Abstract
ObjectivesMedications with anticholinergic or sedative effects are frequently used by older people but can increase risk of falls and adverse events; however, less is known about their effect on movement behaviour. Here we examine the cross-sectional association between medication use and movement behaviour in older adults living in residential aged care.Materials and MethodsTwenty-eight older adults living in residential aged care in metropolitan Australia participated. Medication data were collected from participants’ medical charts and sedative load and anticholinergic burden were determined. Seven-day movement behaviour was objectively assessed by a wrist-worn triaxial accelerometer. Raw accelerations were converted to sleep, sedentary time, and time in light, moderate, and moderate-to-vigorous physical activity. To explore the relationship between medication and movement behaviour, Spearman’s Rho correlations were conducted, as the data were not normally distributed.ResultsAnalyses indicated that while anticholinergic burden was not associated with movement behaviour, sedative load was negatively correlated with a number of variables, accounting for 14% variance in moderate-to-vigorous physical activity (MVPA), and 17% in the bout length of MVPA (p < .02).ConclusionThe findings of this study showed a negative association between sedative load, due to medicines, and an individual’s movement behaviour. The impact of this could be a reduction in the ability of this population to maintain or improve their functional mobility, which may overshadow any benefits of the medicine in some circumstances.
Highlights
Multiple medicine use is common in older people, in the aged care sector where studies indicate older people are taking between nine and 11 medicines, on average (Elliott & Woodward, 2011; McLarin et al, 2016; Roughead, Gilbert & Woodward, 2008)
An active lifestyle, incorporating light and moderate-to-vigorous intensity activity, is associated with lower mortality (Lapeyre-Mestre, 2016) and reduced risk of major mobility disability (MMD) (Mankowski et al, 2017), but unwanted side effects from medicines may impact on physical function, leading to reduced physical activity
A recent study on older adults living in residential care that used accelerometer data to measure behaviour indicated individuals spent only 1% of their time in moderate-to-vigorous intensity physical activity (MVPA), 14% in low and light activity and 85% sedentary (Parry et al, 2019)
Summary
Multiple medicine use is common in older people, in the aged care sector where studies indicate older people are taking between nine and 11 medicines, on average (Elliott & Woodward, 2011; McLarin et al, 2016; Roughead, Gilbert & Woodward, 2008). An active lifestyle, incorporating light and moderate-to-vigorous intensity activity, is associated with lower mortality (Lapeyre-Mestre, 2016) and reduced risk of major mobility disability (MMD) (Mankowski et al, 2017), but unwanted side effects from medicines may impact on physical function, leading to reduced physical activity. Use of medicines with sedative or anticholinergic properties has been shown to be significantly associated with poorer functional outcomes when evaluated using traditional research measures including activities of daily living, grip strength and balance tests (Hukins, Macleod & Boland, 2019; Pratt et al, 2014). A recent study on older adults living in residential care that used accelerometer data to measure behaviour indicated individuals spent only 1% of their time in moderate-to-vigorous intensity physical activity (MVPA), 14% in low and light activity and 85% sedentary (Parry et al, 2019). If time in MVPA is associated with medicine use, this may have implications for medication management and the assessment of the risk-benefit profile of medicines in older people
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