A five-year prospective evaluation of anticholinergic cognitive burden and falls in the Malaysian elders longitudinal research (MELoR) study

Xu, Xiang Jiang and Myint, Phyo Kyaw and Kioh, Sheng Hui and Mat, Sumaiyah and Rajasuriar, Reena and Kamaruzzaman, Shahrul Bahyah and Tan, Maw Pin (2021) A five-year prospective evaluation of anticholinergic cognitive burden and falls in the Malaysian elders longitudinal research (MELoR) study. Archives of Gerontology and Geriatrics, 98. ISSN 0167-4943, DOI https://doi.org/10.1016/j.archger.2021.104535.

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Background: While anticholinergic use is associated with stroke, dementia and mortality, few have evaluated its potential link with falls. To determine the relationship between anticholinergic cognitive burden (ACB) and falls over five years using the Malaysian Elders Longitudinal Research (MELoR). Methods: Community-dwelling adults aged 55 years and over were recruited through electoral roll sampling. Data obtained at baseline and follow-up (FU) at two and five years were included. Falls in the preceding 12 months were recorded. Results: Of the 1499 individuals (mean (SD) age = 68.9(7.5) yrs and 53.3% female) with information on baseline ACB exposure, 575(38.4%) had ACB scores of 1-2 and 117(7.8%) had ACB scores = 3. Differences in age, ethnicity, smoking status, diabetes, hypertension, cardiovascular disease, arthritis and education existed between ACB groups. Fall occurrence differed between ACB groups at recruitment (p = 0.004) and 2-year FU (p = 0.001) but not at 5-year FU (p = 0.053). Logistic regression revealed an independent association between ACB 1-2 and falls at baseline (odds ratio, OR (95% confidence interval, CI) =1.412(1.035-1.926)) and ACB = 3 and falls at 2-yr FU (OR (95%CI) =2.098(1.032-4.263)) following adjustment for confounders. Conclusion: Low level exposure to drugs with anticholinergic properties was associated cross-sectionally with falls, while exposure to higher levels were prospectively associated with falls at 2-year but not at 5-year FU. Future studies should determine whether avoidance of drugs with anticholinergic effects will lead to reduction in falls.

Item Type: Article
Funders: Ministry of Higher Education Fundamental Research Grant Scheme (FRGS/1/2019/SKK02/UM/01/1), Ministry of Higher Education Long-Term Research Grant Scheme (LRGS/1/2019/UM/01/1/1)
Uncontrolled Keywords: Anticholinergic cognitive burden; Falls; Elders; Longitudinal; Malaysia
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 13 Apr 2022 03:37
Last Modified: 13 Apr 2022 03:37
URI: http://eprints.um.edu.my/id/eprint/26353

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