Home Nursing Services, Helsinki City Health Center, Helsinki, Finland.
Ann Pharmacother. 2011 May;45(5):596-602. doi: 10.1345/aph.1P650.
Drugs with anticholinergic properties have harmful effects among frail older people and they may antagonize the effects of cholinesterase inhibitors (ChEIs). However, their association with psychological well-being has not been studied.
To determine (1) the prevalence of the use of anticholinergic drugs, ChEIs, or their combination among older adults in residential care facilities and their association with psychological well-being, and (2) the association of anticholinergic drugs with an individual's psychological well-being.
In 2007, all older adults (N = 1475) living in residential care facilities in the cities of Helsinki and Espoo, Finland, were assessed in a cross-sectional study. A trained nurse retrieved data on demographic factors, regularly administered medications, and diagnoses from medical charts. Psychological well-being was assessed using 6 questions concerning life satisfaction, zest for life, plans for the future, feeling needed, and feeling depressed or lonely, and a psychological well-being score was created (range 0-1).
Residents taking anticholinergic drugs (n = 613) were significantly younger, used more drugs, and were more often on ChEIs compared with nonusers (n = 862). There was no significant difference in Charlson comorbidity index, stage of cognition, or dependence on activities of daily living between the users or nonusers of anticholinergic drugs. The anticholinergic drug users had significantly lower psychological well-being scores compared with the nonusers. Of the participants, 10.7% used ChEIs and anticholinergic drugs concomitantly. In logistic regression analysis where age, sex, comorbidities, and use of ChEIs were used as covariates, lower psychological well-being was associated with the use of anticholinergic drugs (OR 1.40; 95% CI 1.00 to 1.94; p = 0.048).
Concomitant use of anticholinergic drugs and ChEIs is common among older adults. The use of anticholinergic drugs is associated with poor psychological well-being.
具有抗胆碱能特性的药物会对体弱的老年人造成有害影响，并且可能会拮抗胆碱酯酶抑制剂（ChEIs）的作用。然而，它们与心理健康之间的关系尚未得到研究。
确定（1）在居住在养老院的老年人中，使用抗胆碱能药物、ChEIs 或两者联合的情况及其与心理健康的关系，以及（2）抗胆碱能药物与个体心理健康的关系。
在 2007 年，芬兰赫尔辛基和埃斯波市的所有居住在养老院的老年人（N=1475）都参与了一项横断面研究。一名训练有素的护士从病历中检索了人口统计学因素、定期服用的药物和诊断数据。使用 6 个问题评估心理健康状况，这些问题涉及生活满意度、生活热情、未来计划、被需要感以及抑郁或孤独感，并创建了一个心理健康评分（范围 0-1）。
服用抗胆碱能药物的居民（n=613）比未服用者（n=862）年龄更小，服用的药物更多，并且更常使用 ChEIs。抗胆碱能药物使用者和未使用者在 Charlson 合并症指数、认知阶段或日常生活活动依赖方面没有显著差异。与未使用者相比，抗胆碱能药物使用者的心理健康评分明显较低。在参与者中，有 10.7%同时使用了 ChEIs 和抗胆碱能药物。在使用年龄、性别、合并症和 ChEIs 使用情况作为协变量的逻辑回归分析中，较低的心理健康与抗胆碱能药物的使用相关（OR 1.40；95%CI 1.00 至 1.94；p=0.048）。
在老年人中，同时使用抗胆碱能药物和 ChEIs 很常见。使用抗胆碱能药物与较差的心理健康相关。
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