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[Anticholinergic burden and delirium in elderly patients during acute hospital admission].
Rev Esp Geriatr Gerontol. 2016 Jul-Aug; 51(4):217-20.RE

Abstract

BACKGROUND

The use of anticholinergic drugs in the elderly has been associated to an increased frequency of delirium. There are different scales for estimating the anticholinergic burden, such as the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Anticholinergic Cognitive Burden (ACB). The aim of the study is to establish the relationship between anticholinergic burden measured by ADS, ARS, and ACB scales and incident or prevalent delirium.

METHODS

An ambispective observational study was conducted for 76 days in the acute geriatric unit of a tertiary hospital. All patients over 80 years-old were included, except re-admissions or those subjected to palliative care. The data collected included sex, age, chronic medication and any recent changes, recent drugs prescribed prior to an episode of delirium, chronic kidney disease, diabetes mellitus, dementia, visual and auditory impairment, and their combination as sensory impairment, previous falls, stroke, brain tumour, and incident and prevalent delirium.

RESULTS

A total of 72 patients were included. Incident delirium was detected in 8.1% of the patients, and prevalent delirium in 40.9%. A statistically significant association was established between anticholinergic drugs and the incident delirium measured by the ARS scale (P=.017). None of the scales was able to establish a significant association with prevalent delirium.

CONCLUSION

The ARS scale was related to new episodes of delirium. All scales were insufficient when it came to establishing an association with prevalent delirium.

Authors+Show Affiliations

Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: auroramrojo@gmail.com.Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, España.

Pub Type(s)

Journal Article

Language

spa

PubMed ID

27264617

Citation

Rojo-Sanchís, Aurora M., et al. "[Anticholinergic Burden and Delirium in Elderly Patients During Acute Hospital Admission]." Revista Espanola De Geriatria Y Gerontologia, vol. 51, no. 4, 2016, pp. 217-20.
Rojo-Sanchís AM, Vélez-Díaz-Pallarés M, Muñoz García M, et al. [Anticholinergic burden and delirium in elderly patients during acute hospital admission]. Rev Esp Geriatr Gerontol. 2016;51(4):217-20.
Rojo-Sanchís, A. M., Vélez-Díaz-Pallarés, M., Muñoz García, M., Delgado Silveira, E., Bermejo Vicedo, T., & Cruz Jentoft, A. (2016). [Anticholinergic burden and delirium in elderly patients during acute hospital admission]. Revista Espanola De Geriatria Y Gerontologia, 51(4), 217-20. https://doi.org/10.1016/j.regg.2016.04.004
Rojo-Sanchís AM, et al. [Anticholinergic Burden and Delirium in Elderly Patients During Acute Hospital Admission]. Rev Esp Geriatr Gerontol. 2016 Jul-Aug;51(4):217-20. PubMed PMID: 27264617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Anticholinergic burden and delirium in elderly patients during acute hospital admission]. AU - Rojo-Sanchís,Aurora M, AU - Vélez-Díaz-Pallarés,Manuel, AU - Muñoz García,María, AU - Delgado Silveira,Eva, AU - Bermejo Vicedo,Teresa, AU - Cruz Jentoft,Alfonso, Y1 - 2016/06/02/ PY - 2016/01/27/received PY - 2016/04/04/revised PY - 2016/04/15/accepted PY - 2016/6/7/entrez PY - 2016/6/7/pubmed PY - 2017/10/11/medline KW - Anticholinergic drugs KW - Anticholinergic scale KW - Delirium KW - Elderly KW - Escala anticolinérgica KW - Fármacos anticolinérgicos KW - Pacientes mayores SP - 217 EP - 20 JF - Revista espanola de geriatria y gerontologia JO - Rev Esp Geriatr Gerontol VL - 51 IS - 4 N2 - BACKGROUND: The use of anticholinergic drugs in the elderly has been associated to an increased frequency of delirium. There are different scales for estimating the anticholinergic burden, such as the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Anticholinergic Cognitive Burden (ACB). The aim of the study is to establish the relationship between anticholinergic burden measured by ADS, ARS, and ACB scales and incident or prevalent delirium. METHODS: An ambispective observational study was conducted for 76 days in the acute geriatric unit of a tertiary hospital. All patients over 80 years-old were included, except re-admissions or those subjected to palliative care. The data collected included sex, age, chronic medication and any recent changes, recent drugs prescribed prior to an episode of delirium, chronic kidney disease, diabetes mellitus, dementia, visual and auditory impairment, and their combination as sensory impairment, previous falls, stroke, brain tumour, and incident and prevalent delirium. RESULTS: A total of 72 patients were included. Incident delirium was detected in 8.1% of the patients, and prevalent delirium in 40.9%. A statistically significant association was established between anticholinergic drugs and the incident delirium measured by the ARS scale (P=.017). None of the scales was able to establish a significant association with prevalent delirium. CONCLUSION: The ARS scale was related to new episodes of delirium. All scales were insufficient when it came to establishing an association with prevalent delirium. SN - 1578-1747 UR - https://www.unboundmedicine.com/medline/citation/27264617/[Anticholinergic_burden_and_delirium_in_elderly_patients_during_acute_hospital_admission]_ DB - PRIME DP - Unbound Medicine ER -