Journal of the American Medical Directors Association
Original StudyAssociations Between the Anticholinergic Risk Scale Score and Physical Function: Potential Implications for Adverse Outcomes in Older Hospitalized Patients
Section snippets
Study Population
We studied a consecutive series of older patients (older than 60 years) admitted to acute geriatric medicine beds within 2 hospital sites (Aberdeen Royal Infirmary and Woodend Hospital, NHS Grampian, Aberdeen, Scotland, UK) from February 1, 2010, to June 30, 2010. Both units operate a “needs-based” rather than an “age-based” policy of admission, with patients characterized by aging-related frailty and/or complexity due to multiple medical and/or social issues, rather than single-organ
Results
A total number of 362 patients were admitted in the 2 acute geriatric units during the study period. The demographic and clinical characteristics of the study population are described in Table 1. The frequency distributions of the ARS and the dose-adjusted ARS scores were markedly skewed because 65.7% of patients had a score of 0 (i.e., no drugs with anticholinergic effects) (Figure 1).
Discussion
The results of this study suggest that higher ARS scores, unadjusted and dose-adjusted, are independently associated with lower scores in several components of the Barthel Index in a consecutive series of older patients admitted in an acute geriatric medicine service. The magnitude of this association was similar to other established clinical determinants of reduced physical function. Higher ARS scores did not predict increased LOS but predicted in-hospital mortality in the presence of
References (30)
Synthesis, trafficking, and localization of muscarinic acetylcholine receptors
Pharmacol Ther
(2008)- et al.
Postoperative delirium. A review of 80 primary data-collection studies
Arch Intern Med
(1995) - et al.
How to measure comorbidity. A critical review of available methods
J Clin Epidemiol
(2003) - et al.
Prognostic implications of hyponatremia in elderly hospitalized patients
Arch Gerontol Geriatr
(2007) - et al.
A pharmacoepidemiologic study of community-dwelling, disabled older women: Factors associated with medication use
Am J Geriatr Pharmacother
(2010) - et al.
Electrolytes in the aging
Adv Chronic Kidney Dis
(2010) - et al.
A review of drug-induced hyponatremia
Am J Kidney Dis
(2008) - et al.
Drugs with anticholinergic properties and cognitive performance in the elderly: results from the PAQUID Study
Br J Clin Pharmacol
(2005) - et al.
Association between prescribing of antimuscarinic drugs and antimuscarinic adverse effects in older people
Exp Rev Clin Pharmacol
(2010) - et al.
The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity
J Clin Pharmacol
(2006)
Anticholinergic drugs and physical function among frail elderly population
Clin Pharmacol Ther
Cumulative anticholinergic exposure is associated with poor memory and executive function in older men
J Am Geriatr Soc
A systematic literature review of factors affecting outcome in older medical patients admitted to hospital
Age Ageing
Effects of physical activity on health status in older adults. I: Observational studies
Annu Rev Public Health
The relationship of postoperative delirium with psychoactive medications
JAMA
Cited by (0)
The authors declare no conflicts of interest.