Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study
Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study
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DOI：
10.1007/s40266-018-0578-7
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发表时间：
2018-09-01
期刊：
影响因子：
2.8
通讯作者：
Witham, Miles D.
中科院分区：
文献类型：
--
作者：
Clarke, Clare L.;Sniehotta, Falko F.;Witham, Miles D.
中枢作用药物会导致认知减慢和协调不协调，这可能会减少老年人的体力活动水平。这种联系以前从未被研究过。这项研究的目的是在一组老年人中检查阿片类药物、催眠药和抗胆碱能药物与客观测量的体力活动之间的关系。我们使用了苏格兰体力活动队列的数据，这是一个有代表性的65岁及以上社区老年人队列，他们在基线和2-3年后再次进行评估。目的使用STEYHANG RT3加速度计测量7天内的体力活动。基线用药(阿片类药物使用、催眠药物使用、改良的抗胆碱能风险量表[MARS])是从关联的、常规收集的社区处方记录中获得的。使用未调整和调整后的线性回归模型分析了基线用药与基线活动和随时间变化的活动之间的横截面和纵向关联。总共有310名参与者被纳入分析；平均年龄77岁(标准差7)。在未调整或调整的模型中，未发现任何药物类别的基线使用与基线体力活动水平之间存在关联。对于活动随时间的变化，使用催眠药或阿片类药物的人和不使用安眠药或阿片类药物的人之间没有差异。更高的抗胆碱能负荷与随访期内活动的急剧下降有关(MARS 0：-7051次/24小时/年；MARS 1-2：-15,942次/24小时/年；MARS AE 3：-19,544次/24小时/年；p=0.03)，这对多重调整仍然很强。抗胆碱能负荷与老年人随着时间的推移客观测量的体力活动减少更大相关，这一发现在使用催眠药或阿片类药物时是看不到的。
Centrally acting medications cause cognitive slowing and incoordination, which could reduce older people's physical activity levels. This association has not been studied previously.The aim of this study was to examine the association between opioid, hypnotic and anticholinergic medication, and objectively measured physical activity, in a cohort of older people.We used data from the Physical Activity Cohort Scotland, a representative cohort of community-dwelling older people aged 65 years and over who were assessed at baseline and again 2-3 years later. Objective physical activity was measured using Stayhealthy RT3 accelerometers over 7 days. Baseline medication use (opioid use, hypnotic use, modified Anticholinergic Risk Scale [mARS]) was obtained from linked, routinely collected community prescribing records. Cross-sectional and longitudinal associations between baseline medication use and both baseline activity and change in activity over time were analysed using unadjusted and adjusted linear regression models.Overall, 310 participants were included in the analysis; mean age 77 years (standard deviation 7). No association was seen between baseline use of any medication class and baseline physical activity levels in unadjusted or adjusted models. For change in activity over time, there was no difference between users and non-users of hypnotics or opioids. Higher anticholinergic burden was associated with a steeper decline in activity over the follow-up period (mARS 0: - 7051 counts/24 h/year; mARS 1-2: - 15,942 counts/24 h/year; mARS ae 3: - 19,544 counts/24 h/year; p = 0.03) and this remained robust to multiple adjustments.Anticholinergic burden is associated with greater decline in objectively measured physical activity over time in older people, a finding not seen with hypnotic or opioid use.