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Baseline anticholinergic burden from medications predicts poorer baseline and long‐term health‐related quality of life in 16 675 men and women of EPIC‐Norfolk prospective population‐based cohort study
Author(s) -
Yrjana Kaisa R.,
Neal Samuel R.,
Soiza Roy L.,
Keevil Victoria,
Luben Robert N.,
Wareham Nicholas J.,
Khaw KayTee,
Myint Phyo Kyaw
Publication year - 2021
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.5085
Subject(s) - medicine , quartile , anticholinergic , confounding , quality of life (healthcare) , logistic regression , odds ratio , prospective cohort study , cohort study , cross sectional study , longitudinal study , demography , pharmacoepidemiology , anticholinergic agents , cohort , odds , population , confidence interval , environmental health , medical prescription , pharmacology , nursing , pathology , sociology
Purpose Previous studies investigating the association between anticholinergic burden (ACB) and health‐related quality of life (HRQoL) showed conflicting results and focused on older adults or specific patient groups only. Methods Participants from the European Prospective Investigation of Cancer‐Norfolk study were divided into three groups according to their ACB from medications at baseline, representing ACB scores of 0, 1 and ≥2. Outcomes of interest were the physical and mental component summary scores (PCS and MCS) of the Short Form‐36, collected at 18 months from the baseline and again after a mean 13 years of follow‐up. Linear regression and logistic regression for cross‐sectional and longitudinal associations between ACB and HRQoL were constructed adjusting for potential confounders. Results A total of 16 675 participants, mean age 58.9 ± 9.1 years (55.6% female) and 7133 participants, mean age at follow‐up 69.1 ± 8.7 years (56.8% female), were included in the cross‐sectional and longitudinal analyses, respectively. In cross‐sectional analysis, higher anticholinergic burden was associated with higher odds of being in the lowest quartile of PCS (ACB = 1; OR, 1.85[1.64, 2.09] and ACB ≥ 2:2.19[1.85, 2.58] and MCS (ACB = 1:1.47[1.30, 1.66] and ACB ≥ 2:1.68[1.42, 1.98]). In longitudinal analysis, higher anticholinergic burden was similarly associated with higher odds of being in the lowest quartile of PCS (ACB = 1:1.56[1.24, 1.95] and ACB ≥ 2:1.48[1.07, 2.03]) compared with ACB 0 group. The association with MCS scores did not reach statistical significance. Conclusion The use of anticholinergic medications is associated with both short and long‐term poorer physical functions but association with mental functioning appears more short‐term.