Background and importance Anticholinergic drugs (ACD) are closely related to serious negative health outcomes in the elderly but they are widely used in these patients. There are several scales in the literature to predict the risk of suffering anticholinergic effects in the elderly.
Aim and objectives To analyse the anticholinergic risk and its variability using different scales in a sample of institutionalised elderly patients.
Material and methods An observational retrospective study was conducted in institutionalised patients with the following characteristics: age >65 years, polymedicated (>5 drugs) with at least one prescribed ACD. The variables collected were: age, sex, prescribed drugs and anticholinergic risk calculated from the anticholinergic cognitive burden scale (CBA), anticholinergic risk scale (ARS), Chew’s scale (Chew), anticholinergic drug scale (ADS), Duran’s scale (Duran) and drug burden index (DBI). Data were obtained from the electronic clinical history.
Results 41 patients (73.2% women) were included with a mean age of 86.6±7.1 years. Mean prescriptions were 11.2±2.7. Percentage of patients with at least one ACD prescribed according to the different scales was: 75.6% (CBA), 61% (ARS), 56.1% (Chew), 73.2% (ADS), 70.7% (Duran), 90.2% (DBI). Percentage of patients with low anticholinergic risk was: 31.7% (CBA), 34.1% (ARS), 24.4% (Chew), 31.7% (ADS), 34.1% (Duran), 0% (DBI). Percentage of patients with medium anticholinergic risk was: 9.8% (CBA), 14.6% (ARS), 12.2% (Chew), 26.8% (ADS), 0% (Duran), 24.4% (DBI). Percentage of patients with high anticholinergic risk was: 34.1% (CBA), 12.2% (ARS), 19.5% (Chew), 14.6% (ADS), 36.6% (Duran), 65.9% (DBI).
Conclusion and relevance There was a high probability of anticholinergic effects in our sample of patients but according to the scale used, both the percentage of patients at risk of anticholinergic effects and the degree of the risk were variable. It seems that the DBI scale tended to detect greater risk in our patients. Further studies are needed to validate which scale is the most appropriate for our population.
Conflict of interest No conflict of interest
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