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 i...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-020-01657-x |
| _version_ | 1818880012628000768 |
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| author | Carlota M. Grossi Kathryn Richardson George M. Savva Chris Fox Antony Arthur Yoon K. Loke Nicholas Steel Carol Brayne Fiona E. Matthews Louise Robinson Phyo K. Myint Ian D. Maidment |
| author_facet | Carlota M. Grossi Kathryn Richardson George M. Savva Chris Fox Antony Arthur Yoon K. Loke Nicholas Steel Carol Brayne Fiona E. Matthews Louise Robinson Phyo K. Myint Ian D. Maidment |
| author_sort | Carlota M. Grossi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T14:39:12Z |
| format | Article |
| id | doaj.art-de326eeeb12743a4bc1ce7927188d774 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-19T14:39:12Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-de326eeeb12743a4bc1ce7927188d7742022-12-21T20:17:08ZengBMCBMC Geriatrics1471-23182020-07-012011810.1186/s12877-020-01657-xIncreasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and IICarlota M. Grossi0Kathryn Richardson1George M. Savva2Chris Fox3Antony Arthur4Yoon K. Loke5Nicholas Steel6Carol Brayne7Fiona E. Matthews8Louise Robinson9Phyo K. Myint10Ian D. Maidment11University of East AngliaUniversity of East AngliaUniversity of East Anglia, Quadram Institute Bioscience, Norwich Research ParkUniversity of East AngliaUniversity of East AngliaUniversity of East AngliaUniversity of East AngliaUniversity of CambridgeUniversity of NewcastleUniversity of NewcastleUniversity of AberdeenAston UniversityAbstract 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.http://link.springer.com/article/10.1186/s12877-020-01657-xCognitive impairmentAnticholinergic burden |
| spellingShingle | Carlota M. Grossi Kathryn Richardson George M. Savva Chris Fox Antony Arthur Yoon K. Loke Nicholas Steel Carol Brayne Fiona E. Matthews Louise Robinson Phyo K. Myint Ian D. Maidment Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II BMC Geriatrics Cognitive impairment Anticholinergic burden |
| title | Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II |
| title_full | Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II |
| title_fullStr | Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II |
| title_full_unstemmed | Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II |
| title_short | Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II |
| title_sort | increasing prevalence of anticholinergic medication use in older people in england over 20 years cognitive function and ageing study i and ii |
| topic | Cognitive impairment Anticholinergic burden |
| url | http://link.springer.com/article/10.1186/s12877-020-01657-x |
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