Background Taking multiple drugs with anticholinergic risk (AR) can adversely impact cognition and function. There are scales that rank the anticholinergic activity by the mean of the anticholinergic burden (AB) of the treatment, which is the sum of the score for each anticholinergic drug.
Purpose This study investigated the influence of AB on cognition and function in patients with multimorbidity over 65 years.
Material and methods This was an observational and retrospective pilot study of patients with multimorbidity over 65 years. Changes in cognitive and functional performances, assessed using the Pfeiffer and Barthel test, respectively, between 3–15 months, were collected. AB was assessed with the anticholinergic burden calculator (http://www.anticholinergicscales.es/), which contains 10 scales. Included patients had to be treated with at least one drug included in at least one scale for at least half of the period and patients with severe dementia and/or Alzheimer’s disease were excluded.
Results One-hundred and seventy-seven patients were included in preliminary analysis (84±7 years, 62% females). The average number of drugs taken per patient was 10±4. The average number of drugs with AB was 4±2. We identified 77 and 41 patients with a change in cognitive disorder (CD) (44%) and functional disorder (FD) (23%), respectively, and 23 patients (13%) suffered falls.
The patients identified with high AB according to each scale were: 96 patients on the ABC scale (54%), 57 on DBI (32%), 45 on DURAN (25%), 35 on ACB (20%), 32 on ADS (18%), 28 on ALS (16%), 28 on CrAS (16%), 20 on CHEW (11%), 19 on AAS (11%) and 10 on ARS (6%).
Fifty-nine patients (77%) with a change in CD and 31 (76%) patients with a change in FD, had high AB on at least one scale. Eighteen (78%) of patients with falls had high AB on at least one scale.
Conclusion We found a high percentage of patients with multimorbidity over 65 years with deterioration of cognitive and functional function when they have taken anticholinergic drugs. Moreover, there are wide differences among the scales’ scores. It is necessary for a more exhaustive analysis of the results to determine which scales correlate better with DC and DF in these patients.
References and/or acknowledgements Villalba-Moreno, et al. 2016.
No conflict of interest.
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