Use of Anticholinergic Drugs and its Relationship With Psychological Well-Being and Mortality in Long-Term Care Facilities in Helsinki

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http://hdl.handle.net/10138/301998

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Aalto , U L , Roitto , H-M , Finne-Soveri , H , Kautiainen , H & Pitkälä , K 2018 , ' Use of Anticholinergic Drugs and its Relationship With Psychological Well-Being and Mortality in Long-Term Care Facilities in Helsinki ' , Journal of the American Medical Directors Association , vol. 19 , no. 6 , pp. 511-515 . https://doi.org/10.1016/j.jamda.2017.11.013

Title: Use of Anticholinergic Drugs and its Relationship With Psychological Well-Being and Mortality in Long-Term Care Facilities in Helsinki
Author: Aalto, Ulla Liisa; Roitto, Hanna-Maria; Finne-Soveri, Harriet; Kautiainen, Hannu; Pitkälä, Kaisu
Contributor: University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Clinicum
University of Helsinki, Department of General Practice and Primary Health Care
Date: 2018-06
Language: eng
Number of pages: 5
Belongs to series: Journal of the American Medical Directors Association
ISSN: 1525-8610
URI: http://hdl.handle.net/10138/301998
Abstract: Objectives: To assess the burden of drugs with anticholinergic properties (DAPs) and associated factors in long-term care facilities and to explore how psychological well-being and mortality are associated with the use of DAPs. Design: Cross-sectional study and 1-year follow-up of all-cause mortality. Setting and Participants: All 4449 older people (>65 years of age) living in nursing homes and assisted living facilities in Helsinki in 2011 were recruited. After refusals and excluding residents with severe dementia, 2432 participants remained. Measurements: Data on demographics, drug use, and medical history were collected by trained nurses using a structured assessment. Psychological well-being (PWB) of participants was assessed by 6 questions resulting in a validated PWB score (range 0-1). Mortality data were retrieved from central registers. The total number of anticholinergic drugs was determined according to the Anticholinergic Risk Scale. Results: Of the participants, 51% used at least 1 DAP. DAP users were younger and had better cognition than nonusers. There was a linear relationship between the number of DAPs used and poorer PWB. A similar trend was present between the number of DAPs and poorer PWB both among those with and without depression and among those with and without functional dependency. No difference in mortality existed between DAP users and nonusers. Conclusions: Despite DAP users being younger and having better cognition, they had poorer PWB. Clinicians should carefully consider the potential benefits and harm when prescribing DAPs to older people. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Subject: Anticholinergic drug
aged
psychological well-being
mortality
NURSING-HOME RESIDENTS
ELDERLY-PATIENTS
OLDER-ADULTS
COGNITIVE IMPAIRMENT
MEDICATION USE
DEMENTIA
PEOPLE
SCALE
BURDEN
LIFE
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
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