in the incidence rate of dementia/Alzheimer's disease (15, 30, 46, 56 and 77 per 1,000 person-years of follow-up) and in the incidence of mortality (19, 37, 80, 115 and 159 per 1,000 person-years of follow-up). After adjusting for confounders, ACH exposure to one, two, three and four or more ACH medications was associated with a 1.6 (95% CI 1.4-1.9), 2.1 (95% CI 1.7-2.8), 2.6 (95% CI 1.5-4.4), and 2.6 (95% CI 1.1-6.3) times, respectively, increased risk of a dementia/Alzheimer's disease diagnosis compared to periods of no ACH exposure. ACH exposure to one, two, three and four or more medications was associated with a 1.4 (95% CI 1.2-1.6), 2.6 (95% CI 2.1-3.3), 3.8 (95% CI 2.6-5.4), and 3.4 (95% CI 1.8-6.4) times, respectively, increased risk of mortality compared to periods of no ACH exposure.ConclusionsReducing ACH exposure may potentially minimize long-term adverse effects in older adults. Results suggest populations which may benefit from targeted interventions to reduce ACH polypharmacy.
引用
收藏
页数:8
相关论文
共 50 条
  • [31] Sleep in Older Adults With Alzheimer's Disease
    Song, Yeonsu
    Dowling, Glenna A.
    Wallhagen, Margaret I.
    Lee, Kathryn A.
    Strawbridge, William J.
    JOURNAL OF NEUROSCIENCE NURSING, 2010, 42 (04) : 190 - 198
  • [32] Mortality with Alzheimer's disease and dementia in France, 2006
    Brosselin, P.
    Duport, N.
    Bloch, J.
    REVUE D EPIDEMIOLOGIE ET DE SANTE PUBLIQUE, 2010, 58 (04): : 269 - 276
  • [33] Blood cadmium levels and Alzheimer's disease mortality risk in older US adults
    Min, Jin-young
    Min, Kyoung-bok
    ENVIRONMENTAL HEALTH, 2016, 15
  • [34] Blood cadmium levels and Alzheimer’s disease mortality risk in older US adults
    Jin-young Min
    Kyoung-bok Min
    Environmental Health, 15
  • [35] Serum Lycopene, Lutein and Zeaxanthin, and the Risk of Alzheimer's Disease Mortality in Older Adults
    Min, Jin-young
    Min, Kyoung-bok
    DEMENTIA AND GERIATRIC COGNITIVE DISORDERS, 2014, 37 (3-4) : 246 - 256
  • [36] Medication Exposure and Risk of Dementia and Alzheimer's Disease
    Sharma, Niti
    An, Seong Soo A.
    Kim, Sang Yun
    INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2024, 25 (23)
  • [37] Feasibility of Oral Function Evaluation According to Dementia Severity in Older Adults with Alzheimer's Disease
    Shirobe, Maki
    Edahiro, Ayako
    Motokawa, Keiko
    Morishita, Shiho
    Motohashi, Yoshiko
    Matsubara, Chiaki
    Iwasaki, Masanori
    Watanabe, Yutaka
    Hirano, Hirohiko
    NUTRIENTS, 2024, 16 (07)
  • [38] Incidence of Dementia and Alzheimer's Disease, Genetic Susceptibility, and Grip Strength Among Older Adults
    Kim, Youngwon
    Wang, Mengyao
    Sharp, Stephen J.
    Au Yeung, Shiu Lun
    Luo, Shan
    Jang, Haeyoon
    Jiesisibieke, Zhu Liduzi
    Shi, Qiaoxin
    Chen, Ziyuan
    Brage, Soren
    JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2024, 79 (03):
  • [39] Anticholinergic Drug Use in Older Adults with Dementia: a Systematic Review
    Sacco, Allegra
    Monahan, Kathleen
    Tamlyn, Autumn
    Gaudet, Charles
    ARCHIVES OF CLINICAL NEUROPSYCHOLOGY, 2024, 39 (07) : 1042 - 1042
  • [40] FACTORS ASSOCIATED WITH CUMULATIVE ANTICHOLINERGIC BURDEN IN OLDER ADULTS WITH DEMENTIA
    Masurkar, P.
    Aparasu, R. R.
    VALUE IN HEALTH, 2022, 25 (07) : S590 - S591