Cossette Benoit, Bagna Maimouna, Sene Modou, Sirois Caroline, Lefebvre Gabrielle P, Germain Olivier, Morais José A, Gaudreau Pierrette, Payette Hélène
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada.
Drugs Aging. 2017 Oct;34(10):785-792. doi: 10.1007/s40266-017-0486-2.
The use of drugs with anticholinergic properties (AC drugs) has been associated with decreased functioning and impaired cognition in older adults. Studies assessing the association between AC-drug use and health-related quality of life (HRQoL) show conflicting results.
The aim was to evaluate the association between AC-drug use and HRQoL in community-dwelling older adults.
The NuAge cohort study enrolled 1793 men and women aged 68-82 years. The participants were free of disabilities in activities of daily living, not cognitively impaired at recruitment and followed annually for 3 years (December 2003-May 2005). AC-drug exposure was assessed using the Anticholinergic Cognitive Burden Scale (ACBS). HRQoL was assessed using the physical (PCS) and mental (MCS) component summaries of the 36-item Short Form Survey (SF-36) questionnaire. The association between AC drug and HRQoL was determined by a mixed model analysis using four annual time points.
At recruitment the mean age was 74.4 ± 4.2 years, 52% were female and 33% of participants were prescribed at least one AC drug. The mean PCS and MCS (/100) scores were 49.0 ± 8.2 and 54.9 ± 8.1, respectively. In the mixed model analysis, an increase of 1 on the ACBS was associated with a decrease of -0.50 (95% CI -0.68 to -0.31) in the PCS and an increase of 0.19 (95% CI 0.01-0.37) in the MCS.
In a cohort of generally healthy community-dwelling older adults, AC-drug exposure was associated with a statistically significant decrease in the PCS and increase in the MCS throughout the entire follow-up period. However, the effects on the PCS and MCS were small and likely not clinically relevant.
使用具有抗胆碱能特性的药物（AC药物）与老年人功能减退和认知障碍有关。评估AC药物使用与健康相关生活质量（HRQoL）之间关联的研究结果相互矛盾。
旨在评估社区居住的老年人中AC药物使用与HRQoL之间的关联。
NuAge队列研究纳入了1793名年龄在68 - 82岁的男性和女性。参与者在日常生活活动中无残疾，招募时无认知障碍，并每年随访3年（2003年12月 - 2005年5月）。使用抗胆碱能认知负担量表（ACBS）评估AC药物暴露情况。使用36项简短调查问卷（SF - 36）的身体（PCS）和精神（MCS）成分总结来评估HRQoL。通过使用四个年度时间点的混合模型分析来确定AC药物与HRQoL之间的关联。
招募时的平均年龄为74.4 ± 4.2岁，52%为女性，33%的参与者至少开具了一种AC药物。PCS和MCS（/100）的平均得分分别为49.0 ± 8.2和54.9 ± 8.1。在混合模型分析中，ACBS增加1与PCS降低 - 0.50（95%CI - 0.68至 - 0.31）以及MCS增加0.19（95%CI 0.01 - 0.37）相关。
在一组总体健康的社区居住老年人中，在整个随访期间，AC药物暴露与PCS有统计学意义的降低以及MCS的增加相关。然而，对PCS和MCS的影响较小，可能不具有临床相关性。
