Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, Australia.
J Clin Psychopharmacol. 2012 Apr;32(2):273-7. doi: 10.1097/JCP.0b013e3182487825.
We aimed to assess the relationship between Drug Burden Index (DBI), a risk assessment tool that measures anticholinergic and sedative medication exposure and cognitive performance, and cognitive impairment in older people. The study population consisted of community-dwelling older men, 70 years or older, living in Sydney, Australia. The Addenbrooke's Cognitive Examination (ACE) and the Trail Making Task (TMT) cognitive tests were performed, and participants were categorized as having intact cognition, mild cognitive impairment, or dementia using clinical diagnostic criteria. The analyses were restricted to participants with English-speaking background (n = 987) and to the subgroup whose cognition was intact (n = 887). In the study group, DBI exposure was not associated with poorer performance on the ACE (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.66-1.47) or the TMT (OR, 0.71; 95% CI, 0.40-1.24) tests, after controlling for covariates. Similarly, DBI exposure was not associated with cognitive impairment (OR, 1.34; 95% CI, 0.83-2.16). There was no association between increasing DBI scores and poorer performance on any of the outcomes. On subgroup analysis of cognitively intact subgroup, DBI exposure or increasing DBI scores were not associated with poorer performance on the ACE or the TMT tests. In this study of community-dwelling older men, DBI was not associated with limitations on objective cognitive performance measures or with a clinical diagnosis of mild cognitive impairment or dementia.
我们旨在评估药物负担指数（DBI）与认知障碍之间的关系。DBI 是一种风险评估工具，用于衡量抗胆碱能和镇静药物的暴露程度与认知表现。研究对象为居住在澳大利亚悉尼的社区老年人，年龄在 70 岁或以上。采用 Addenbrooke 认知测验（ACE）和连线测验（TMT）评估认知功能，根据临床诊断标准将参与者分为认知正常、轻度认知障碍或痴呆。分析仅限于以英语为母语的参与者（n=987）和认知正常的亚组（n=887）。在研究组中，控制了混杂因素后，DBI 暴露与 ACE 测试表现（比值比[OR]，0.98；95%置信区间[CI]，0.66-1.47）或 TMT 测试表现（OR，0.71；95% CI，0.40-1.24）差无关。同样，DBI 暴露与认知障碍（OR，1.34；95% CI，0.83-2.16）无关。DBI 评分的增加与任何结果的表现下降之间均无关联。在认知正常亚组的亚组分析中，DBI 暴露或 DBI 评分的增加与 ACE 或 TMT 测试的表现下降无关。在这项针对社区居住的老年男性的研究中，DBI 与客观认知功能测试的限制或轻度认知障碍或痴呆的临床诊断无关。
