Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)

Samuel R. Neal; Adrian D. Wood; Andrew D. Ablett; Jenny S. Gregory; Jordan Guillot; Helen M. Macdonald; David M. Reid; Phyo Kyaw Myint

doi:10.1177/2042098620929852

Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)

Samuel R. Neal, Adrian D. Wood, Andrew D. Ablett, Jenny S. Gregory, Jordan Guillot, Helen M. Macdonald, David M. Reid, Phyo Kyaw Myint^*

^*Corresponding author for this work

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Abstract

Background: Anticholinergic burden (ACB) is a recognized risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.

Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997-1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (≥2 falls) during the 12 months prior to follow up (2007-2011). Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.

Results: A total of 2,125 women (mean age (SD):54.7(2.2) years at baseline and 66.0(2.2) years at follow-up) were included. Prevalence of baseline ACB score of 0, 1 and ≥2 was 87.1%, 7.3% and 5.6%, respectively. Compared to no ACB, ACB ≥2 was associated with recurrent falls in the previous 12 months (adjusted odds ratio: 2.34, 95% confidence interval: 1.31, 4.19) at an average of 11 year after initial exposure. No such association was found for an ACB score of 1.

Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.

Original language	English
Pages (from-to)	1-9
Number of pages	9
Journal	Therapeutic Advances in Drug Safety
Volume	11
Early online date	27 May 2020
DOIs	https://doi.org/10.1177/2042098620929852
Publication status	Published - 2020

Bibliographical note

ACKNOWLEDGEMENTS AND FUNDING

The Aberdeen Prospective Osteoporosis Screening Study (APOSS) was funded by the Grampian Osteoporosis Trust. SRN received an Aberdeen Summer Research Scholarship supported by funding from the Institute of Applied Health Sciences, University of Aberdeen, UK. The funder had no role in design, analysis, interpretation or reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for their permission to conduct this research.

Keywords

Accidental Falls
Cholinergic Antagonists
Middle Aged
Polypharmacy
accidental falls
cholinergic antagonists
middle aged
polypharmacy

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Cite this

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title = "Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)",

abstract = "Background: Anticholinergic burden (ACB) is a recognized risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997-1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (≥2 falls) during the 12 months prior to follow up (2007-2011). Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.Results: A total of 2,125 women (mean age (SD):54.7(2.2) years at baseline and 66.0(2.2) years at follow-up) were included. Prevalence of baseline ACB score of 0, 1 and ≥2 was 87.1%, 7.3% and 5.6%, respectively. Compared to no ACB, ACB ≥2 was associated with recurrent falls in the previous 12 months (adjusted odds ratio: 2.34, 95% confidence interval: 1.31, 4.19) at an average of 11 year after initial exposure. No such association was found for an ACB score of 1.Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.",

keywords = "Accidental Falls, Cholinergic Antagonists, Middle Aged, Polypharmacy, accidental falls, cholinergic antagonists, middle aged, polypharmacy",

author = "Neal, {Samuel R.} and Wood, {Adrian D.} and Ablett, {Andrew D.} and Gregory, {Jenny S.} and Jordan Guillot and Macdonald, {Helen M.} and Reid, {David M.} and Myint, {Phyo Kyaw}",

note = "ACKNOWLEDGEMENTS AND FUNDING The Aberdeen Prospective Osteoporosis Screening Study (APOSS) was funded by the Grampian Osteoporosis Trust. SRN received an Aberdeen Summer Research Scholarship supported by funding from the Institute of Applied Health Sciences, University of Aberdeen, UK. The funder had no role in design, analysis, interpretation or reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for their permission to conduct this research.",

year = "2020",

doi = "10.1177/2042098620929852",

language = "English",

volume = "11",

pages = "1--9",

journal = "Therapeutic Advances in Drug Safety",

issn = "2042-0986",

publisher = "SAGE Publications Ltd",

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T1 - Anticholinergic burden in middle-aged women and recurrent falls in later life

T2 - findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)

AU - Neal, Samuel R.

AU - Wood, Adrian D.

AU - Ablett, Andrew D.

AU - Gregory, Jenny S.

AU - Guillot, Jordan

AU - Macdonald, Helen M.

AU - Reid, David M.

AU - Myint, Phyo Kyaw

N1 - ACKNOWLEDGEMENTS AND FUNDING The Aberdeen Prospective Osteoporosis Screening Study (APOSS) was funded by the Grampian Osteoporosis Trust. SRN received an Aberdeen Summer Research Scholarship supported by funding from the Institute of Applied Health Sciences, University of Aberdeen, UK. The funder had no role in design, analysis, interpretation or reporting of the work presented. We gratefully acknowledge the Steering Committee of APOSS for their permission to conduct this research.

PY - 2020

Y1 - 2020

N2 - Background: Anticholinergic burden (ACB) is a recognized risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997-1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (≥2 falls) during the 12 months prior to follow up (2007-2011). Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.Results: A total of 2,125 women (mean age (SD):54.7(2.2) years at baseline and 66.0(2.2) years at follow-up) were included. Prevalence of baseline ACB score of 0, 1 and ≥2 was 87.1%, 7.3% and 5.6%, respectively. Compared to no ACB, ACB ≥2 was associated with recurrent falls in the previous 12 months (adjusted odds ratio: 2.34, 95% confidence interval: 1.31, 4.19) at an average of 11 year after initial exposure. No such association was found for an ACB score of 1.Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.

AB - Background: Anticholinergic burden (ACB) is a recognized risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.Methods: We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997-1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (≥2 falls) during the 12 months prior to follow up (2007-2011). Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.Results: A total of 2,125 women (mean age (SD):54.7(2.2) years at baseline and 66.0(2.2) years at follow-up) were included. Prevalence of baseline ACB score of 0, 1 and ≥2 was 87.1%, 7.3% and 5.6%, respectively. Compared to no ACB, ACB ≥2 was associated with recurrent falls in the previous 12 months (adjusted odds ratio: 2.34, 95% confidence interval: 1.31, 4.19) at an average of 11 year after initial exposure. No such association was found for an ACB score of 1.Conclusions: These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.

KW - Accidental Falls

KW - Cholinergic Antagonists

KW - Middle Aged

KW - Polypharmacy

KW - accidental falls

KW - cholinergic antagonists

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KW - polypharmacy

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DO - 10.1177/2042098620929852

M3 - Article

C2 - 32547728

SN - 2042-0986

VL - 11

SP - 1

EP - 9

JO - Therapeutic Advances in Drug Safety

JF - Therapeutic Advances in Drug Safety

ER -

Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen Prospective Osteoporosis Screening Study (APOSS)

Abstract

Bibliographical note

Keywords

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