Analysis of anticholinergic and sedative medicine effects on physical function, cognitive function, appetite and frailty: a cross-sectional study in Australia

Abstract

ObjectiveTo test the association between use of medicines with anticholinergic or sedative properties and physical function, cognitive function, appetite and frailty.Design, setting and participantsThis cross-sectional study analysed baseline data collected as part of the Australian Longitudinal Study of Ageing, a population-based cohort of 2087 participants aged 65 years or over living in South Australia.Main outcome measuresPhysical function was measured at baseline using measures including hand grip strength, walking speed, chair stands, activities of daily living and instrumental activities of daily living (IADL). Cognitive function was measured using Mini-Mental State Examination. Appetite was measured using Center for Epidemiologic Studies Depression question 2. Frailty was measured using frailty index. The association between use of anticholinergics or sedatives and physical or cognitive function, appetite, or frailty was assessed using analysis of covariance and ordinal or binary logistic regression.ResultsAlmost half of the population were using anticholinergics or sedatives (n=954, 45.7%). Use of anticholinergics was significantly associated with poorer grip strength, slower walking speed, poorer IADL and poorer appetite. Use of sedatives was significantly associated with poorer grip strength, slower walking speed and poorer IADL. We found no significant association between medicine use and cognitive function. Users of anticholinergics or sedatives were significantly more likely to be frail compared with non-users.ConclusionUse of medicines with anticholinergic or sedative properties is significantly associated with poorer physical function, poorer appetite and increased frailty. Early identification of signs and symptoms of deterioration associated with medicine use is particularly important in older people so that worsening frailty and subsequent adverse events are prevented.

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Associations Between Anticholinergic Medication Exposure and Adverse Health Outcomes in Older People with Frailty: A Systematic Review and Meta-analysis

“…A re-run of the comprehensive search was conducted in April 2021 yielding 588 studies; however, screening of titles, abstracts and full texts was not conducted, and it is unclear whether any studies would have met the inclusion criteria. The search was limited to studies containing phrases relating to ‘frailty’ in the title or abstract, and yielded only nine studies, of which two would have been eligible for screening of full-texts as per the methods [ 64 , 65 ]. However, it is possible more newly published studies reported the characteristics of a frail sample, without explicitly using phrases such as ‘frailty’ in the texts.…”

Prevalence and predictors of mortality for older adults referred to hospital avoidance program

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