Sura Sneha D, Carnahan Ryan M, Chen Hua, Aparasu Rajender R
J Am Pharm Assoc (2003). 2015 May-Jun;55(3):282-7. doi: 10.1331/JAPhA.2015.14068.
To examine the association between the use of anticholinergic drugs and the health-related quality of life (HRQoL) among community-dwelling older adults with dementia.
This was a retrospective, longitudinal, cohort study of older adults aged 65 years and above diagnosed with dementia using Medical Expenditure Panel Survey data. Anticholinergic drug exposure was measured using the Anticholinergic Drug Scale. The HRQoL measures of interest were Physical Component Score (PCS) and Mental Component Score (MCS). Two separate unweighted multiple linear regression analyses were performed to determine the association of anticholinergic drugs with PCS and MCS, while adjusting for other factors and baseline HRQoL measures.
The study included 112 patients with dementia; 15.18% of whom used anticholinergic drugs. The majority of the patients were between the ages of 65 and 79 years (53%), women (57%), and had poor or low family income (65%). After controlling for other factors and baseline HRQoL, anticholinergic drug use was associated with 7.48 unit reductions in PCS (P <0.01), whereas no association was found between anticholinergic drug use and MCS. Baseline HRQoL measures were found to be significant in both models.
Anticholinergic drugs are associated with reduced PCS of HRQoL in older adults with dementia. The study findings suggest the need for carefully monitoring the health status of elderly patients when prescribing anticholinergic agents in this vulnerable population.
探讨抗胆碱能药物的使用与社区居住的老年痴呆患者健康相关生活质量(HRQoL)之间的关联。
这是一项回顾性纵向队列研究,利用医疗支出面板调查数据对65岁及以上被诊断为痴呆的老年人进行研究。使用抗胆碱能药物量表来衡量抗胆碱能药物暴露情况。感兴趣的HRQoL指标是身体成分得分(PCS)和精神成分得分(MCS)。进行了两项单独的非加权多元线性回归分析,以确定抗胆碱能药物与PCS和MCS之间的关联,同时对其他因素和基线HRQoL指标进行调整。
该研究纳入了112例痴呆患者;其中15.18%使用了抗胆碱能药物。大多数患者年龄在65至79岁之间(53%),为女性(57%),且家庭收入较差或较低(65%)。在控制了其他因素和基线HRQoL后,使用抗胆碱能药物与PCS降低7.48个单位相关(P<0.01),而未发现使用抗胆碱能药物与MCS之间存在关联。在两个模型中,基线HRQoL指标均具有显著性。
抗胆碱能药物与老年痴呆患者HRQoL的PCS降低有关。研究结果表明,在为这一脆弱人群开具抗胆碱能药物时,需要仔细监测老年患者的健康状况。