A Rising Drug Burden Index Is Related With Malnutrition in Community-Dwelling Older Adults With Dementia

Malnutrition is common in dementia patients and can lead to poor outcomes. Also, these patients are often prescribed medications with sedative and anticholinergic effects for various reasons. Thus, we aimed to explore the relationship between drug burden index (DBI), anticholinergic burden (ACB), and nutrition status in community-dwelling older adults with dementia.

A total of 415 outpatients with dementia, evaluated by Mini Nutrition Assessment, and whose drug information is registered are included in study. DBI score was calculated by summing the scores of regularly used anticholinergic and/or sedative drugs taken for at least four weeks prior to admission.

The mean age of participants was 77.4 ± 6.3 years, and the majority were female (64.3%). The most prevalent type of dementia (71.6%) was Alzheimer's dementia. The prevalence of malnutrition is 23.6%. Polypharmacy was present in approximately half of the participants (47.5). In total, 57.0% of the participants were using anticholinergic drugs, and 77% of the participants had drug exposure. In the fully adjusted multivariate models, an increase in DBI score raised the risk of "malnutrition" by 2.12 times (OR, 2.12; 95% CI, 1.15-4.01; P = 0.02), whereas no relationship was determined between ACB score and "malnutrition" (OR, 1.21; 95% CI, 0.98-1.49; P = 0.07).

Older adults with dementia are frequently exposed to drugs with sedative and anticholinergic properties. Considering the relationship between DBI and malnutrition, these drugs and doses should be optimized to prevent malnutrition and its adverse outcomes in this vulnerable population.