Abstract
Background
While anticholinergic use is associated with stroke, dementia and mortality, few have evaluated its potential link with falls. To determine the relationship between anticholinergic cognitive burden (ACB) and falls over five years using the Malaysian Elders Longitudinal Research (MELoR).
Methods
Community-dwelling adults aged 55 years and over were recruited through electoral roll sampling. Data obtained at baseline and follow-up (FU) at two and five years were included. Falls in the preceding 12 months were recorded.
Results
Of the 1499 individuals (mean (SD) age= 68.9(7.5) yrs and 53.3% female) with information on baseline ACB exposure, 575(38.4%) had ACB scores of 1-2 and 117(7.8%) had ACB scores . Differences in age, ethnicity, smoking status, diabetes, hypertension, cardiovascular disease, arthritis and education existed between ACB groups. Fall occurrence differed between ACB groups at recruitment (p = 0.004) and 2-year FU (p = 0.001) but not at 5-year FU (p = 0.053). Logistic regression revealed an independent association between ACB 1-2 and falls at baseline (odds ratio, OR (95% confidence interval, CI) =1.412(1.035-1.926)) and ACB and falls at 2-yr FU (OR (95%CI) =2.098(1.032-4.263)) following adjustment for confounders.
Conclusion
Low level exposure to drugs with anticholinergic properties was associated cross-sectionally with falls, while exposure to higher levels were prospectively associated with falls at 2-year but not at 5-year FU. Future studies should determine whether avoidance of drugs with anticholinergic effects will lead to reduction in falls.
While anticholinergic use is associated with stroke, dementia and mortality, few have evaluated its potential link with falls. To determine the relationship between anticholinergic cognitive burden (ACB) and falls over five years using the Malaysian Elders Longitudinal Research (MELoR).
Methods
Community-dwelling adults aged 55 years and over were recruited through electoral roll sampling. Data obtained at baseline and follow-up (FU) at two and five years were included. Falls in the preceding 12 months were recorded.
Results
Of the 1499 individuals (mean (SD) age= 68.9(7.5) yrs and 53.3% female) with information on baseline ACB exposure, 575(38.4%) had ACB scores of 1-2 and 117(7.8%) had ACB scores . Differences in age, ethnicity, smoking status, diabetes, hypertension, cardiovascular disease, arthritis and education existed between ACB groups. Fall occurrence differed between ACB groups at recruitment (p = 0.004) and 2-year FU (p = 0.001) but not at 5-year FU (p = 0.053). Logistic regression revealed an independent association between ACB 1-2 and falls at baseline (odds ratio, OR (95% confidence interval, CI) =1.412(1.035-1.926)) and ACB and falls at 2-yr FU (OR (95%CI) =2.098(1.032-4.263)) following adjustment for confounders.
Conclusion
Low level exposure to drugs with anticholinergic properties was associated cross-sectionally with falls, while exposure to higher levels were prospectively associated with falls at 2-year but not at 5-year FU. Future studies should determine whether avoidance of drugs with anticholinergic effects will lead to reduction in falls.
Original language | English |
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Article number | 104535 |
Number of pages | 6 |
Journal | Archives of Gerontology and Geriatrics |
Volume | 98 |
Early online date | 30 Sept 2021 |
DOIs | |
Publication status | Published - 28 Feb 2022 |
Bibliographical note
AcknowledgementsThis third-wave follow-up interviews were funded by the Ministry of Higher Education Fundamental Research Grant Scheme (FRGS/1/2019/SKK02/UM/01/1). The Malaysian Elders Longitudinal Research study is now part of the Transforming Cognitive Frailty into Later-Life Self-Sufficiency (AGELESS) study which merges two existing longitudinal studies of ageing and is funded by the Ministry of Higher Education Long-Term Research Grant Scheme (LRGS/1/2019/UM/01/1/1). We would also like to acknowledge the hard work and dedication of the MELoR investigators and research team.
Keywords
- Anticholinergic cognitive burden
- Falls
- Elders
- Longitudinal
- Malaysia