Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211 Kuopio, Finland.
Drugs Aging. 2013 May;30(5):321-30. doi: 10.1007/s40266-013-0063-2.
The serum anticholinergic activity (SAA) assay has been used to quantify patients' anticholinergic load. In addition, several ranked lists of anticholinergic drugs have been developed to assess anticholinergic drug burden.
This study investigated whether SAA assay results and scores from three ranked lists of anticholinergic drugs (Carnahan's Anticholinergic Drug Scale, Rudolph's Anticholinergic Risk Scale, and Chew's list) are associated with anticholinergic adverse drug events (ADEs) in older people.
We analyzed data from participants in the population-based Geriatric Multidisciplinary Good Care of the Elderly Study in Kuopio, Finland (n = 621). Demographic, diagnostic, and drug use data were collected during standardized interviews and verified from medical records. Vision, functional capacity, cognition, and mood were assessed using validated techniques. The SAA was measured from blood samples.
The SAA was not associated with anticholinergic ADEs. Anticholinergic drug burden computed using each of the three lists was inversely associated with short-distance vision (p < 0.01), activities of daily living (p < 0.05), and instrumental activities of daily living (p < 0.05) in persons with and without dementia. Furthermore, poorer Mini Mental State Examination and poorer Geriatric Depression Scale scores were associated with the anticholinergic drug burden in persons without dementia (p < 0.05-p < 0.001). The association between anticholinergic drug burden and ADEs was strongest when using the lists developed by Carnahan and Chew.
Scores obtained from ranked lists of anticholinergic drugs were associated with clinically significant anticholinergic ADEs but the SAA was not. This finding supports the usefulness of these lists to help identify patients at risk of anticholinergic ADEs in clinical practice.
血清抗胆碱能活性（SAA）测定已用于量化患者的抗胆碱能负荷。此外，已经开发出几种抗胆碱能药物的排序列表来评估抗胆碱能药物负担。
本研究旨在探讨 SAA 测定结果以及三种抗胆碱能药物排序列表（卡纳汉的抗胆碱能药物量表、鲁道夫的抗胆碱能风险量表和切夫的列表）的评分是否与老年人的抗胆碱能不良药物事件（ADEs）相关。
我们分析了来自芬兰库奥皮奥人群为基础的老年多学科良好护理研究（Geriatric Multidisciplinary Good Care of the Elderly Study）参与者的数据（n=621）。在标准化访谈中收集人口统计学、诊断和药物使用数据，并从病历中进行验证。使用经过验证的技术评估视力、功能能力、认知和情绪。从血液样本中测量 SAA。
SAA 与抗胆碱能 ADEs 无关。使用三种列表中的每一种计算的抗胆碱能药物负担与有或无痴呆症的个体的短距离视力（p<0.01）、日常生活活动（p<0.05）和工具性日常生活活动（p<0.05）呈负相关。此外，无痴呆症的个体的简易精神状态检查和老年抑郁量表评分较差与抗胆碱能药物负担相关（p<0.05-p<0.001）。当使用卡纳汉和切夫开发的列表时，抗胆碱能药物负担与 ADEs 之间的关联最强。
从抗胆碱能药物排序列表中获得的评分与临床上显著的抗胆碱能 ADEs 相关，但 SAA 则不然。这一发现支持这些列表在临床实践中帮助识别有抗胆碱能 ADEs 风险的患者的有用性。
