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ToolsXu, Xiang Jiang, Myint, Phyo Kyaw, Wong, Man Chun, Mat, Sumaiyah, Lee, Shaun Wen Huey, Sami, Saber and Tan, Maw Pin (2025) Changes in anticholinergic cognitive burden and risk of single and recurrent falls: population-based cohort study. Age and Ageing, 54 (6). ISSN 0002-0729
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Abstract
Background: Medications with high anticholinergic cognitive burden (ACB) are associated with increased fall risk in older adults. However, the potential alteration of risk with changes in ACB over time has yet to be established. Objective: To estimate the association between the changes in ACB with single and recurrent falls. Methods: Data from European Investigation of Cancer-Norfolk (EPIC-Norfolk) study participants, aged 40 years and above, who attended the first (1HC:1993–98), second (2HC:1998–2000) and third (3HC: 2004–11) health checks were utilised. The main outcome was a single fall event or recurrent (≤2) falls occurring during the 12 months preceding the time point of the 3HC. Results: Data from 10 717 participants with a median, Interquartile range (IQR) age of 55.6 (13.1) years were included. Three thousand four hundred forty-five (32.2%) participants had an ACB of one or greater at baseline. Participants were classified into four groups: no (67.8%), late (21.1%), transient (6.8%) and continuous (4.3%). Late (OR 1.49, 95% CI 1.25–1.79), transient (1.66, 1.28–2.14) and continuous (1.67, 1.22–2.29) exposure were significantly associated with increased recurrent falls compared with no exposure. Mediation analysis revealed that gait speed (GS) contributed to 16.9% (CI: 9.4%–27.8%) of the increase in risk of recurrent falls associated with ACB. Discussion: Anticholinergic medication use, in adults aged 40 years and above, was linked to recurrent falls at 14-year follow-up, regardless of whether introduction or cessation occurred during the follow-up. Future research should determine effective strategies for minimising the long-term risk of falls when starting anticholinergic medications, which could include GS as a risk-detection and monitoring tool.
| Item Type: | Article |
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| Additional Information: | Data Availability: EPIC-Norfolk has a wide range of collaborators. Contact details, publications and the process for collaborating and data requests can be found on the website (www.epic-norfolk.org.uk). Requests are reviewed by the EPIC-Norfolk management committee, and proposals should fulfil a number of criteria including that the work is within the bounds of consent given by participants. Scientific proposals must be satisfactorily peer-reviewed and ethically reviewed and approved. Declaration of Sources of Funding: The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1, MC-UU-12015/1 and MC-UU-00006/1) and Cancer Research UK (C864/A14136). |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Mental Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 07 Jul 2025 15:30 |
| Last Modified: | 07 Jul 2025 15:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/99855 |
| DOI: | 10.1093/ageing/afaf177 |
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