Ruiz Sergio J, Cevallos Victor, Baskaran Dhanya, Mintzer Michael J, Ruiz Jorge G
Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Veterans Successful Aging for Frail Elders (VSAFE), 1201 NW 16th Street, Miami, FL, 33125, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Aging Clin Exp Res. 2021 Aug;33(8):2283-2289. doi: 10.1007/s40520-020-01742-6. Epub 2020 Nov 12.
Anticholinergic drugs may contribute to frailty by impairing cognitive and physical functions. Strong anticholinergic drugs in particular may have adverse effects among older adults.
Determine the association between frailty and the use of strong anticholinergic drugs among older US Veterans.
This is a cross-sectional study of community-dwelling Veterans 65 years and older who had determinations of frailty status. Prescription data for patients using strong anticholinergic medications (never/past/current) was obtained via electronic health records. A 31-item VA Frailty Index (VA-FI) was generated at the time of the assessment. We dichotomized the groups into non-frail (FI = < 0.21) and frail (FI ≥ 0.21) patients. We used binomial logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Frailty was the dependent variable and use of strong anticholinergic drugs was the independent variable. Multivariate adjustment was conducted for age, gender, race, ethnicity, marital status, and BMI.
Population sample consisted of 17,084 Veterans who were 71.05% Caucasian, 97.34% male, and with a mean age 75.60 (SD = 8.04) years. Among the population, 9940 (58.18%) patients had no previous use of strong anticholinergic drugs, whereas 5182 (30.33%) had past exposure and 1962 (11.49%) had current exposure. In binomial logistic regression, individuals with past (OR 3.27, 95% CI 3.03-3.54, p < 0.0005) or current (OR 4.78, 95% CI 4.30-5.31, p < 0.0005) exposure showed a higher association with frailty as compared to individuals who were never exposed.
Past and current use of strong anticholinergic drugs were associated with frailty in older Veterans. These results suggest that screening for frailty in patients with past or current exposure to strong anticholinergic medications may be necessary for proper management.
抗胆碱能药物可能通过损害认知和身体功能导致身体虚弱。尤其是强效抗胆碱能药物可能对老年人产生不良影响。
确定美国老年退伍军人身体虚弱与强效抗胆碱能药物使用之间的关联。
这是一项对65岁及以上社区居住退伍军人进行的横断面研究，这些退伍军人已确定身体虚弱状况。通过电子健康记录获取使用强效抗胆碱能药物（从未使用/过去使用/当前使用）患者的处方数据。在评估时生成一份包含31个项目的退伍军人事务部虚弱指数（VA-FI）。我们将研究对象分为非虚弱组（FI＜0.21）和虚弱组（FI≥0.21）。我们使用二项逻辑回归来计算比值比（OR）和95%置信区间（CI）。身体虚弱是因变量，强效抗胆碱能药物的使用是自变量。对年龄、性别、种族、民族、婚姻状况和体重指数进行多变量调整。
研究人群样本包括17084名退伍军人，其中71.05%为白种人，97.34%为男性，平均年龄75.60岁（标准差=8.04）。在该人群中，9940名（58.18%）患者以前从未使用过强效抗胆碱能药物，而5182名（30.33%）曾有过接触，1962名（11.49%）目前正在使用。在二项逻辑回归中，与从未接触过的个体相比，曾有过接触（OR 3.27，95% CI 3.03 - 3.54，p＜0.0005）或目前正在接触（OR 4.78，95% CI 4.30 - 5.31，p＜0.0005）的个体与身体虚弱的关联更高。
过去和目前使用强效抗胆碱能药物与老年退伍军人的身体虚弱有关。这些结果表明，对于过去或目前接触强效抗胆碱能药物的患者，进行身体虚弱筛查可能对适当管理很有必要。
