Investigating the association of anticholinergic burden with depression in older adults: a cross‐sectional study

• Published in: Psychogeriatrics Vol. 24; no. 3; pp. 597 - 604
• Main Authors: Kayahan Satış, Neslihan, Naharcı, Mehmet İlkin
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.05.2024; Blackwell Publishing Ltd
• Subjects: Aged; Aged, 80 and over; anticholinergic burden; Anticholinergics; Cholinergic Antagonists - adverse effects; Cognitive ability; Comorbidity; Cross-Sectional Studies; depression; Depression - drug therapy; Depression - epidemiology; Drug therapy; Female; Geriatric Assessment - methods; Geriatrics; Humans; Independent Living; Logistic Models; Male; Mental depression; older adults; Older people; polypharmacy; Prevalence; Psychiatric Status Rating Scales; older adults; depression; anticholinergic burden; polypharmacy
• ISSN: 1346-3500; 1479-8301
• DOI: 10.1111/psyg.13102

Background Although depression and anticholinergic drug use are common comorbidities that impair health status in later life, there are insufficient data on their relationship. This study aimed to investigate the relationship between depressive symptoms and anticholinergic use in older individuals. Methods Community‐dwelling older adults (≥65 years) admitted to the tertiary referral geriatric outpatient clinic were included. Participants were evaluated for depressive symptoms using the Geriatric Depression Scale (GDS) with a cut‐off score of ≥6 for depression. Exposure to anticholinergic drugs was assessed using the anticholinergic cognitive burden (ACB) scale and three subgroups were created: ACB = 0, ACB = 1, and ACB ≥ 2. The relationship between these two parameters was assessed using multivariate logistic regression analysis considering other potential variables. Results The study included 1232 participants (mean age 78.4 ± 7.2 years and 65.2% female) and the prevalence of depression was 24%. After adjusting for potential confounders, compared to ACB = 0, having ACB ≥ 2 was related to depression symptoms (odds ratio (OR): 1.56, 95% CI: 1.04–2.35, P = 0.034), whereas having ACB = 1 did not increase the risk (OR: 1.27, 95% CI: 0.88–1.83, P = 0.205). Conclusion Our findings indicate that special attention should be paid to drug therapy in preventing depression in older adults, as exposure to a high anticholinergic load is negatively associated with psychological status.