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Anticholinergic Cognitive Burden (ACB)

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https://www.readbyqxmd.com/read/30056424/anticholinergic-burden-and-risk-of-stroke-and-death-in-people-with-different-types-of-dementia
#1
Edwin C K Tan, Maria Eriksdotter, Sara Garcia-Ptacek, Johan Fastbom, Kristina Johnell
BACKGROUND: Anticholinergic burden is associated with poorer cognitive and functional outcomes in people with dementia. However, the impact of anticholinergics on significant adverse outcomes such as stroke has not been studied previously. OBJECTIVE: To investigate the association between total anticholinergic cognitive burden (ACB) and risk of stroke and death in people with different dementia subtypes. METHODS: This was a cohort study of 39,107 people with dementia and no prior history of stroke registered in the Swedish Dementia Registry (SveDem) from 2008-2014...
July 21, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/30049542/anticholinergic-burden-is-associated-with-increased-mortality-in-older-patients-with-dependency-discharged-from-hospital
#2
Fabrizia Lattanzio, Graziano Onder, Mattia Miriam La Fauci, Stefano Volpato, Antonio Cherubini, Paolo Fabbietti, Carmelinda Ruggiero, Sabrina Garasto, Annalisa Cozza, Lucia Crescibene, Assunta Tarsitano, Andrea Corsonello
OBJECTIVES: To determine whether anticholinergic burden may predict differently 1-year mortality in older patients discharged from acute care hospitals with or without dependency in basic activities of daily living (BADL). DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: Our series consisted of 807 patients aged 65 years or older consecutively discharged from 7 acute care geriatric wards throughout Italy between June 2010 and May 2011...
July 23, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29729025/anticholinergic-medications-in-patients-admitted-with-cognitive-impairment-or-falls-amici-the-impact-of-hospital-admission-on-anticholinergic-cognitive-medication-burden-results-of-a-multicentre-observational-study
#3
I Weichert, R Romero-Ortuno, J Tolonen, T Soe, C Lebus, S Choudhury, C V Nadarajah, P Nanayakkara, M Orrù, S Di Somma
WHAT IS KNOWN AND OBJECTIVE: Drugs with anticholinergic properties increase the risk of falls, delirium, chronic cognitive impairment, and mortality and counteract procholinergic medications used in the treatment of dementia. Medication review and optimisation to reduce anticholinergic burden in patients at risk is recommended by specialist bodies. Little is known how effective this review is in patients who present acutely and how often drugs with anticholinergic properties are used temporarily during an admission...
May 4, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29695481/anticholinergic-drugs-and-risk-of-dementia-case-control-study
#4
Kathryn Richardson, Chris Fox, Ian Maidment, Nicholas Steel, Yoon K Loke, Antony Arthur, Phyo K Myint, Carlota M Grossi, Katharina Mattishent, Kathleen Bennett, Noll L Campbell, Malaz Boustani, Louise Robinson, Carol Brayne, Fiona E Matthews, George M Savva
OBJECTIVES: To estimate the association between the duration and level of exposure to different classes of anticholinergic drugs and subsequent incident dementia. DESIGN: Case-control study. SETTING: General practices in the UK contributing to the Clinical Practice Research Datalink. PARTICIPANTS: 40 770 patients aged 65-99 with a diagnosis of dementia between April 2006 and July 2015, and 283 933 controls without dementia...
April 25, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29500684/the-association-between-anticholinergic-drug-use-and-rehabilitation-outcome-in-post-acute-hip-fractured-patients-a-retrospective-cohort-study
#5
Avital Hershkovitz, Corina Angel, Shai Brill, Ran Nissan
BACKGROUND: Anticholinergic (AC) drugs are associated with significant impairment in cognitive and physical function which may affect rehabilitation in older people. We aimed to evaluate whether AC burden is associated with rehabilitation achievement in post-acute hip-fractured patients. METHODS: A retrospective cohort study carried out in a post-acute geriatric rehabilitation center on 1019 hip-fractured patients admitted from January 2011 to October 2015. The Anticholinergic Cognitive Burden Scale (ACB) was used to quantify the AC burden...
April 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29404965/medication-profiles-of-patients-with-cognitive-impairment-and-high-anticholinergic-burden
#6
Ariel R Green, Liza M Reifler, Cynthia M Boyd, Linda A Weffald, Elizabeth A Bayliss
BACKGROUND: Drugs with anticholinergic properties are considered potentially inappropriate in patients with cognitive impairment because harms-including delirium, falls, and fractures-may outweigh benefits. OBJECTIVE: 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...
March 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29292589/anticholinergic-burden-and-1-year-mortality-among-older-patients-discharged-from-acute-care-hospital
#7
Fabrizia Lattanzio, Francesco Corica, Roberto Schepisi, Diana Amantea, Francesco Bruno, Annalisa Cozza, Graziano Onder, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Marcello G Maggio, Andrea Corsonello
AIM: The association between anticholinergic burden and mortality is controversial. We aimed to investigate whether the anticholinergic cognitive burden (ACB) score predicts 1-year mortality in older patients discharged from acute care hospitals. METHODS: Our series consisted of 807 hospitalized patients aged ≥65 years. Patients were followed up for 12 months after discharge. All-cause mortality was the outcome of the study. The ACB score at discharge (0, 1, ≥2) and increasing ACB score from admission to discharge (no increase, +1, +2 or more) were calculated and used as exposure variables...
May 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29188908/anticholinergic-burden-and-cognition-in-older-patients-with-schizophrenia
#8
Christopher Tsoutsoulas, Benoit H Mulsant, Sanjeev Kumar, Zaid Ghazala, Aristotle N Voineskos, Mahesh Menon, Bruce G Pollock, Tarek K Rajji
OBJECTIVE: Older individuals with schizophrenia are at risk of being treated with anticholinergic medications due to the prevalence of medical comorbidities and polypharmacy. High anticholinergic burden impairs cognition and is a risk factor for Alzheimer's dementia. Thus, we assessed the impact of anticholinergic burden on Alzheimer's dementia-related and schizophrenia-related cognitive functions in older patients with schizophrenia. METHODS: Anticholinergic burden was measured using the Anticholinergic Cognitive Burden scale (ACB) in 60 community-dwelling patients aged ≥ 50 years who met DSM-IV criteria for schizophrenia between May 2007 and November 2011...
November 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#9
COMPARATIVE STUDY
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29119486/potentially-harmful-medication-use-and-decline-in-health-related-quality-of-life-among-community-dwelling-older-adults
#10
Kenya Ie, Eric Chou, Richard D Boyce, Steven M Albert
BACKGROUND: Several scales to quantify the impact of potentially harmful medications (PHMs) have been shown to predict mortality and functional decline; however, the effect of PHMs on quality of life (QoL) has not been well-studied. OBJECTIVE: The aims of this study were to investigate an association between PHM use and change in health-related QoL among community-dwelling older adults, and to compare the predictive capacity of PHM scales. METHODS: We conducted a retrospective cohort study using prescription claims data and survey responses...
December 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28869467/potentially-inappropriate-medication-anticholinergic-burden-and-mortality-in-people-attending-memory-clinics
#11
MULTICENTER STUDY
Amanda J Cross, Johnson George, Michael C Woodward, David Ames, Henry Brodaty, Rory Wolfe, Michael H Connors, Rohan A Elliott
BACKGROUND: There is limited evidence regarding the association between potentially inappropriate medications (PIM) and mortality in older people with cognitive impairment. OBJECTIVE: To examine whether use of medications considered to be potentially inappropriate in older people with cognitive impairment (PIMcog) and anticholinergic cognitive burden (ACB) were associated with mortality in people who attended memory clinics. METHODS: Cross-sectional and longitudinal analyses of data from the Prospective Research In MEmory clinics (PRIME) study...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28868891/anticholinergic-burden-in-older-inpatients-on-psychotropic-medication-do-we-care
#12
Mei Shiang Lee, Steve Kisely, Boris Zolotarev, Andrew Warren, Jack Henderson, Manoj George
OBJECTIVES: This quality activity explored the prescribing patterns in an Older Persons Mental Health Inpatient Unit in order to establish whether the Anticholinergic Cognitive Burden Scale (ACB Scale) score on admission was reviewed to minimise anticholinergic cognitive burden (ACB) while maintaining therapeutic effects. METHODS: A retrospective electronic chart review of 50 discharged patients for any documented ACB review by the treating team, as well as the ACB Scale scores on admission and discharge...
December 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28801707/association-between-anticholinergic-drug-use-and-health-related-quality-of-life-in-community-dwelling-older-adults
#13
Benoit Cossette, Maimouna Bagna, Modou Sene, Caroline Sirois, Gabrielle P Lefebvre, Olivier Germain, José A Morais, Pierrette Gaudreau, Hélène Payette
BACKGROUND: The use of drugs with anticholinergic properties (AC drugs) has been associated with decreased functioning and impaired cognition in older adults. Studies assessing the association between AC-drug use and health-related quality of life (HRQoL) show conflicting results. OBJECTIVE: The aim was to evaluate the association between AC-drug use and HRQoL in community-dwelling older adults. METHODS: The NuAge cohort study enrolled 1793 men and women aged 68-82 years...
October 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28764796/anticholinergic-drugs-and-functional-cognitive-impairment-and-behavioral-disturbances-in-patients-from-a-memory-clinic-with-subjective-cognitive-decline-or-neurocognitive-disorders
#14
Virginie Dauphinot, Christelle Mouchoux, Sébastien Veillard, Floriane Delphin-Combe, Pierre Krolak-Salmon
BACKGROUND: Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients. METHODS: A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD)...
August 1, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28603629/anticholinergic-drug-exposure-is-associated-with-delirium-and-postdischarge-institutionalization-in-acutely-ill-hospitalized-older-patients
#15
Angelique Egberts, Saskia T van der Craats, Melissa D van Wijk, Shams Alkilabe, Patricia M L A van den Bemt, Francesco U S Mattace-Raso
Several studies investigated the possible association between anticholinergic drugs and diverse clinical outcomes in older persons, but the results are inconsistent. The aim of this study was to investigate whether anticholinergic drug exposure is associated with delirium on admission, length of hospital stay, postdischarge institutionalization and in-hospital mortality in acutely ill hospitalized older patients. In this observational chart review study, we included acutely ill patients aged 65 and older who were admitted to the geriatric ward of the Erasmus University Medical Center, Rotterdam, The Netherlands, between 2012 and 2015 ( n  = 905)...
June 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28503836/role-of-anticholinergic-burden-in-primary-care-patients-with-first-cognitive-complaints
#16
G Grande, I Tramacere, D L Vetrano, F Clerici, S Pomati, C Mariani, G Filippini
BACKGROUND AND PURPOSE: Drugs with anticholinergic properties might have a negative impact on cognition, but findings are still conflicting. The association was evaluated between anticholinergic drugs and cognitive performance in primary care patients with first cognitive complaints. METHODS: From April 2013 to March 2014, 353 general practitioners administered the Mini-Mental State Examination (MMSE) to patients presenting with first cognitive complaints. Drug history was collected and the anticholinergic cognitive burden (ACB) was scored and categorized as ACB 0, ACB 1 and ACB 2+...
July 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28187171/anticholinergic-burden-and-cognitive-function-in-a-large-german-cohort-of-hospitalized-geriatric-patients
#17
Barbara Pfistermeister, Thomas Tümena, Karl-Günter Gaßmann, Renke Maas, Martin F Fromm
PURPOSE: Previous studies suggest an association between use of anticholinergic drugs in elderly patients and cognitive impairment. However, there are still limited data on the association of anticholinergic drug use and cognitive impairment as well as contribution of individual drugs to anticholinergic load using large, well-documented patient cohorts treated in geriatric units from Europe. METHODS: We investigated 797,440 prescriptions to 89,579 hospitalized patients treated in geriatric units within the GiB-DAT database...
2017: PloS One
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#18
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27711982/association-of-anticholinergic-burden-with-cognitive-impairment-and-health-care-utilization-among-a-diverse-ambulatory-older-adult-population
#19
Noll L Campbell, Anthony J Perkins, Pamela Bradt, Sinem Perk, Ronald C Wielage, Malaz A Boustani, Daniel B Ng
STUDY OBJECTIVE: To determine the association between Anticholinergic Cognitive Burden (ACB) score and both cognitive impairment and health care utilization among a diverse ambulatory older adult population. DESIGN: Retrospective cohort study. DATA SOURCE: Medication exposure and other clinical data were extracted from the Regenstrief Medical Record System (RMRS), and cognitive diagnosis was derived from a dementia screening and diagnosis study...
November 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27660331/association-of-anticholinergic-burden-with-adverse-effects-in-older-people-with-intellectual-disabilities-an-observational-cross-sectional-study
#20
Máire O'Dwyer, Ian D Maidment, Kathleen Bennett, Jure Peklar, Niamh Mulryan, Philip McCallion, Mary McCarron, Martin C Henman
BACKGROUND: No studies to date have investigated cumulative anticholinergic exposure and its effects in adults with intellectual disabilities. AIMS: To determine the cumulative exposure to anticholinergics and the factors associated with high exposure. METHOD: A modified Anticholinergic Cognitive Burden (ACB) scale score was calculated for a representative cohort of 736 people over 40 years old with intellectual disabilities, and associations with demographic and clinical factors assessed...
December 2016: British Journal of Psychiatry: the Journal of Mental Science
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