| Title |
Medication Profiles of Patients with Cognitive Impairment and High Anticholinergic Burden
|
|---|---|
| Published in |
Drugs & Aging, February 2018
|
| DOI | 10.1007/s40266-018-0522-x |
| Pubmed ID | |
| Authors |
Ariel R. Green, Liza M. Reifler, Cynthia M. Boyd, Linda A. Weffald, Elizabeth A. Bayliss |
| Abstract |
Drugs with anticholinergic properties are considered potentially inappropriate in patients with cognitive impairment because harms-including delirium, falls, and fractures-may outweigh benefits. To highlight opportunities to improve clinical decision making and care for patients with cognitive impairment and multiple chronic conditions, we identified distinct subgroups of patients with mild cognitive impairment (MCI) and dementia who had high cumulative anticholinergic burden and specific patterns of anticholinergic use. We conducted a retrospective cohort study in a not-for-profit, integrated delivery system. Participants included community-dwelling adults aged 65 years and older (n = 13,627) with MCI or dementia and at least two other chronic diseases. We calculated the Anticholinergic Cognitive Burden (ACB) score for each participant from pharmacy and electronic health record (EHR) data. Among individuals with a mean 12-month ACB score ≥ 2, we used agglomerative hierarchical clustering to identify groups or clusters of individuals with similar anticholinergic prescription patterns. Twenty-four percent (3257 participants) had high anticholinergic burden, defined as an ACB score ≥ 2. Clinically meaningful clusters based upon anchoring medications or drug classes included a cluster of cardiovascular medications (n = 1497; 46%); two clusters of antidepressant medications (n = 633; 20%); and a cluster based on use of bladder antimuscarinics (n = 431; 13%). Several clusters comprised multiple central nervous system (CNS)-active drugs. Cardiovascular and CNS-active medications comprise a substantial portion of anticholinergic burden in people with cognitive impairment and multiple chronic conditions. Antidepressants were highly prevalent. Clinical profiles elucidated by these clusters of anticholinergic medications can inform targeted approaches to care. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 123 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 123 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 17 | 14% |
| Student > Master | 16 | 13% |
| Researcher | 13 | 11% |
| Student > Bachelor | 13 | 11% |
| Student > Doctoral Student | 8 | 7% |
| Other | 17 | 14% |
| Unknown | 39 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 26% |
| Nursing and Health Professions | 11 | 9% |
| Psychology | 11 | 9% |
| Pharmacology, Toxicology and Pharmaceutical Science | 10 | 8% |
| Neuroscience | 4 | 3% |
| Other | 9 | 7% |
| Unknown | 46 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 February 2018.
All research outputs
#18,585,544
of 23,020,670 outputs
Outputs from Drugs & Aging
#1,059
of 1,215 outputs
Outputs of similar age
#327,807
of 437,326 outputs
Outputs of similar age from Drugs & Aging
#20
of 22 outputs
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