Anticholinergic Load and Nutritional Status in Older Individuals

J Nutr Health Aging. 2020;24(1):20-27. doi: 10.1007/s12603-019-1283-x.

Abstract

Objectives: The association between anticholinergic load-based Anticholinergic Risk Scale scores and nutritional status is unclear in Japanese patients. The aim of this study was to establish whether anticholinergic load affects the nutritional status of geriatric patients in convalescent stages.

Design: Retrospective longitudinal cohort study.

Setting: Convalescent rehabilitation wards.

Participants: Of the 1490 patients aged ≥65 years who were discharged from convalescent rehabilitation wards between July 2010 and October 2018, 908 patients met the eligibility criteria. They were categorized according to the presence or absence of increased anticholinergic load from admission to discharge.

Measurements: Demographic data, laboratory data, the Functional Independence Measure were analyzed between the groups. The primary outcome was Geriatric Nutritional Risk Index (GNRI) at discharge. Multiple linear regression analysis was performed to analyze the relationship between anticholinergic load and GNRI at discharge.

Results: Multiple linear regression analysis after adjusting for confounding factors revealed that anticholinergic load was independently and negatively correlated with GNRI at discharge. Particularly, the use of chlorpromazine, hydroxyzine, haloperidol, metoclopramide, risperidone, etc. increased significantly from admission to discharge.

Conclusion: Increased anticholinergic load during hospitalization may be a predictor of nutritional status in geriatric patients.

Keywords: Anticholinergic drug; anticholinergic risk scale; geriatric nutritional risk index; older individuals.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chlorpromazine / pharmacokinetics
  • Cholinergic Antagonists / blood*
  • Cholinergic Antagonists / pharmacokinetics*
  • Cholinergic Antagonists / therapeutic use
  • Female
  • Geriatric Assessment
  • Haloperidol / pharmacokinetics
  • Hospitalization
  • Humans
  • Hydroxyzine / pharmacokinetics
  • Japan / epidemiology
  • Linear Models
  • Longitudinal Studies
  • Male
  • Malnutrition / epidemiology*
  • Metoclopramide / pharmacokinetics
  • Multivariate Analysis
  • Nutrition Assessment
  • Nutritional Status / physiology*
  • Patient Discharge
  • Regression Analysis
  • Retrospective Studies
  • Risperidone / pharmacokinetics

Substances

  • Cholinergic Antagonists
  • Hydroxyzine
  • Haloperidol
  • Metoclopramide
  • Risperidone
  • Chlorpromazine