Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan
Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan
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DOI：
10.1111/ggi.13032
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发表时间：
2017-04-01
影响因子：
3.3
通讯作者：
Chen, Liang-Kung
中科院分区：
文献类型：
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作者：
Wu, Yi-Hui;Wang, Chih-Jen;Chen, Liang-Kung
抗胆碱能药物的使用与老年人的不良健康结果密切相关，特别是在认知障碍或痴呆症中。本研究旨在评估与使用抗胆碱能药物的老年男性生活在退伍军人的家园在Taiwan.MethodsThis回顾性队列研究的纵向老年退伍军人研究的子研究。研究对象为274名居住在四所台湾退伍军人之家的居民，于2012年1月至2014年12月期间连续接受两次简易精神状态检查。所有参与者的药物清单由同一名医生审查，并使用抗胆碱能认知负担量表评价个体药物的抗胆碱能特性。认知功能下降被定义为在研究期间简易精神状态检查分数的下降。（50.7%）在基线时暴露于抗胆碱能药物AC[+]，最常用的抗胆碱能药物为心血管药物抗精神病药占21.6%，茶碱占20.1%，抗抑郁药占12.2%，胃肠道药占11.5%，抗组胺药占8.6%。校正协变量后，AC（+）参与者发生短期认知功能下降的风险显著较高（OR 2.69，95% CI 1.36-5.31）。排除30名使用抗精神病药物的参与者后，非抗精神病药物AC（+）参与者仍有显着较高的短期认知功能下降的风险（OR 2.24，95%CI 1.26-3.99）.ConclusionsExposure抗胆碱能药物显着增加了老年男性短期认知功能下降的风险，并且当排除抗精神病药物进行分析时，不良反应仍然相似。需要进一步的干预研究来评估减少抗胆碱能负荷是否可以改善老年人的认知功能。Geriatr Gerontol Int 2017：17（Suppl. 1）：57-64.
AimThe use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan.MethodsThis retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6months from January 2012 to December 2014 were enrolled in the present study. The medication lists for all participants were reviewed by the same physician, and the anticholinergic properties of the individual medications were evaluated by using the Anticholinergic Cognitive Burden scale. Cognitive decline was defined as the decrease of Mini-Mental State Examinations scores during the study period.ResultsOverall, 139 persons (50.7%) had exposure to anticholinergic drugs at baseline (designated as AC[+]), and the most frequently used anticholinergic drugs were cardiovascular drugs (48.2%), antipsychotics (21.6%), theophylline (20.1%), antidepressants (12.2%), gastrointestinal drugs (11.5%) and antihistamines (8.6%). After adjusting for covariates, AC(+) participants had a significantly higher risk for short-term cognitive decline (OR 2.69, 95% CI 1.36-5.31). After excluding 30 participants using antipsychotics, non-antipsychotics AC(+)participants still had a significantly higher risk for short-term cognitive decline (OR 2.24, 95% CI 1.26-3.99).ConclusionsExposure to anticholinergic drugs significantly increased the risk for short-term cognitive decline among older men, and the adverse effects remained similar when antipsychotics were excluded for analysis. A further intervention study is required to evaluate whether reducing anticholinergic burden might improve cognitive function among older adults. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 57-64.