Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex
| Autor: | Ulrike Haug, Malte Braitmaier, Jonas Reinold, Oliver Riedel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Health Care Providers Urinary incontinence Cholinergic Antagonists Continuous variable 0302 clinical medicine Germany Medicine and Health Sciences Prevalence Medical Personnel 030212 general & internal medicine Cognitive decline Aged 80 and over education.field_of_study Multidisciplinary Pharmaceutics Drugs Antidepressants Middle Aged Professions Overactive bladder Medicine Female medicine.symptom Research Article Adult medicine.medical_specialty Adolescent medicine.drug_class Urology Science Population Cardiology Gastroenterology and Hepatology Age and sex Drug Prescriptions Risk Assessment Young Adult 03 medical and health sciences Drug Therapy Physicians Claims data Internal medicine medicine Anticholinergic Humans Cognitive Dysfunction education Aged Pharmacology business.industry Pharmacoepidemiology medicine.disease Health Care Women's health Medical risk factors Gastroenterology and hepatology Age groups Age Groups People and Places Women's Health Population Groupings Accidental Falls business Administrative Claims Healthcare Receptor Antagonist Therapy 030217 neurology & neurosurgery |
| Zdroj: | PLoS ONE, Vol 16, Iss 6, p e0253336 (2021) PLOS ONE, 16(6):e0253336 PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Purpose The cumulative effect of medication inhibiting acetylcholine activity—also known as anticholinergic burden (AB)—can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a large and unselected population sample. Methods Using the German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% of the German population we analyzed outpatient drug dispensations in 2016. Based on the Anticholinergic Cognitive Burden (ACB) scale, we classified persons into four categories and determined the cumulative AB as continuous variable. Results Among 16,470,946 persons (54% female), the prevalence of clinically relevant AB (ACB≥3) was 10% (women) and 7% (men). Below age 40 it was highest in persons ≤18 years (6% both sexes). At older ages (50–59 vs. 90–99 years), prevalence of ACB≥3 increased from 7% to 26% (men) and from 10% to 32% (women). Medication classes contributing to the cumulative AB differed by age: antihistamines, antibiotics, glucocorticoids (≤19 years), antidepressants (20–49 years), antidepressants, cardiovascular medication, antidiabetics (50–64 years), and additionally medication for urinary incontinence/overactive bladder (≥65 years). Medication dispensed by general physicians contributed most to the cumulative AB. Conclusion Although a clinically relevant AB is particularly common in older persons, prevalence in younger age groups was up to 7%. Given the risks associated with AB in older persons, targeted interventions at the prescriber level are needed. Furthermore, risks associated with AB in younger persons should be explored. |
| Databáze: | OpenAIRE |
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