接受口腔护理的老年（≥50 岁）人群中的抗胆碱能负担和口干问题：一项回顾性、横断面分析。

Anticholinergic Burden and Dry Mouth Problems Among Older Adults (≥ 50 Years) Receiving Dental Care-A Retrospective, Cross-Sectional Analysis.

机构信息

Polyclinic for Operative Dentistry and Periodontology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

出版信息

Clin Exp Dent Res. 2024 Dec;10(6):e70009. doi: 10.1002/cre2.70009.

DOI:10.1002/cre2.70009

PMID:39498813

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11536193/

Abstract

OBJECTIVES

Anticholinergics cause dry mouth and are highly relevant for dentists, but little is known about the relationships between intake and the occurrence of subjective and objective dry mouth with age. The German anticholinergic burden score (GACB) is a novel anticholinergic score that re-evaluates medications, particularly, those with classification discrepancies.

MATERIAL AND METHODS

We retrospectively investigated the GACB in older patients receiving dental care, evaluated whether GACB is related to xerostomia and unstimulated salivary secretion, and determined the influence of increasing age (beginning at 50 years of age). The GACB score quantified cumulative anticholinergic effects: 0 for no effect, 1 for possible, 2 for moderate, and 3 for strong. Cross-sectional data in patients ≥ 50 years were collected, including xerostomia with the visual analog scale, unstimulated salivary flow rates, and the GACB scores.

RESULTS

Among 172 patients (mean age 65.67 ± 9.51 years), 23.8% had a GACB score ≥ 1. A moderate negative correlation was observed between GACB and unstimulated salivary flow rates ( = -0.51). Patients with GACB ≥ 1 had fewer teeth (mean 21.76 ± 5.41) than those with GACB = 0 (24.07 ± 5.57). Moreover, unstimulated hyposalivation was observed in 61.0% with GACB ≥ 1 versus 6.8% with GACB = 0 (p < 0.001). Escalating chronic systemic conditions and prescribed medications were recorded with increasing age; those aged 76-80 years had the highest burden.

CONCLUSIONS

The GACB quickly and reliably assesses anticholinergic exposure and risks for oral health in older patients. Routine use in those aged ≥ 50 years could enable early identification of risks and initiation of preventive dental measures.

TRIAL REGISTRATION

German Registry for Clinical Trials: DRKS00032877 (https://www.germanctr.de; date of registration: 17.10.2023).

摘要

目的

抗胆碱能药物会导致口干，这与牙医密切相关，但人们对其摄入量与口干的主观和客观症状随年龄变化的关系知之甚少。德国抗胆碱能药物负担评分（GACB）是一种新的抗胆碱能评分，它重新评估了药物，特别是那些分类有差异的药物。

材料和方法

我们回顾性地调查了接受牙科护理的老年患者的 GACB，评估 GACB 是否与口干和非刺激性唾液分泌有关，并确定了年龄增长（从 50 岁开始）的影响。GACB 评分量化了累积的抗胆碱能作用：0 表示无作用，1 表示可能有作用，2 表示中度作用，3 表示强作用。收集了≥50 岁患者的横断面数据，包括口干的视觉模拟评分、非刺激性唾液流率和 GACB 评分。

结果

在 172 名患者（平均年龄 65.67±9.51 岁）中，23.8%的患者 GACB 评分≥1。GACB 与非刺激性唾液流率之间存在中度负相关（r=-0.51）。GACB≥1 的患者牙齿较少（平均 21.76±5.41 颗），而 GACB=0 的患者牙齿较多（24.07±5.57 颗）。此外，GACB≥1 的患者中有 61.0%存在非刺激性低流涎症，而 GACB=0 的患者中仅有 6.8%存在该症状（p<0.001）。随着年龄的增长，记录到慢性系统性疾病和处方药物的增加；76-80 岁年龄组的负担最高。