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.
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 language | English |
|---|---|
| Pages (from-to) | 135-143 |
| Number of pages | 9 |
| Journal | Pharmacoepidemiology and Drug Safety |
| Volume | 30 |
| Issue number | 2 |
| Early online date | 5 Aug 2020 |
| DOIs | |
| Publication status | Published - Feb 2021 |
Bibliographical note
Funding informationCancer Research UK, Grant/Award Number:C864/A14136; Innes Will Endowed Scholarship, Grant/Award Number: ACAT/DT/2018; Medical Research Council, Grant/Award Numbers: MR/N003284/1, MCUU_12015/1.
We would like to thank the participants of EPIC-Norfolk study as well as the participating general practitioners and administrative and research staff who make the study possible. The EPIC-Norfolk study (DOI: https://doi.org/10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK (C864/A14136). We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. KRY was supported by HotStart Undergraduate Scholarship Programme funded by the Development Trust, University of Aberdeen.
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
Access to Document
- Yrjana_et_al_PDS_BaselineAnticholinergicBurden_AAM
This is the peer reviewed version of the following article: Yrjana, KR, Neal, SR, Soiza, RL, et al. 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. Pharmacoepidemiol Drug Saf. 2021; 30: 135– 143., which has been published in final form at http://dx.doi.org/10.1002/pds.5085. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.