Ageing Clinical & Experimental Research (ACER) Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences, and Nutrition, University of Aberdeen, UK; Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK.
Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, UK; Arthritis and Musculoskeletal Medicine Research Programme, Institute of Medical Sciences, University of Aberdeen, UK; Medicines Monitoring Unit, University of Dundee, Dundee, UK.
Ann Epidemiol. 2018 Aug;28(8):557-562.e2. doi: 10.1016/j.annepidem.2018.05.011. Epub 2018 Jun 2.
To examine the cross-sectional association between anticholinergic medication burden (ACB) and a history of falls, bone mineral density, and low trauma fractures in middle-aged women aged under 65 years from the Aberdeen Prospective Osteoporosis Screening Study.
ACB (0 = none, 1 = possible, ≥2 = definite) was calculated from medication use for 3883 Caucasian women [mean age (SD) = 54.3 (2.3) years] attending the second Aberdeen Prospective Osteoporosis Screening Study visit (1997-2000). Outcomes were examined using logistic regression. Model adjustments were selected a priori based on expert opinion.
Of 3883 participants, 3293 scored ACB = 0, 328 scored ACB = 1, and 262 scored ACB ≥2. High ACB burden (≥2) was associated with increased odds (ACB = 0 reference) for falls (fully adjusted odds ratio [95% confidence intervals] = 1.81 [1.25-2.62]; P = 0.002) and having low bone mineral density (lowest quintile-20%) at Ward's triangle (3.22 [1.30-7.99]; P = 0.01). A history of falls over the year prior to the study visit in participants with ACB score ≥2 was 32 per 100. For ACB categories 1 and 0, a history of falls per 100 was 21 and 22, respectively.
The risk of falling associated with ACB observed in older age may also extend to middle-aged women.
在年龄在 65 岁以下的中年女性中，从阿伯丁前瞻性骨质疏松症筛查研究中，研究抗胆碱能药物负担 (ACB) 与跌倒史、骨密度和低创伤性骨折之间的横断面关联。
根据 3883 名参加第二次阿伯丁前瞻性骨质疏松症筛查研究（1997-2000 年）的白种人女性（平均年龄 [标准差] 54.3 [2.3] 岁）使用药物的情况，计算 ACB（0 = 无，1 = 可能，≥2 = 明确）。使用逻辑回归检查结果。根据专家意见，预先选择模型调整。
在 3883 名参与者中，3293 名的 ACB = 0，328 名的 ACB = 1，262 名的 ACB ≥2。高 ACB 负担（≥2）与跌倒的几率增加相关（ACB = 0 参考）（完全调整后的优势比 [95%置信区间] = 1.81 [1.25-2.62]；P = 0.002）和在 Ward 三角区的骨密度较低（最低五分位数-20%）（3.22 [1.30-7.99]；P = 0.01）。在 ACB 评分≥2 的参与者中，研究前一年有跌倒史的比例为 32 每 100。对于 ACB 类别 1 和 0，每 100 例跌倒的历史分别为 21 和 22。
在老年人群中观察到的与 ACB 相关的跌倒风险可能也会扩展到中年女性。
