The Drug Burden Index Is Associated With Measures of Cognitive Function Among Older Adults in the Health, Aging, and Body Composition Study.

Autor:	DiNatale JC; Department of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA., McDonough IM; Department of Psychology, Binghamton University, Binghamton, New York, USA., Ellis AC; Department of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA., Douglas JW; Department of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA.; Department of Psychology, Binghamton University, Binghamton, New York, USA., Yaffe K; Department of Psychiatry, Neurology and Epidemiology, Center for Population Brain Health, University of California San Francisco, San Francisco, California, USA., Crowe-White KM; Department of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2024 Jul 01; Vol. 79 (7).
DOI:	10.1093/gerona/glae097
Abstrakt:	Background: Anticholinergic and sedative medications affect cognition among older adults. The Drug Burden Index (DBI) is a validated measure of exposure to these medications, with higher DBI scores indicating higher drug burden. This ancillary analysis investigated the association between DBI and cognition assessed by the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST). Methods: The Health, Aging, and Body Composition Study was a prospective study of community-dwelling adults aged 70-79 years at enrollment. Using data from years 1, 5, and 10, DBI was calculated using medication data per participant. Linear mixed modeling was used to assess cross-sectional and longitudinal effects of DBI on 3MS and DSST. Adjusted models included biological sex, race, education level, APOE status, and death. Sensitivity analyses included testing the strength of the associations for each year and testing attrition due to death as a possible confounding factor via Cox-Proportional Hazard models. Results: After adjustment, DBI was inversely associated with 3MS and DSST scores. These associations became stronger in each subsequent year. Neither DBI at year 1 nor within-person change in DBI were predictive of longitudinal declines in either cognitive measure. Sensitivity analyses indicated that DBI, 3MS, and DSST were associated with a greater risk of attrition due to death. Conclusions: Results suggest that in years when older adults had a higher DBI scores, they had significantly lower global cognition and slower processing speed. These findings further substantiate the DBI as a useful pharmacological tool for assessing the effect of medication exposure. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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