From pills to plate: Anticholinergic burden and malnutrition in older adults across three nutrition assessment tools:...

Increased anticholinergic cognitive burden (ACB) in the geriatric population has been identified as a predisposing factor for various adverse health outcomes, including malnutrition. This study aimed to assess the association between ACB and malnutrition, which has previously only been demonstrated by screening tests, using the Global Leadership Initiative on Malnutrition (GLIM) as a diagnostic criterion and different nutrition assessment tools.

This cross-sectional study included adults aged ≥65 years who were admitted to the geriatric clinic of a tertiary hospital. Nutrition status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening, and the GLIM criteria. ACB was calculated according to the ACB scale, and multimorbidity was assessed using the Charlson Comorbidity Index.

A total of 629 patients (61.7% female, 77.9 ± 7.3 years) were included in the final analysis. According to different nutrition assessment tools, the prevalence of malnutrition ranged from 27.7% to 37.2%. According to all nutrition tools, the high ACB group (ACB ≥ 3) had a poor nutrition status compared with the reference (ACB:0). According to binary logistic regression analysis, ACB ≥ 3 status was a positive risk factor for malnutrition according to both MNA-SF (odds ratio [OR]: 2.61; 95% CI: 1.03-6.61) and GLIM criteria (OR: 2.38; 95% CI: 1.07-5.26).

Higher ACB use (ACB ≥ 3) was a positive predictor of malnutrition according to both the GLIM diagnostic criteria and MNA-SF. Prescribing medications with anticholinergic properties in the geriatric population deserves more attention as a modifiable risk factor in the management of clinically detected malnutrition.