Association of anticholinergic drugs with hospitalization and mortality among older cardiovascular XXXX : A prospective study.

@entity1 @entity303 @entity2133 @entity73 @entity23 @entity1296 @entity933 @entity1142 @entity65
BACKGROUND: Many potentially inappropriate drugs prescribed to older people have anticholinergic properties as adverse effects and are therefore potentially harmful. These effects typically include @entity1142 , @entity2133 , blurred vision, @entity1296 and slowing of urination. It has been shown that drugs with anticholinergic properties (DAPs) are associated with @entity73 and @entity303 , may contribute to events such as falls, @entity933 and @entity23 , are associated with self-reported adverse effects and @entity73 , and may even be associated with mortality. However, studies of the prognostic implications of DAPs remain scarce. OBJECTIVE: To evaluate the impact of DAPs on hospitalization and mortality in older @entity1 with stable @entity65 ( @entity65 ). METHODS: This was a prospective study with a mean follow-up of 3.3 years involving two study groups: users (n   =   295) and non-users (n   =   105) of DAPs. The @entity1 were 400 community-dwelling older @entity1 (aged 75-90 years) with stable @entity65 participating in a secondary prevention study of @entity65 (DEBATE) in Helsinki, Finland. The use of DAPs was estimated using definitions from the previous scientific literature. The Charlson Comorbidity Index (CCI) was used to estimate the burden of co-morbidity and the Mini-Mental State Examination test was used to assess cognitive function. The risks in the two study groups for hospital visits, number of days spent in hospital care and mortality were measured from 2000 to the end of 2003. RESULTS: The unadjusted follow-up mortality was 20.7% and 9.5% among the users and non-users of DAPs, respectively (p   =   0.010). However, the use of DAPs was not a significant predictor of mortality in multivariate analysis after adjustment for age, sex and CCI score (hazard ratio 1.57; 95% CI 0.78, 3.15). The mean        SD number of hospital days per @entity1 -year was higher in the DAP user group (14.9        32.5) than in the non-user group (5.2        12.3) [p   <   0.001]. In a bootstrap-type analysis of covariance adjusted for age, sex and CCI score, the use of DAPs predicted the number of days spent in hospital (p   =   0.011). CONCLUSIONS: The use of DAPs in older @entity1 with stable @entity65 was associated with an increased number of hospital days but not with mortality.
