Anticholinergic burden measures and older people’s falls risk: a systematic prognostic review

Stewart, Carrie, Taylor-Rowan, Martin, Soiza, Roy L., Quinn, Terence J., Loke, Yoon K. and Myint, Phyo Kyaw (2021) Anticholinergic burden measures and older people’s falls risk: a systematic prognostic review. Therapeutic Advances in Drug Safety, 12. ISSN 2042-0986

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Introduction: Several adverse outcomes have been associated with anticholinergic burden (ACB), and these risks increase with age. Several approaches to measuring this burden are available but, to date, no comparison of their prognostic abilities has been conducted. This PROSPERO-registered systematic review (CRD42019115918) compared the evidence behind ACB measures in relation to their ability to predict risk of falling in older people. Methods: Medline (OVID), EMBASE (OVID), CINAHL (EMBSCO) and PsycINFO (OVID) were searched using comprehensive search terms and a validated search filter for prognostic studies. Inclusion criteria included: participants aged 65 years and older, use of one or more ACB measure(s) as a prognostic factor, cohort or case-control in design, and reporting falls as an outcome. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results: Eight studies reporting temporal associations between ACB and falls were included. All studies were rated high risk of bias in ⩾1 QUIPS tool categories, with five rated high risk ⩾3 categories. All studies (274,647 participants) showed some degree of association between anticholinergic score and increased risk of falls. Findings were most significant with moderate to high levels of ACB. Most studies (6/8) utilised the anticholinergic cognitive burden scale. No studies directly compared two or more ACB measures and there was variation in how falls were measured for analysis. Conclusion: The evidence supports an association between moderate to high ACB and risk of falling in older people, but no conclusion can be made regarding which ACB scale offers best prognostic value in older people.

Item Type: Article
Uncontrolled Keywords: adverse outcomes,anticholinergics,measurement scales,older adults,prognostic study,pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/2700/2736
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 16 Jun 2021 00:20
Last Modified: 20 Apr 2023 21:34
DOI: 10.1177/20420986211016645

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