Anticholinergic Burden in Elderly People in Nursing Homes: Cross-Sectional Assessment Using ACB Calculator and CRIDECO Anticholinergic Load Scale

养老院老年人抗胆碱能负荷:使用ACB计算器和CRIDECO抗胆碱能负荷量表的横断面评估

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Abstract

BACKGROUND/OBJECTIVES: Anticholinergic burden is an important risk marker in older adults, associated with cognitive decline, falls, and increased mortality. This study aimed to assess anticholinergic burden in institutionalized elderly individuals using two tools (ACB calculator and CALS-CRIDECO Anticholinergic Load Scale), as well as to analyze its relationship with pharmacotherapeutic variables like polypharmacy. METHODS: A descriptive cross-sectional study was conducted by analyzing the pharmacotherapeutic profiles of institutionalized elderly individuals (≥65 years) utilizing individualized medication preparation services from a community pharmacy in Alentejo (Portugal). Participants agreed to the study and had complete, up-to-date pharmacotherapeutic profiles. RESULTS: The pharmacotherapeutic profiles of 75 institutionalized elderly people were analyzed; the sample comprised mostly women (72%) who had experienced excessive polypharmacy (≥10 medications) (56%) and had an average age of 85.62 ± 7.62 years. It was found that 90.7% (ACB) and 89.3% (CALS-CRIDECO) of the elderly had anticholinergic burden, with mean values of 3.60 ± 2.84 and 3.33 ± 2.51, respectively. Women exhibited higher anticholinergic burden in unadjusted analyses (p < 0.05). The burden correlated moderately with the total number of medications (p < 0.05). CONCLUSIONS: The results show high exposure to anticholinergic medications in the institutionalized elderly population, reinforcing the rationale for systematic therapeutic reviews focused on the pharmacological safety of institutionalized older adults in community pharmacies.

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