Anticholinergic Burden Among Hospitalised Older Adults with Psychiatric Illnesses- A Retrospective Study

Abstract

Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. Case records of older adults who sought in-patient care under the Geriatric Psychiatry Unit from January 2019 to June 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012. Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%), and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden (ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3. Nearly half of the older adults in the psychiatry in-patient setting had a clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoringanticholinergic effects of psychotropics in older adults.