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Use of Medications with Anticholinergic Properties and the Long-Term Risk of Hospitalization for Falls and Fractures in the EPIC-Norfolk Longitudinal Cohort Study
- Source :
- Drugs Aging
- Publication Year :
- 2019
-
Abstract
- The consumption of medications with anticholinergic activity has been suggested to result in the adverse effects of mental confusion, visual disturbance, and muscle weakness, which may lead to falls. Existing published evidence linking anticholinergic drugs with falls, however, remains weak. This study was conducted to evaluate the relationship between anticholinergic cognitive burden (ACB) and the long-term risk of hospitalization with falls and fractures in a large population study. The dataset comprised information from 25,639 men and women (aged 40–79 years) recruited from 1993 to 1997 from Norfolk, United Kingdom into the European Prospective Investigation into Cancer (EPIC)-Norfolk study. The time to first hospital admission with a fall with or without fracture was obtained from the National Health Service hospital information system. Cox-proportional hazards analyses were conducted to adjust for confounders and competing risks. The fall hospitalization rate was 5.8% over a median follow-up of ~ 19.4 years. The unadjusted incidence rate ratio for the use of any drugs with anticholinergic properties was 1.79 (95% CI 1.66–1.93). The hazard ratios (95% CI) for ACB scores of 1, 2–3, and ≥ 4 compared with ACB = 0 for fall hospitalization were 1.20 (1.09–1.33), 1.42 (1.25–1.60), and 1.39 (1.21–1.60) after adjustment for age, gender, medical conditions, physical activity, and blood pressure. Medications with anticholinergic activity are associated with an increased risk of subsequent hospitalization with a fall over a 19-year follow-up period. The biological mechanisms underlying the long-term risk of hospitalization with a fall or fracture following baseline ACB exposure remains unclear and requires further evaluation.
- Subjects :
- Adult
Male
Risk
medicine.medical_specialty
medicine.drug_class
Population
Datasets as Topic
Cholinergic Antagonists
State Medicine
Article
Cohort Studies
03 medical and health sciences
Fractures, Bone
0302 clinical medicine
Anticholinergic
Medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Longitudinal Studies
education
Adverse effect
Aged
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
education.field_of_study
business.industry
Proportional hazards model
Confounding
Hazard ratio
Retrospective cohort study
Middle Aged
United Kingdom
Hospitalization
Emergency medicine
Accidental Falls
Female
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 11791969
- Volume :
- 37
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Drugsaging
- Accession number :
- edsair.doi.dedup.....5b18f71033429e1f3b5492881f89742d