Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)

Samuel R. Neal, Adrian D. Wood, Andrew D. Ablett, Jenny S. Gregory, Jordan Guillot, Helen M. Macdonald, David M. Reid, Phyo Kyaw Myint*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Anticholinergic burden (ACB) is a recognized risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.

Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997-1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (≥2 falls) during the 12 months prior to follow up (2007-2011). Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.

Results: A total of 2,125 women (mean age (SD):54.7(2.2) years at baseline and 66.0(2.2) years at follow-up) were included. Prevalence of baseline ACB score of 0, 1 and ≥2 was 87.1%, 7.3% and 5.6%, respectively. Compared to no ACB, ACB ≥2 was associated with recurrent falls in the previous 12 months (adjusted odds ratio: 2.34, 95% confidence interval: 1.31, 4.19) at an average of 11 year after initial exposure. No such association was found for an ACB score of 1.

Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalTherapeutic Advances in Drug Safety
Volume11
Early online date27 May 2020
DOIs
Publication statusPublished - 2020

Keywords

  • Accidental Falls
  • Cholinergic Antagonists
  • Middle Aged
  • Polypharmacy
  • accidental falls
  • cholinergic antagonists
  • middle aged
  • polypharmacy

ASJC Scopus subject areas

  • Pharmacology (medical)

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