Baseline anticholinergic burden from medications predicts poorer baseline and long-term health-related quality of life in 16 675 men and women of EPIC-Norfolk prospective population-based cohort study

Kaisa R. Yrjana, Samuel R. Neal, Roy L. Soiza, Victoria Keevil, Robert N. Luben, Nicholas J. Wareham, Kay-Tee Khaw, Phyo K. Myint* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Previous studies investigating the association between anticholinergic
burden (ACB) and health-related quality of life (HRQoL) showed conflicting results and focused on older adults or specific patient groups only.
Methods: Participants from the European Prospective Investigation of Cancer-Norfolk study were divided into three groups according to their ACB from medications at baseline, representing ACB scores of 0, 1 and ≥2. Outcomes of interest were the physical and mental component summary scores (PCS and MCS) of the Short Form-36, collected at 18 months from the baseline and again after a mean 13 years of follow-up. Linear regression and logistic regression for cross-sectional and longitudinal associations between ACB and HRQoL were constructed adjusting for potential confounders.
Results: A total of 16 675 participants, mean age 58.9 ± 9.1 years (55.6% female) and 7133 participants, mean age at follow-up 69.1 ± 8.7 years (56.8% female), were included in the cross-sectional and longitudinal analyses, respectively. In crosssectional analysis, higher anticholinergic burden was associated with higher odds of being in the lowest quartile of PCS (ACB = 1; OR, 1.85[1.64, 2.09] and ACB ≥ 2:2.19 [1.85, 2.58] and MCS (ACB = 1:1.47[1.30, 1.66] and ACB ≥ 2:1.68[1.42, 1.98]). In longitudinal analysis, higher anticholinergic burden was similarly associated with higher odds of being in the lowest quartile of PCS (ACB = 1:1.56[1.24, 1.95] and ACB ≥ 2:1.48[1.07, 2.03]) compared with ACB 0 group. The association with MCS scores did not reach statistical significance.
Conclusion: The use of anticholinergic medications is associated with both short and long-term poorer physical functions but association with mental functioning appears more short-term.
Original languageEnglish
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Early online date5 Aug 2020
DOIs
Publication statusE-pub ahead of print - 5 Aug 2020

Keywords

  • anticholinergic burden
  • antimuscarinic
  • health-related quality of life
  • mental functional health
  • pharmacoepidemiology
  • physical functional health
  • MORTALITY
  • LOAD
  • SF-36
  • IMPACT
  • EPIC-NORFOLK
  • DISEASE
  • MIDDLE

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