抗胆碱能负担与老年智力障碍患者不良反应的关联：一项观察性横断面研究。
Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an observational cross-sectional study.
机构信息
Máire O'Dwyer, PhD, School of Pharmacy and Pharmaceutical Sciences and IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Ian D. Maidment, PhD, School of Life and Health Sciences, Aston University, Birmingham, UK; Kathleen Bennett, PhD, Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James Hospital, Dublin, Ireland; Jure Peklar, MPharm, School of Pharmacy, University of Ljubljana, Ljubljana, Slovenia; Niamh Mulryan, MB MRCPsych, IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Philip McCallion, PhD, Centre for Aging and Excellence in Community Wellness, University At Albany, New York, USA; Mary McCarron, PhD, Trinity College Dublin, Ireland; Martin C. Henman, PhD, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland
Máire O'Dwyer, PhD, School of Pharmacy and Pharmaceutical Sciences and IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Ian D. Maidment, PhD, School of Life and Health Sciences, Aston University, Birmingham, UK; Kathleen Bennett, PhD, Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James Hospital, Dublin, Ireland; Jure Peklar, MPharm, School of Pharmacy, University of Ljubljana, Ljubljana, Slovenia; Niamh Mulryan, MB MRCPsych, IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Philip McCallion, PhD, Centre for Aging and Excellence in Community Wellness, University At Albany, New York, USA; Mary McCarron, PhD, Trinity College Dublin, Ireland; Martin C. Henman, PhD, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland.
出版信息
Br J Psychiatry. 2016 Dec;209(6):504-510. doi: 10.1192/bjp.bp.115.173971. Epub 2016 Sep 22.
BACKGROUND
No studies to date have investigated cumulative anticholinergic exposure and its effects in adults with intellectual disabilities.
AIMS
To determine the cumulative exposure to anticholinergics and the factors associated with high exposure.
METHOD
A modified Anticholinergic Cognitive Burden (ACB) scale score was calculated for a representative cohort of 736 people over 40 years old with intellectual disabilities, and associations with demographic and clinical factors assessed.
RESULTS
Age over 65 years was associated with higher exposure (ACB 1-4 odds ratio (OR) = 3.28, 95% CI 1.49-7.28, ACB 5+ OR = 3.08, 95% CI 1.20-7.63), as was a mental health condition (ACB 1-4 OR = 9.79, 95% CI 5.63-17.02, ACB 5+ OR = 23.74, 95% CI 12.29-45.83). Daytime drowsiness was associated with higher ACB (P<0.001) and chronic constipation reported more frequently (26.6% ACB 5+ v. 7.5% ACB 0, P<0.001).
CONCLUSIONS
Older people with intellectual disabilities and with mental health conditions were exposed to high anticholinergic burden. This was associated with daytime dozing and constipation.
背景
目前尚无研究调查累积抗胆碱能暴露及其对成年智力障碍患者的影响。
目的
确定抗胆碱能药物的累积暴露情况，并确定与高暴露相关的因素。
方法
为 736 名年龄在 40 岁以上的智力障碍患者代表性队列计算改良的抗胆碱能认知负担（ACB）量表评分，并评估与人口统计学和临床因素的相关性。
结果
65 岁以上与更高的暴露相关（ACB 1-4 比值比（OR）=3.28，95%CI 1.49-7.28，ACB 5+ OR = 3.08，95%CI 1.20-7.63），精神健康状况也是如此（ACB 1-4 OR = 9.79，95%CI 5.63-17.02，ACB 5+ OR = 23.74，95%CI 12.29-45.83）。白天嗜睡与更高的 ACB 相关（P<0.001），且报告更频繁的慢性便秘（26.6% ACB 5+ vs. 7.5% ACB 0，P<0.001）。
结论
智力障碍的老年人和有精神健康状况的人暴露于高抗胆碱能负担下。这与白天嗜睡和便秘有关。
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