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Anticholinergic drugs and physical function among frail elderly population
1Department of Gerontology, Geriatrics and Physiatry, Catholic University of Sacred Heart, Roma, Italy. francesco_landi@rm.unicatt.it
Clinical Pharmacology and Therapeutics
|December 29, 2006
Summary
Anticholinergic drug use in older adults (80+) is linked to poorer physical performance and function. This study found significant associations even after accounting for other health factors, highlighting potential risks.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Growing evidence links anticholinergic drugs to physical and mental impairment in various populations.
- Understanding the impact of these medications on the elderly is crucial due to their vulnerability and higher medication usage.
- The ilSIRENTE study provides a unique cohort for investigating health outcomes in an older Italian community.
Purpose of the Study:
- To investigate the association between anticholinergic medication use and physical performance, muscle strength, and functional status in individuals aged 80 and older.
- To quantify the relationship between anticholinergic drug exposure and key geriatric assessment measures.
Main Methods:
- Prospective cohort study involving 364 participants aged 80+ from the ilSIRENTE study in Central Italy.
- Physical performance assessed via the Short Physical Performance Battery (SPPB), including gait speed, balance, and chair stands.
- Muscle strength measured by hand grip strength; functional status evaluated using Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales.
- Statistical analyses, including ANCOVA, adjusted for multiple confounders to determine the relationship between anticholinergic drug use and functional outcomes.
Main Results:
- Anticholinergic drug use was significantly associated with lower physical performance battery scores (P=0.05) and reduced hand grip strength (P=0.05).
- Users of anticholinergic medications demonstrated significantly worse scores on both ADL (P=0.03) and IADL (P<0.001) scales compared to non-users.
- These associations remained statistically significant after adjusting for potential confounding factors, indicating a robust link.
Conclusions:
- The use of medications with anticholinergic properties is prevalent among community-dwelling older adults in Italy.
- Anticholinergic drug use in the 'old-old' (80+ years) is associated with objectively impaired physical performance and reduced functional status.
- These findings underscore the importance of carefully considering the anticholinergic burden in geriatric pharmacotherapy to mitigate adverse functional outcomes.
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