medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function , but limited evidence exists for delirium or mortality outcomes
OBJECTIVES to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes .
Association of Anticholinergic Drugs with Hospitalization and Mortality among Older Cardiovascular Patients
Abstract Background : Many potentially inappropriate drugs prescribed to older people have anticholinergic properties as adverse effects and are therefore potentially harmful . These effects typically include constipation , dry mouth , blurred vision , dizziness and slowing of urination . It has been shown that drugs with anticholinergic properties ( DAPs ) are associated with cognitive decline and dementia , may contribute to events such as falls , delirium and impulsive behaviour , are associated with self-reported adverse effects and physical impairment , and may even be associated with mortality . However , studies of the prognostic implication s of DAPs remain scarce . Objective : To evaluate the impact of DAPs on hospitalization and mortality in older patients with stable cardiovascular disease ( CVD ) . Methods : This was a prospect i ve study with a mean follow-up of 3.3 years involving two study groups : users ( n = 295 ) and non-users ( n = 105 ) of DAPs . The participants were 400 community-dwelling older people ( aged 75–90 years ) with stable CVD participating in a secondary prevention study of CVD ( DEBATE ) in Helsinki , Finl and . The use of DAPs was estimated using definitions from the previous scientific literature . The Charlson Comorbidity Index ( CCI ) was used to estimate the burden of co-morbidity and the Mini-Mental State Examination test was used to assess cognitive function . The risks in the two study groups for hospital visits , number of days spent in hospital care and mortality were measured from 2000 to the end of 2003 . Results : The unadjusted follow-up mortality was 20.7 % and 9.5 % among the users and non-users of DAPs , respectively ( p = 0.010 ) . However , the use of DAPs was not a significant predictor of mortality in multivariate analysis after adjustment for age , sex and CCI score ( hazard ratio 1.57 ; 95 % CI 0.78 , 3.15 ) . The mean ± SD number of hospital days per person-year was higher in the DAP user group ( 14.9± 32.5 ) than in the non-user group ( 5.2± 12.3 ) [ p < 0.001 ] . In a bootstrap-type analysis of covariance adjusted for age , sex and CCI score , the use of DAPs predicted the number of days spent in hospital ( p = 0.011 ) . Conclusions : The use of DAPs in older patients with stable CVD was associated with an increased number of hospital days but not with mortality
medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function , but limited evidence exists for delirium or mortality outcomes
OBJECTIVES to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes .