Abstract
The use of anticholinergic medications by residents in aged care homes is associated with increased risk of adverse effects. These include cognitive impairment, sleep disturbances, and falls, and necessitate increased healthcare visits and the associated burden on healthcare systems. The objective of this study was to investigate associations between anticholinergic burden and health outcomes such as independence in activities for daily living, frailty, quality of life, and sleep quality. The study was conducted among residents in Malaysian aged care homes, aged 60 years and above. Anticholinergic burden was calculated using the Anticholinergic Cognitive Burden (ACB) scale. Health outcome measures included independence, assessed using the Katz Activities for Daily Living scale (Katz ADL); quality of life, assessed using the Older People’s Quality of Life Questionnaire (OPQOL); frailty, assessed using the Groningen Frailty Index (GFI); and sleep quality, measured using the Pittsburg Sleep Quality Index (PSQI). Just over one-third (36%) of the study population was exposed to at least one medication with anticholinergic effect. An increased anticholinergic cognitive burden was associated with frailty (p = 0.031), sleep latency (p = 0.007), and sleep disturbances (p = 0.015). Further studies are required to assess the effect of prolonged exposure to anticholinergic medications on health outcomes.
Highlights
Malaysia is a multi-ethnic country with a population of 32 million and an expected annual growth rate of 1.1% [1]
The primary aim of the current study was to determine the correlation between anticholinergic cognitive burden and sleep quality, activities of daily living, frailty, and quality of life, to rationalize the safe use of medicines and inform health policy
The current study evaluated the use of anticholinergic medicines among older adults residing in aged care homes in Malaysia
Summary
Malaysia is a multi-ethnic country with a population of 32 million (in 2017) and an expected annual growth rate of 1.1% [1]. Increasing numbers of frail elderly people with multiple morbidities will result in a high demand for long-term care facilities [3]. Older people may require multiple medications, predisposing them to polypharmacy. It has been reported that at least one medication is likely to have anticholinergic and/or sedative properties [4]. Drugs with anticholinergic effects may cause dizziness, drowsiness, sedation, confusion, memory impairment, blurred vision, cognitive impairment, and increased risk of falls due to the action on acetylcholine. Drugs with anticholinergic properties, such as diuretics and stimulants, are known to cause sleep disturbances, whereas sedatives may lead to daytime drowsiness. These effects of polypharmacy may negatively impact sleep quality and quality of life [5].
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