Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Ziołowa 45/47, 40-635 Katowice, Poland.
Student Scientific Interest Group, Department of Geriatrics, Faculty of Medical Sciences, Medical University of Silesia, Ziołowa 45/47, 40-635 Katowice, Poland.
Medicina (Kaunas). 2021 Oct 16;57(10):1115. doi: 10.3390/medicina57101115.
: Anticholinergic drug use in the pharmacotherapy of elderly persons is common despite the increased risk of side effects. We examined the prevalence of anticholinergic drug use and total anticholinergic drug burden among patients admitted to an acute care geriatric ward in Poland. : Cross-sectional study of 329 subjects hospitalized at the geriatric ward. Patient condition was assessed with a comprehensive geriatric assessment. The Anticholinergic Cognitive Burden (ACB) scale was used to estimate the total anticholinergic load. : Mean patient age was 79.61 ± 6.82 years. 40.73% of them were burdened with at least one anticholinergic drug. The clinically significant anticholinergic burden was observed in 13.98% of subjects. Patients with dementia, risk of falls, and severe disability had significantly higher total ACB scores compared to other groups. The receiver operating characteristics (ROC) curve revealed that the total ACB score ≥ 1 was significantly associated with dementia and the risk of falls. Total ACB score ≥ 2 was significantly associated with severe disability. : Patients admitted to an acute care geriatric ward had an anticholinergic cognitive burden score comparable to other patient populations. We found associations at both low and elevated levels of anticholinergic burden with dementia and risk of falls. At elevated anticholinergic burden levels, we found associations with severe disability. Despite recommendations against the use of anticholinergics in older adults these medications are still commonly prescribed. Further study is necessary to define the characteristics of anticholinergic medication most closely associated with negative outcomes in elderly populations.
抗胆碱能药物在老年人的药物治疗中很常见，尽管副作用风险增加。我们研究了在波兰一家急性老年护理病房住院患者中抗胆碱能药物的使用情况和总抗胆碱能药物负担。
这是一项对 329 名住院老年病房患者的横断面研究。患者病情采用全面老年评估进行评估。使用抗胆碱能认知负担量表（ACB）来估计总抗胆碱能负荷。
患者平均年龄为 79.61 ± 6.82 岁。其中 40.73%的患者至少使用了一种抗胆碱能药物。13.98%的患者存在有临床意义的抗胆碱能负担。患有痴呆症、有跌倒风险和严重残疾的患者的总 ACB 评分明显高于其他组。受试者工作特征（ROC）曲线显示，总 ACB 评分≥1 与痴呆症和跌倒风险显著相关。总 ACB 评分≥2 与严重残疾显著相关。
入住急性老年护理病房的患者的抗胆碱能认知负担评分与其他患者群体相当。我们发现，在低和高抗胆碱能负担水平上，与痴呆症和跌倒风险都存在关联。在高抗胆碱能负担水平上，与严重残疾有关。尽管建议老年人避免使用抗胆碱能药物，但这些药物仍被广泛使用。需要进一步研究以确定与老年人群负面结果最密切相关的抗胆碱能药物特征。
