Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA
Introduction: Anticholinergic and sedative medication is prescribed for various conditions in older patients. While the general association between anticholinergic and sedative medication and impaired functioning is well established, its specific role in older individuals with vertigo, dizziness, an...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1136757/full |
| _version_ | 1811160824412110848 |
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| author | Benedict Katzenberger Benedict Katzenberger Benedict Katzenberger Daniela Koller Daniela Koller Ralf Strobl Ralf Strobl Rebecca Kisch Linda Sanftenberg Karen Voigt Eva Grill Eva Grill |
| author_facet | Benedict Katzenberger Benedict Katzenberger Benedict Katzenberger Daniela Koller Daniela Koller Ralf Strobl Ralf Strobl Rebecca Kisch Linda Sanftenberg Karen Voigt Eva Grill Eva Grill |
| author_sort | Benedict Katzenberger |
| collection | DOAJ |
| description | Introduction: Anticholinergic and sedative medication is prescribed for various conditions in older patients. While the general association between anticholinergic and sedative medication and impaired functioning is well established, its specific role in older individuals with vertigo, dizziness, and balance disorders (VDB) is still incompletely understood. The objective of this study was to investigate, whether an exposure to anticholinergic and sedative medication is associated with lower generic and lower vertigo-specific functioning in older patients with VDB.Methods: Data originates from the longitudinal multicenter study MobilE-TRA with two follow-ups, conducted from 2017 to 2019 in two German federal states. Exposure to anticholinergic and sedative medication was quantified using the drug burden index (DBI). Generic functioning was assessed by the Health Assessment Questionnaire Disability Index, appraising the amount of difficulties in performing activities of daily living (ADL). Vertigo-specific functioning was measured using the Vestibular Activities and Participation (VAP) questionnaire, assessing patient-reported functioning regarding activities of daily living that are difficult to perform because of their propensity to provoke VDB (Scale 1) as well as immediate consequences of VDB on activities and participation related to mobility (Scale 2). Longitudinal linear mixed models were applied to assess the association of exposure to anticholinergic and sedative medication at baseline and the level of generic and vertigo-specific functioning status over time.Results: An overall of 19 (7 from Bavaria) primary care physicians (mean age = 54 years, 29% female) recruited 158 (59% from Bavaria) patients with VDB (median age = 78 years, 70% female). Anticholinergic and sedative medication at baseline was present in 56 (35%) patients. An exposure to anticholinergic and sedative medication at baseline was significantly associated with lower generic functioning [Beta = 0.40, 95%-CI (0.18; 0.61)] and lower vertigo-specific functioning [VAP Scale 1: Beta = 2.47, 95%-CI (0.92; 4.02)], and VAP Scale 2: Beta = 3.74, 95%-CI [2.23; 5.24]).Conclusion: Our results highlight the importance of a close monitoring of anticholinergic and sedative medication use in older patients with VDB. When feasible, anticholinergic and sedative medication should be replaced by equivalent alternative therapies in order to potentially reduce the burden of VDB. |
| first_indexed | 2024-04-10T06:04:07Z |
| format | Article |
| id | doaj.art-a3fc64739f9f4cb7812b105707b6db13 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-10T06:04:07Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-a3fc64739f9f4cb7812b105707b6db132023-03-03T04:43:05ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-03-011410.3389/fphar.2023.11367571136757Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRABenedict Katzenberger0Benedict Katzenberger1Benedict Katzenberger2Daniela Koller3Daniela Koller4Ralf Strobl5Ralf Strobl6Rebecca Kisch7Linda Sanftenberg8Karen Voigt9Eva Grill10Eva Grill11Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, GermanyPettenkofer School of Public Health, Munich, GermanyMunich Center of Health Sciences, Ludwig Maximilian University of Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, GermanyMunich Center of Health Sciences, Ludwig Maximilian University of Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders, University Hospital Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, GermanyInstitute of General Practice and Family Medicine, University Hospital Munich, Munich, GermanyDepartment of General Practice/Medical Clinic III, Faculty of Medicine, University Hospital Carl Gustav Carus, Dresden, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, GermanyGerman Center for Vertigo and Balance Disorders, University Hospital Munich, Munich, GermanyIntroduction: Anticholinergic and sedative medication is prescribed for various conditions in older patients. While the general association between anticholinergic and sedative medication and impaired functioning is well established, its specific role in older individuals with vertigo, dizziness, and balance disorders (VDB) is still incompletely understood. The objective of this study was to investigate, whether an exposure to anticholinergic and sedative medication is associated with lower generic and lower vertigo-specific functioning in older patients with VDB.Methods: Data originates from the longitudinal multicenter study MobilE-TRA with two follow-ups, conducted from 2017 to 2019 in two German federal states. Exposure to anticholinergic and sedative medication was quantified using the drug burden index (DBI). Generic functioning was assessed by the Health Assessment Questionnaire Disability Index, appraising the amount of difficulties in performing activities of daily living (ADL). Vertigo-specific functioning was measured using the Vestibular Activities and Participation (VAP) questionnaire, assessing patient-reported functioning regarding activities of daily living that are difficult to perform because of their propensity to provoke VDB (Scale 1) as well as immediate consequences of VDB on activities and participation related to mobility (Scale 2). Longitudinal linear mixed models were applied to assess the association of exposure to anticholinergic and sedative medication at baseline and the level of generic and vertigo-specific functioning status over time.Results: An overall of 19 (7 from Bavaria) primary care physicians (mean age = 54 years, 29% female) recruited 158 (59% from Bavaria) patients with VDB (median age = 78 years, 70% female). Anticholinergic and sedative medication at baseline was present in 56 (35%) patients. An exposure to anticholinergic and sedative medication at baseline was significantly associated with lower generic functioning [Beta = 0.40, 95%-CI (0.18; 0.61)] and lower vertigo-specific functioning [VAP Scale 1: Beta = 2.47, 95%-CI (0.92; 4.02)], and VAP Scale 2: Beta = 3.74, 95%-CI [2.23; 5.24]).Conclusion: Our results highlight the importance of a close monitoring of anticholinergic and sedative medication use in older patients with VDB. When feasible, anticholinergic and sedative medication should be replaced by equivalent alternative therapies in order to potentially reduce the burden of VDB.https://www.frontiersin.org/articles/10.3389/fphar.2023.1136757/fullvertigodizzinessbalance disordersanticholinergic and sedative medicationsdrug burden indexfunctioning |
| spellingShingle | Benedict Katzenberger Benedict Katzenberger Benedict Katzenberger Daniela Koller Daniela Koller Ralf Strobl Ralf Strobl Rebecca Kisch Linda Sanftenberg Karen Voigt Eva Grill Eva Grill Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA Frontiers in Pharmacology vertigo dizziness balance disorders anticholinergic and sedative medications drug burden index functioning |
| title | Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA |
| title_full | Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA |
| title_fullStr | Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA |
| title_full_unstemmed | Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA |
| title_short | Exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo, dizziness and balance disorders—Results from the longitudinal multicenter study MobilE-TRA |
| title_sort | exposure to anticholinergic and sedative medication is associated with impaired functioning in older people with vertigo dizziness and balance disorders results from the longitudinal multicenter study mobile tra |
| topic | vertigo dizziness balance disorders anticholinergic and sedative medications drug burden index functioning |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1136757/full |
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