Anticholinergic Burden Among Hospitalised Older Adults with Psychiatric Illnesses- A Retrospective Study

Title:Anticholinergic Burden Among Hospitalised Older Adults with Psychiatric Illnesses- A Retrospective Study

Volume: 16 Issue: 3

Author(s): Shiva Shanker Reddy Mukku, Preeti Sinha*, Palanimuthu Thangaraju Sivakumar and Mathew Varghese

Affiliation:

• Department of Psychiatry, National Institute of Mental Health and Neuroscience, Bangalore,India

Keywords: Anticholinergic drugs, psychotropics, older adults, psychiatric illness, cognitive impairment, hospitalised patients.

Abstract:

Background: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders.

Objective: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders.

Methods: Case records of older adults who sought in-patient care under the Geriatric Psychiatry Unit from January 2019 to June 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012.

Results: Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%), and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden (ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3.

Conclusion: Nearly half of the older adults in the psychiatry in-patient setting had a clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoringanticholinergic effects of psychotropics in older adults.

Cite this article as:

Mukku Shanker Reddy Shiva , Sinha Preeti *, Sivakumar Thangaraju Palanimuthu and Varghese Mathew , Anticholinergic Burden Among Hospitalised Older Adults with Psychiatric Illnesses- A Retrospective Study, Current Drug Safety 2021; 16 (3) . https://dx.doi.org/10.2174/1574886315666201026123655