A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study

Andrew D. Ablett; Adrian D. Wood; Rebecca Barr; Jordan Guillot; Alison J. Black; Helen M. MacDonald; David M. Reid; Phyo K. Myint

doi:10.1016/j.annepidem.2018.05.011

A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study

Andrew D. Ablett, Adrian D. Wood, Rebecca Barr, Jordan Guillot, Alison J. Black, Helen M. MacDonald, David M. Reid, Phyo K. Myint

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Abstract

Purpose To examine the cross-sectional association between anti-cholinergic medication burden (ACB) and a history of falls, bone mineral density (BMD), and low trauma fractures in middle-aged women under 65 years of age from the Aberdeen Prospective Osteoporosis Screening Study (APOSS).
Methods ACB (0= none, 1=possible, ≥2= definite) was calculated from medication use for 3883 Caucasian women (mean age (SD) = 54.3 (2.3) years) attending the second APOSS study visit (1997-2000). Outcomes were examined using logistic regression. Model adjustments were selected a-priori based on expert opinion.
Results Of 3883 participants, 3293 scored ACB = 0, 328 scored ACB = 1, and 262 scored ACB > 2. High ACB burden (≥2) was associated with increased odds (ACB=0 reference) for falls (fully adjusted OR (95% CI) = 1.81 (1.25-2.62); P=0.002), and having low BMD (lowest quintile- 20%) at Ward’s triangle (3.22 (1.30-7.99); P=0.01). A history of falls over the year prior to study visits in participants with ACB score ≥2 was 32 per 100. For ACB categories 1 and 0, a history of falls per 100 was 21 and 22 respectively.
Conclusions The risk of falling associated with ACB observed in older age may also extend to middle-age women.

Original language	English
Pages (from-to)	557-562
Number of pages	6
Journal	Annals of Epidemiology
Volume	28
Issue number	8
Early online date	2 Jun 2018
DOIs	https://doi.org/10.1016/j.annepidem.2018.05.011
Publication status	Published - Aug 2018

Bibliographical note

APOSS was funded by the Grampian Osteoporosis Trust. A.D.A. received an Aberdeen Summer Research Scholarship supported by the funding from the Grampian Osteoporosis Trust Charity. The funder has no role in design, analysis, interpretation and reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for permission to conduct this research.

Keywords

anti-cholinergic
epidemiology
bone mineral density
falls
fracture
women
middle age

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© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Accepted author manuscript, 615 KBLicence: CC BY-NC-ND

Cite this

Ablett, A. D., Wood, A. D., Barr, R., Guillot, J., Black, A. J., MacDonald, H. M., Reid, D. M., & Myint, P. K. (2018). A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study. Annals of Epidemiology, 28(8), 557-562. https://doi.org/10.1016/j.annepidem.2018.05.011

A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study. / Ablett, Andrew D.; Wood, Adrian D.; Barr, Rebecca et al.
In: Annals of Epidemiology, Vol. 28, No. 8, 08.2018, p. 557-562.

Research output: Contribution to journal › Article › peer-review

Ablett, AD, Wood, AD, Barr, R, Guillot, J, Black, AJ, MacDonald, HM , Reid, DM & Myint, PK 2018, 'A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study', Annals of Epidemiology, vol. 28, no. 8, pp. 557-562. https://doi.org/10.1016/j.annepidem.2018.05.011

@article{f239754ed03f4068b15e7637e729509d,

title = "A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study",

abstract = "Purpose To examine the cross-sectional association between anti-cholinergic medication burden (ACB) and a history of falls, bone mineral density (BMD), and low trauma fractures in middle-aged women under 65 years of age from the Aberdeen Prospective Osteoporosis Screening Study (APOSS).Methods ACB (0= none, 1=possible, ≥2= definite) was calculated from medication use for 3883 Caucasian women (mean age (SD) = 54.3 (2.3) years) attending the second APOSS study visit (1997-2000). Outcomes were examined using logistic regression. Model adjustments were selected a-priori based on expert opinion.Results Of 3883 participants, 3293 scored ACB = 0, 328 scored ACB = 1, and 262 scored ACB > 2. High ACB burden (≥2) was associated with increased odds (ACB=0 reference) for falls (fully adjusted OR (95% CI) = 1.81 (1.25-2.62); P=0.002), and having low BMD (lowest quintile- 20%) at Ward{\textquoteright}s triangle (3.22 (1.30-7.99); P=0.01). A history of falls over the year prior to study visits in participants with ACB score ≥2 was 32 per 100. For ACB categories 1 and 0, a history of falls per 100 was 21 and 22 respectively.Conclusions The risk of falling associated with ACB observed in older age may also extend to middle-age women.",

keywords = "anti-cholinergic, epidemiology, bone mineral density, falls, fracture, women, middle age",

author = "Ablett, {Andrew D.} and Wood, {Adrian D.} and Rebecca Barr and Jordan Guillot and Black, {Alison J.} and MacDonald, {Helen M.} and Reid, {David M.} and Myint, {Phyo K.}",

note = "APOSS was funded by the Grampian Osteoporosis Trust. A.D.A. received an Aberdeen Summer Research Scholarship supported by the funding from the Grampian Osteoporosis Trust Charity. The funder has no role in design, analysis, interpretation and reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for permission to conduct this research.",

year = "2018",

month = aug,

doi = "10.1016/j.annepidem.2018.05.011",

language = "English",

volume = "28",

pages = "557--562",

journal = "Annals of Epidemiology",

issn = "1047-2797",

publisher = "Elsevier Inc.",

number = "8",

}

TY - JOUR

T1 - A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women

T2 - findings from the Aberdeen Prospective Osteoporosis Screening Study

AU - Ablett, Andrew D.

AU - Wood, Adrian D.

AU - Barr, Rebecca

AU - Guillot, Jordan

AU - Black, Alison J.

AU - MacDonald, Helen M.

AU - Reid, David M.

AU - Myint, Phyo K.

N1 - APOSS was funded by the Grampian Osteoporosis Trust. A.D.A. received an Aberdeen Summer Research Scholarship supported by the funding from the Grampian Osteoporosis Trust Charity. The funder has no role in design, analysis, interpretation and reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for permission to conduct this research.

PY - 2018/8

Y1 - 2018/8

N2 - Purpose To examine the cross-sectional association between anti-cholinergic medication burden (ACB) and a history of falls, bone mineral density (BMD), and low trauma fractures in middle-aged women under 65 years of age from the Aberdeen Prospective Osteoporosis Screening Study (APOSS).Methods ACB (0= none, 1=possible, ≥2= definite) was calculated from medication use for 3883 Caucasian women (mean age (SD) = 54.3 (2.3) years) attending the second APOSS study visit (1997-2000). Outcomes were examined using logistic regression. Model adjustments were selected a-priori based on expert opinion.Results Of 3883 participants, 3293 scored ACB = 0, 328 scored ACB = 1, and 262 scored ACB > 2. High ACB burden (≥2) was associated with increased odds (ACB=0 reference) for falls (fully adjusted OR (95% CI) = 1.81 (1.25-2.62); P=0.002), and having low BMD (lowest quintile- 20%) at Ward’s triangle (3.22 (1.30-7.99); P=0.01). A history of falls over the year prior to study visits in participants with ACB score ≥2 was 32 per 100. For ACB categories 1 and 0, a history of falls per 100 was 21 and 22 respectively.Conclusions The risk of falling associated with ACB observed in older age may also extend to middle-age women.

AB - Purpose To examine the cross-sectional association between anti-cholinergic medication burden (ACB) and a history of falls, bone mineral density (BMD), and low trauma fractures in middle-aged women under 65 years of age from the Aberdeen Prospective Osteoporosis Screening Study (APOSS).Methods ACB (0= none, 1=possible, ≥2= definite) was calculated from medication use for 3883 Caucasian women (mean age (SD) = 54.3 (2.3) years) attending the second APOSS study visit (1997-2000). Outcomes were examined using logistic regression. Model adjustments were selected a-priori based on expert opinion.Results Of 3883 participants, 3293 scored ACB = 0, 328 scored ACB = 1, and 262 scored ACB > 2. High ACB burden (≥2) was associated with increased odds (ACB=0 reference) for falls (fully adjusted OR (95% CI) = 1.81 (1.25-2.62); P=0.002), and having low BMD (lowest quintile- 20%) at Ward’s triangle (3.22 (1.30-7.99); P=0.01). A history of falls over the year prior to study visits in participants with ACB score ≥2 was 32 per 100. For ACB categories 1 and 0, a history of falls per 100 was 21 and 22 respectively.Conclusions The risk of falling associated with ACB observed in older age may also extend to middle-age women.

KW - anti-cholinergic

KW - epidemiology

KW - bone mineral density

KW - falls

KW - fracture

KW - women

KW - middle age

U2 - 10.1016/j.annepidem.2018.05.011

DO - 10.1016/j.annepidem.2018.05.011

M3 - Article

C2 - 29937404

SN - 1047-2797

VL - 28

SP - 557

EP - 562

JO - Annals of Epidemiology

JF - Annals of Epidemiology

IS - 8

ER -

A high anti-cholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study

Abstract

Bibliographical note

Keywords

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