Tags

Type your tag names separated by a space and hit enter

Anticholinergic burden is associated with recurrent and injurious falls in older individuals.
Maturitas. 2016 Feb; 84:32-7.M

Abstract

OBJECTIVE

While the anticholinergic activity of medications has been linked to cognitive decline, few studies have linked anticholinergic burden with falls in older people. We evaluated the relationship between anticholinergic burden and recurrent and injurious falls among community-dwelling older adults.

STUDY DESIGN

This case-control study was performed on 428 participants aged ≥65 years, 263 cases with two or more falls or one injurious fall in the preceding 12 months, and 165 controls with no falls in the preceding 12 months. Anticholinergic burden was determined using the anticholinergic cognitive burden (ACB) scale. Upper and lower limb functional abilities were assessed with timed up and go (TUG), functional reach (FR) and grip strength (GS). Logistic regression analysis was employed to calculate the mediation effect of TUG, FR and GS on ACB associated falls.

RESULTS

Univariate analysis revealed a significant association between an ACB score of ≥1 with falls (OR, 1.8; 95% CI; 1.1-3.0; p=0.01) and significantly poorer TUG and FR. The association between ACB≥1 and falls was no longer significant after adjustment for either TUG (OR for ACB associated falls, 1.4; 95% CI, 0.88-2.4; p=0.14) or FR (OR for ACB associated falls, 1.4; 95% CI, 0.89-2.4, p=0.12) but remained significant with GS.

CONCLUSION

The association between recurrent and injurious falls and the use of any medications listed in the ACB scale was mediated through gait and balance impairment but not by muscular weakness, providing a novel insight into the potential mechanistic link between ACB and falls. Future studies should determine whether TUG and FR measurements could help inform risk to benefit decisions where ACB medications are being considered.

Authors+Show Affiliations

Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: Dr.anamzia@yahoo.com.Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: Shahrulk@gmail.com.AGEING, Epidemiology Group, School of Medicine & Dentistry, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Centre of Innovation in Medical Engineering, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: mptan@ummc.edu.my.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26531071

Citation

Zia, Anam, et al. "Anticholinergic Burden Is Associated With Recurrent and Injurious Falls in Older Individuals." Maturitas, vol. 84, 2016, pp. 32-7.
Zia A, Kamaruzzaman S, Myint PK, et al. Anticholinergic burden is associated with recurrent and injurious falls in older individuals. Maturitas. 2016;84:32-7.
Zia, A., Kamaruzzaman, S., Myint, P. K., & Tan, M. P. (2016). Anticholinergic burden is associated with recurrent and injurious falls in older individuals. Maturitas, 84, 32-7. https://doi.org/10.1016/j.maturitas.2015.10.009
Zia A, et al. Anticholinergic Burden Is Associated With Recurrent and Injurious Falls in Older Individuals. Maturitas. 2016;84:32-7. PubMed PMID: 26531071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic burden is associated with recurrent and injurious falls in older individuals. AU - Zia,Anam, AU - Kamaruzzaman,S, AU - Myint,Phyo Kyaw, AU - Tan,M P, Y1 - 2015/10/23/ PY - 2015/06/21/received PY - 2015/10/11/revised PY - 2015/10/12/accepted PY - 2015/11/5/entrez PY - 2015/11/5/pubmed PY - 2016/8/10/medline KW - Aged KW - Anticholinergic Cognitive Burden KW - Falls KW - Functional Reach KW - Scale KW - Timed up and go SP - 32 EP - 7 JF - Maturitas JO - Maturitas VL - 84 N2 - OBJECTIVE: While the anticholinergic activity of medications has been linked to cognitive decline, few studies have linked anticholinergic burden with falls in older people. We evaluated the relationship between anticholinergic burden and recurrent and injurious falls among community-dwelling older adults. STUDY DESIGN: This case-control study was performed on 428 participants aged ≥65 years, 263 cases with two or more falls or one injurious fall in the preceding 12 months, and 165 controls with no falls in the preceding 12 months. Anticholinergic burden was determined using the anticholinergic cognitive burden (ACB) scale. Upper and lower limb functional abilities were assessed with timed up and go (TUG), functional reach (FR) and grip strength (GS). Logistic regression analysis was employed to calculate the mediation effect of TUG, FR and GS on ACB associated falls. RESULTS: Univariate analysis revealed a significant association between an ACB score of ≥1 with falls (OR, 1.8; 95% CI; 1.1-3.0; p=0.01) and significantly poorer TUG and FR. The association between ACB≥1 and falls was no longer significant after adjustment for either TUG (OR for ACB associated falls, 1.4; 95% CI, 0.88-2.4; p=0.14) or FR (OR for ACB associated falls, 1.4; 95% CI, 0.89-2.4, p=0.12) but remained significant with GS. CONCLUSION: The association between recurrent and injurious falls and the use of any medications listed in the ACB scale was mediated through gait and balance impairment but not by muscular weakness, providing a novel insight into the potential mechanistic link between ACB and falls. Future studies should determine whether TUG and FR measurements could help inform risk to benefit decisions where ACB medications are being considered. SN - 1873-4111 UR - https://www.unboundmedicine.com/medline/citation/26531071/Anticholinergic_burden_is_associated_with_recurrent_and_injurious_falls_in_older_individuals_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-5122(15)30068-2 DB - PRIME DP - Unbound Medicine ER -