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Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.

Abstract：

BACKGROUND:Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality, and their use should be limited in older people. Here we estimate the prevalence of anticholinergic use in England's older population in 1991 and 2011, and describe changes in use by participant's age, sex, cognition and disability. METHODS:We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N = 7635) and 2008-2011 (N = 7762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score = 3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. RESULTS:Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95% CI 1.67-2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergics in CFAS II (16.5% [95% CI 12.0-22.3%]). Large increases in the prevalence of the use medication with 'any' anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). CONCLUSIONS:Use of potent anticholinergic medications nearly doubled in England's older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.

journal_name

BMC Geriatr

journal_title

BMC geriatrics

authors

Grossi CM,Richardson K,Savva GM,Fox C,Arthur A,Loke YK,Steel N,Brayne C,Matthews FE,Robinson L,Myint PK,Maidment ID

doi

10.1186/s12877-020-01657-x

subject

Has Abstract

pub_date

2020-07-31 00:00:00

pages

267

issue

issn

1471-2318

pii

10.1186/s12877-020-01657-x

journal_volume

pub_type

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Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II.