Open AccessAnticholinergic Cognitive Burden in Older People Over Acute Admission
Author(s) -
Shan D. Rice,
Nina Kim,
Charlotte Farris
Publication year - 2021
Publication title -
the senior care pharmacist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.229
H-Index - 21
eISSN - 2639-9644
pISSN - 2639-9636
DOI - 10.4140/tcp.n.2021.104
Subject(s) - anticholinergic , medicine , acute care , deprescribing , emergency medicine , retrospective cohort study , hospital admission , geriatrics , delirium , physical therapy , pediatrics , intensive care medicine , polypharmacy , health care , psychiatry , economics , economic growth
Objective To evaluate the change of geriatric anticholinergic cognitive burden (ACB) over acute admission for fall, fracture, or altered mental status (AMS) with a secondary endpoint of associated 30-day all-cause readmission. Design Retrospective, single-center chart review. Setting An academic, 636-bed level-I trauma and tertiary care hospital in Texas. Patients, Participants Participants at least 65 years of age admitted for acute fall, fracture, or AMS between January 1, 2014, and August 31, 2018. A total of 265 participants were included; average age was 83 years, with 56% female. Main Outcome Measures Change in ACB of home medications from hospital admission to discharge. Results At admission, ACB averaged 2.6 with 43.4% of participants having clinically significant scores, defined as ACB greater than or equal to 3. Overall, ACB decreased by 0.1 by discharge with 63.8% and 13.9% of participants having no change and increases in their ACB over admission, respectively. Clinically significant anticholinergic burden at discharge was significantly associated with 30-day all-cause readmission (P<0.001). Conclusions Anticholinergic burden in older people admitted for fall, fracture, or AMS is not consistently intervened upon in this acute care setting. Strategies to optimize deprescribing in this setting are needed.