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Anticholinergic burden and 1-year mortality among older patients discharged from acute care hospital.
Geriatr Gerontol Int. 2018 May; 18(5):705-713.GG

Abstract

AIM

The association between anticholinergic burden and mortality is controversial. We aimed to investigate whether the anticholinergic cognitive burden (ACB) score predicts 1-year mortality in older patients discharged from acute care hospitals.

METHODS

Our series consisted of 807 hospitalized patients aged ≥65 years. Patients were followed up for 12 months after discharge. All-cause mortality was the outcome of the study. The ACB score at discharge (0, 1, ≥2) and increasing ACB score from admission to discharge (no increase, +1, +2 or more) were calculated and used as exposure variables. Cox proportional hazards models adjusted for potential confounders were used for the analysis. Interactions between the ACB score and cognitive impairment or history of falls were also investigated.

RESULTS

During the follow-up period, 177 out of 807 participants (21.9%) died. After adjusting for potential confounders, a discharge ACB score of ≥2 (HR 1.69, 95% CI 1.09-2.65) was significantly associated with the outcome, whereas the association between increasing ACB score of +2 or more and mortality was weaker (HR 1.30, 95% CI 0.95-1.92). The interaction between the ACB score at discharge or increasing ACB score and cognitive impairment was statistically significant (P = 0.003 and P = 0.004, respectively), whereas that between the ACB score and falls was not.

CONCLUSIONS

The ACB score at discharge and, to a lesser extent, an increasing ACB score during hospital stay are associated with an increased risk of 1-year mortality in older patients discharged from hospital. Such an association is stronger among patients with cognitive impairment. Geriatr Gerontol Int 2018; 18: 705-713.

Authors+Show Affiliations

Italian National Research Center on Aging (INRCA), Ancona and Cosenza, Italy.Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.Italian National Research Center on Aging (INRCA), Ancona and Cosenza, Italy.Department of Gerontology, Neuroscience and Orthopedics, Catholic University of Sacred Heart, Gemelli University Hospital, Rome, Italy.Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy.Italian National Research Center on Aging (INRCA), Ancona and Cosenza, Italy.Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy.Department of Clinical and Experimental Medicine and Geriatric Rehabilitation Department, University of Parma, Parma, Italy.Italian National Research Center on Aging (INRCA), Ancona and Cosenza, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29292589

Citation

Lattanzio, Fabrizia, et al. "Anticholinergic Burden and 1-year Mortality Among Older Patients Discharged From Acute Care Hospital." Geriatrics & Gerontology International, vol. 18, no. 5, 2018, pp. 705-713.
Lattanzio F, Corica F, Schepisi R, et al. Anticholinergic burden and 1-year mortality among older patients discharged from acute care hospital. Geriatr Gerontol Int. 2018;18(5):705-713.
Lattanzio, F., Corica, F., Schepisi, R., Amantea, D., Bruno, F., Cozza, A., Onder, G., Volpato, S., Cherubini, A., Ruggiero, C., Maggio, M. G., & Corsonello, A. (2018). Anticholinergic burden and 1-year mortality among older patients discharged from acute care hospital. Geriatrics & Gerontology International, 18(5), 705-713. https://doi.org/10.1111/ggi.13234
Lattanzio F, et al. Anticholinergic Burden and 1-year Mortality Among Older Patients Discharged From Acute Care Hospital. Geriatr Gerontol Int. 2018;18(5):705-713. PubMed PMID: 29292589.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic burden and 1-year mortality among older patients discharged from acute care hospital. AU - Lattanzio,Fabrizia, AU - Corica,Francesco, AU - Schepisi,Roberto, AU - Amantea,Diana, AU - Bruno,Francesco, AU - Cozza,Annalisa, AU - Onder,Graziano, AU - Volpato,Stefano, AU - Cherubini,Antonio, AU - Ruggiero,Carmelinda, AU - Maggio,Marcello G, AU - Corsonello,Andrea, Y1 - 2018/01/02/ PY - 2017/10/13/revised PY - 2017/11/13/accepted PY - 2018/1/3/pubmed PY - 2019/4/11/medline PY - 2018/1/3/entrez KW - anticholinergic burden KW - cognitive impairment KW - drugs KW - falls KW - mortality SP - 705 EP - 713 JF - Geriatrics & gerontology international JO - Geriatr Gerontol Int VL - 18 IS - 5 N2 - AIM: The association between anticholinergic burden and mortality is controversial. We aimed to investigate whether the anticholinergic cognitive burden (ACB) score predicts 1-year mortality in older patients discharged from acute care hospitals. METHODS: Our series consisted of 807 hospitalized patients aged ≥65 years. Patients were followed up for 12 months after discharge. All-cause mortality was the outcome of the study. The ACB score at discharge (0, 1, ≥2) and increasing ACB score from admission to discharge (no increase, +1, +2 or more) were calculated and used as exposure variables. Cox proportional hazards models adjusted for potential confounders were used for the analysis. Interactions between the ACB score and cognitive impairment or history of falls were also investigated. RESULTS: During the follow-up period, 177 out of 807 participants (21.9%) died. After adjusting for potential confounders, a discharge ACB score of ≥2 (HR 1.69, 95% CI 1.09-2.65) was significantly associated with the outcome, whereas the association between increasing ACB score of +2 or more and mortality was weaker (HR 1.30, 95% CI 0.95-1.92). The interaction between the ACB score at discharge or increasing ACB score and cognitive impairment was statistically significant (P = 0.003 and P = 0.004, respectively), whereas that between the ACB score and falls was not. CONCLUSIONS: The ACB score at discharge and, to a lesser extent, an increasing ACB score during hospital stay are associated with an increased risk of 1-year mortality in older patients discharged from hospital. Such an association is stronger among patients with cognitive impairment. Geriatr Gerontol Int 2018; 18: 705-713. SN - 1447-0594 UR - https://www.unboundmedicine.com/medline/citation/29292589/Anticholinergic_burden_and_1_year_mortality_among_older_patients_discharged_from_acute_care_hospital_ DB - PRIME DP - Unbound Medicine ER -