TY  - JOUR
PY  - 2023//
TI  - Polypharmacy and cumulative anticholinergic burden in older adults hospitalized with fall
JO  - Aging medicine (Milton (N.S.W))
A1  - Wong, Ho Lun
A1  - Weaver, Claire
A1  - Marsh, Lauren
A1  - Mon, Khine Oo
A1  - Dapito, John M.
A1  - Amin, Fouad R.
A1  - Chauhan, Rahul
A1  - Mandal, Amit K. J.
A1  - Missouris, Constantinos G.
SP  - 116
EP  - 123
VL  - 6
IS  - 2
N2  - INTRODUCTION: Polypharmacy is a growing phenomenon associated with adverse effects in older adults. We assessed the potential confounding effects of cumulative anticholinergic burden (ACB) in patients who were hospitalized with falls. <br><br>METHODS: A noninterventional, prospective cohort study of unselected, acute admissions aged ≥ 65 years. Data were derived from electronic patient health records. <br><br>RESULTS were analyzed to determine the frequency of polypharmacy and degree of ACB and their relationship to falls risk. Primary outcomes were polypharmacy, defined as prescription of 5 or more regular oral medications, and ACB score. KEY RESULTS: Four hundred eleven (411) consecutive subjects were included, mean age 83.8 ± 8.0 years: 40.6% men. There were 38.4% patients who were admitted with falls. Incidence of polypharmacy was 80.8%, (88.0% and 76.3% among those admitted with and without fall, respectively). Incidence of ACB score of 0, 1, 2, ≥ 3 was 38.7%, 20.9%, 14.6%, and 25.8%, respectively. On multivariate analysis, age [odds ratio (OR) = 1.030, 95% CI:1.000 ~ 1.050, P = 0.049], ACB score (OR = 1.150, 95% CI:1.020 ~ 1.290, P = 0.025), polypharmacy (OR = 2.140, 95% CI:1.190 ~ 3.870, P = 0.012), but not Charlson Comorbidity Index (OR = 0.920, 95% CI:0.810 ~ 1.040, P = 0.172) were significantly associated with higher falls rate. Of patients admitted with falls, 29.8% had drug-related orthostatic hypotension, 24.7% had drug-related bradycardia, 37.3% were prescribed centrally acting drugs, and 12.0% were taking inappropriate hypoglycemic agents. <br><br>CONCLUSION: Polypharmacy results in cumulative ACB and both are significantly associated with falls risk in older adults. The presence of polypharmacy and each unit rise in ACB score have a stronger effect of increasing falls risk compared to age and comorbidities.<p />  <p>Language: en</p>
LA  - en
SN  - 2475-0360
UR  - http://dx.doi.org/10.1002/agm2.12250
ID  - ref1
ER  -