老年人精神疾病患者的抗胆碱能负担：一项横断面研究。

Anticholinergic burden in older adults with psychiatric illnesses: A cross-sectional study.

机构信息

PharmD Program, School of Pharmacy, Lebanese International University, Beirut, Lebanon.

出版信息

Arch Psychiatr Nurs. 2023 Jun;44:26-34. doi: 10.1016/j.apnu.2023.03.006. Epub 2023 Mar 28.

DOI:10.1016/j.apnu.2023.03.006

PMID:37197858

Abstract

OBJECTIVES

We aimed in this study to determine the extent of exposure to anticholinergic drugs in older adults with psychiatric illnesses using the anticholinergic cognitive burden (ACB) scale and to identify the factors associated with anticholinergic drugs use and higher ACB scores.

METHODS

A cross-sectional study was conducted in the psychogeriatric division of an elderly care hospital. The study sample comprised all inpatients, aged ≥65 years, and diagnosed with psychiatric illness.

RESULTS

Anticholinergic drugs use was reported in 117 (79.6 %) patients, 76 (51.7 %) had an ACB score ≥ 3. Schizophrenia [OR = 5.4 (95 % CI 1.1-10.2), p = 0.02], anemia [OR = 2.2 (95 % CI 1.54-7.89), p = 0.01], and anticholinergic adverse effects [OR = 2.8 (95 % CI 1.12-7.07), p = 0.04] were significantly associated with a higher likelihood of using anticholinergic drugs. The odds of having an ACB score ≥ 3 over an ACB score = 0 were significantly increased by schizophrenia [OR = 4.9 (95 % CI 1.65-8.02), p = 0.01], anemia [OR = 1.32 (95 % CI 1.90-6.90), p = 0.02], and polypharmacy [OR = 1.74 (95 % CI 1.10-2.40), p = 0.04], while they were significantly decreased by age [OR = 0.86 (95 % CI 0.78-0.96), p < 0.001]. Patients with cognitive impairment were less likely than those without cognitive impairment to have an ACB score ≥ 3 over an ACB score = 0.

CONCLUSIONS

Our study revealed that older adults with psychiatric illnesses were exposed to high anticholinergic burden.

摘要

目的

本研究旨在使用抗胆碱能认知负担（ACB）量表确定患有精神疾病的老年患者抗胆碱能药物的暴露程度，并确定与抗胆碱能药物使用和更高 ACB 评分相关的因素。

方法

在一家老年护理医院的精神科进行了一项横断面研究。研究样本包括所有年龄≥65 岁且被诊断为精神疾病的住院患者。

结果

报告了 117 名（79.6%）患者使用抗胆碱能药物，76 名（51.7%）的 ACB 评分≥3。精神分裂症[比值比（OR）=5.4（95%置信区间 1.1-10.2），p=0.02]、贫血[OR=2.2（95%置信区间 1.54-7.89），p=0.01]和抗胆碱能药物不良反应[OR=2.8（95%置信区间 1.12-7.07），p=0.04]与使用抗胆碱能药物的可能性显著相关。ACB 评分≥3 的可能性与 ACB 评分=0 相比，精神分裂症[OR=4.9（95%置信区间 1.65-8.02），p=0.01]、贫血[OR=1.32（95%置信区间 1.90-6.90），p=0.02]和多种药物治疗[OR=1.74（95%置信区间 1.10-2.40），p=0.04]显著增加，而年龄[OR=0.86（95%置信区间 0.78-0.96），p<0.001]显著降低。与无认知障碍的患者相比，有认知障碍的患者 ACB 评分≥3 的可能性更低。