Anticholinergic Drugs and Their Effects on Delirium and Mortality in the Elderly

• Published in: Dementia and geriatric cognitive disorders extra Vol. 1; no. 1; pp. 43 - 50
• Main Authors: Luukkanen, M.J., Uusvaara, J., Laurila, J.V., Strandberg, T.E., Raivio, M.M., Tilvis, R.S., Pitkälä, K.H.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2011; Karger Publishers
• Subjects: Anticholinergic effects; Comorbidities; Delirium; Dementia; Elderly patients; Original; Original Research Article; Delirium; Anticholinergic effects; Comorbidities; Elderly patients; Dementia
• ISSN: 1664-5464; 1664-5464
• DOI: 10.1159/000322883

Aim: To investigate the use of drugs with anticholinergic properties (DAPs) and their associations with delirium and mortality among elderly patients with comorbidities. Methods: 425 patients (≧70 years of age) in geriatric wards and nursing homes were assessed. The use of DAPs was retrieved from their medical records. Delirium was diagnosed according to the DSM-IV criteria. Results: Of the 341 patients (80.2%) treated with multiple DAPs (≧2), 92 patients (27.0%) suffered from delirium, whereas 14 of 84 patients (16.7%) without DAP treatment had delirium (p = 0.050). In a logistic regression analysis with age, gender, and Charlson Comorbidity Index as covariates, DAP treatment did not predict delirium (odds ratio 1.67, 95% confidence interval 0.87–3.21). The 2-year mortality was 49.3% (n = 168) in DAP users and 35.7% (n = 30) in non-users, respectively (p = 0.026). In the Cox proportional hazard model adjusted for age, gender, and comorbidity, DAPs did not predict mortality (hazard ratio 1.12, 95% confidence interval 0.75–1.68). Conclusion: The use of DAPs is very frequent among frail inpatients with comorbidities, but their use has no independent prognostic significance.