Clinical features and medicines contributing to cumulative anticholinergic cognitive burden among geriatric patients: A hospital-based retrospective study
Khalid Elsayed Elsorady, Maha Tarek Mohammed, Dina Sayed AbdelrahimABSTRACT
Background:
Cumulative anticholinergic cognitive burden (ACB) is substantial for older patients.
Objectives:
The study aimed to determine the clinical features and medicines contributing to ACB among critically ill geriatric patients.
Methods:
A retrospective cohort study included 333 critically ill older patients at a geriatric hospital in Egypt. Reviewing of medical records was conducted. Charlson comorbidity index and hospital length of stay (LOS) were calculated. Laboratory parameters were checked with observation of multidrug-resistant (MDR) bacterial infections. Medications records were reviewed. Anticholinergics were defined and classified into light, moderate, and strong. On-line ACB calculator determined the cumulative ACB score. Statistical analyses were performed.
Results:
The mean age was 75.68 years. Median ACB score was 3. High ACB (ACB ≥3) occurred in 67.9% of the participants. Top ten anticholinergics included omeprazole, ipratropium, clindamycin, fentanyl, hydrocortisone, ampicillin, dexamethasone, digoxin, vancomycin, and tramadol. Combination of light anticholinergics represented 91.3% of prescriptions. High ACB was associated with male gender (odds ratio [OR] 1.877,
Conclusion:
High cumulative ACB is common among older patients and mostly attributed to the combination of light anticholinerics. The study revealed its predictors and culprit medications.