Association Between Anticholinergic Drug Use and Health-Related Quality of Life in Community-Dwelling Older Adults

Drugs Aging. 2017 Oct;34(10):785-792. doi: 10.1007/s40266-017-0486-2.

Abstract

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. The participants were free of disabilities in activities of daily living, not cognitively impaired at recruitment and followed annually for 3 years (December 2003-May 2005). AC-drug exposure was assessed using the Anticholinergic Cognitive Burden Scale (ACBS). HRQoL was assessed using the physical (PCS) and mental (MCS) component summaries of the 36-item Short Form Survey (SF-36) questionnaire. The association between AC drug and HRQoL was determined by a mixed model analysis using four annual time points.

Results: At recruitment the mean age was 74.4 ± 4.2 years, 52% were female and 33% of participants were prescribed at least one AC drug. The mean PCS and MCS (/100) scores were 49.0 ± 8.2 and 54.9 ± 8.1, respectively. In the mixed model analysis, an increase of 1 on the ACBS was associated with a decrease of -0.50 (95% CI -0.68 to -0.31) in the PCS and an increase of 0.19 (95% CI 0.01-0.37) in the MCS.

Conclusions: In a cohort of generally healthy community-dwelling older adults, AC-drug exposure was associated with a statistically significant decrease in the PCS and increase in the MCS throughout the entire follow-up period. However, the effects on the PCS and MCS were small and likely not clinically relevant.

MeSH terms

  • Activities of Daily Living / psychology*
  • Adult
  • Aged
  • Cholinergic Antagonists / administration & dosage*
  • Cholinergic Antagonists / adverse effects*
  • Cognitive Aging / psychology
  • Cohort Studies
  • Female
  • Humans
  • Independent Living / psychology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Physical Fitness / psychology
  • Quality of Life* / psychology
  • Surveys and Questionnaires

Substances

  • Cholinergic Antagonists