Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16849
Title: Potentially inappropriate medication, anticholinergic burden, and mortality in people attending memory clinics
Authors: Cross, Amanda J;George, Johnson;Woodward, Michael C;Ames, David;Brodaty, Henry;Wolfe, Rory;Connors, Michael H;Elliott, Rohan A
Issue Date: 2017
EDate: 2017-09-01
Citation: Journal of Alzheimer's Disease 2017; 60(2): 349-358
Abstract: Background:There is limited evidence regarding the association between potentially inappropriate medications (PIM) and mortality in older people with cognitive impairment. Objective:To examine whether use of medications considered to be potentially inappropriate in older people with cognitive impairment (PIMcog) and anticholinergic cognitive burden (ACB) were associated with mortality in people who attended memory clinics. Methods:Cross-sectional and longitudinal analyses of data from the Prospective Research In MEmory clinics (PRIME) study. Participants were community-dwelling people who attended nine memory clinics and had a diagnosis of mild cognitive impairment or dementia. PIMcog was defined as any medication considered potentially inappropriate for a person with cognitive impairment according to Beers or STOPP criteria. Anticholinergic burden was calculated using the ACB scale. Time-dependent Cox-proportional hazards regression was used to analyze associations between PIMcog use/ACB score and all-cause mortality over a three-year follow-up period. The regression model included the baseline variables: age, gender, education, cognitive diagnoses, total number of medications, disease-burden, cognition, physical function, and neuropsychiatric symptoms. Results:Of 964 participants, 360 (37.3%) used one or more PIMcog at some time during the study; most commonly anticholinergics and sedatives. 624 (64.7%) participants used a medication with potential or definite anticholinergic properties (ACB>0) at some point during the study. Both PIMcog use (adjusted hazard ratio: 1.42 95% CI: 1.12–1.80) and ACB score (adjusted hazard ratio: 1.18 95% CI: 1.06–1.32) were associated with mortality. Conclusion:Use of PIMcogs and medications with anticholinergic properties was common among memory clinic patients and both were associated with mortality.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16849
DOI: 10.3233/JAD-170265
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28869467
Type: Journal Article
Subjects: Alzheimer’s disease
Cholinergic antagonists
Cognitive dysfunction
Dementia
Inappropriate prescribing
Mortality
Potentially inappropriate medication list
Appears in Collections:Journal articles

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