Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.

<h4>Purpose</h4>The cumulative effect of medication inhibiting acetylcholine activity-also known as anticholinergic burden (AB)-can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a lar...

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Autores principales:	Jonas Reinold, Malte Braitmaier, Oliver Riedel, Ulrike Haug
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/247f61a2fab54521a437fff2ffec68bc
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spelling	oai:doaj.org-article:247f61a2fab54521a437fff2ffec68bc2021-12-02T20:15:45ZAnticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.1932-620310.1371/journal.pone.0253336https://doaj.org/article/247f61a2fab54521a437fff2ffec68bc2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253336https://doaj.org/toc/1932-6203<h4>Purpose</h4>The cumulative effect of medication inhibiting acetylcholine activity-also known as anticholinergic burden (AB)-can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a large and unselected population sample.<h4>Methods</h4>Using the German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% of the German population we analyzed outpatient drug dispensations in 2016. Based on the Anticholinergic Cognitive Burden (ACB) scale, we classified persons into four categories and determined the cumulative AB as continuous variable.<h4>Results</h4>Among 16,470,946 persons (54% female), the prevalence of clinically relevant AB (ACB≥3) was 10% (women) and 7% (men). Below age 40 it was highest in persons ≤18 years (6% both sexes). At older ages (50-59 vs. 90-99 years), prevalence of ACB≥3 increased from 7% to 26% (men) and from 10% to 32% (women). Medication classes contributing to the cumulative AB differed by age: antihistamines, antibiotics, glucocorticoids (≤19 years), antidepressants (20-49 years), antidepressants, cardiovascular medication, antidiabetics (50-64 years), and additionally medication for urinary incontinence/overactive bladder (≥65 years). Medication dispensed by general physicians contributed most to the cumulative AB.<h4>Conclusion</h4>Although a clinically relevant AB is particularly common in older persons, prevalence in younger age groups was up to 7%. Given the risks associated with AB in older persons, targeted interventions at the prescriber level are needed. Furthermore, risks associated with AB in younger persons should be explored.Jonas ReinoldMalte BraitmaierOliver RiedelUlrike HaugPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253336 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonas Reinold Malte Braitmaier Oliver Riedel Ulrike Haug Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
description	<h4>Purpose</h4>The cumulative effect of medication inhibiting acetylcholine activity-also known as anticholinergic burden (AB)-can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a large and unselected population sample.<h4>Methods</h4>Using the German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% of the German population we analyzed outpatient drug dispensations in 2016. Based on the Anticholinergic Cognitive Burden (ACB) scale, we classified persons into four categories and determined the cumulative AB as continuous variable.<h4>Results</h4>Among 16,470,946 persons (54% female), the prevalence of clinically relevant AB (ACB≥3) was 10% (women) and 7% (men). Below age 40 it was highest in persons ≤18 years (6% both sexes). At older ages (50-59 vs. 90-99 years), prevalence of ACB≥3 increased from 7% to 26% (men) and from 10% to 32% (women). Medication classes contributing to the cumulative AB differed by age: antihistamines, antibiotics, glucocorticoids (≤19 years), antidepressants (20-49 years), antidepressants, cardiovascular medication, antidiabetics (50-64 years), and additionally medication for urinary incontinence/overactive bladder (≥65 years). Medication dispensed by general physicians contributed most to the cumulative AB.<h4>Conclusion</h4>Although a clinically relevant AB is particularly common in older persons, prevalence in younger age groups was up to 7%. Given the risks associated with AB in older persons, targeted interventions at the prescriber level are needed. Furthermore, risks associated with AB in younger persons should be explored.
format	article
author	Jonas Reinold Malte Braitmaier Oliver Riedel Ulrike Haug
author_facet	Jonas Reinold Malte Braitmaier Oliver Riedel Ulrike Haug
author_sort	Jonas Reinold
title	Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
title_short	Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
title_full	Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
title_fullStr	Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
title_full_unstemmed	Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
title_sort	anticholinergic burden: first comprehensive analysis using claims data shows large variation by age and sex.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/247f61a2fab54521a437fff2ffec68bc
work_keys_str_mv	AT jonasreinold anticholinergicburdenfirstcomprehensiveanalysisusingclaimsdatashowslargevariationbyageandsex AT maltebraitmaier anticholinergicburdenfirstcomprehensiveanalysisusingclaimsdatashowslargevariationbyageandsex AT oliverriedel anticholinergicburdenfirstcomprehensiveanalysisusingclaimsdatashowslargevariationbyageandsex AT ulrikehaug anticholinergicburdenfirstcomprehensiveanalysisusingclaimsdatashowslargevariationbyageandsex
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Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.

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