Anticholinergic Toxicity, Dementia, Drug Use, Malnutrition Severe
Conditions
Keywords
Drug burden index,, older adults, malnutrition, anticholinergic drugs, dementia
Brief summary
Malnutrition leads to poor clinical outcomes in dementia patients. The investigator aimed to examine the association between drug burden index (DBI) and anticholinergic burden (ACB) scores with nutrition status in community-dwelling older adults with dementia, considering that drugs may contribute malnutrition. A total of 415 outpatients with dementia, evaluated by Mini Nutrition Assessment test and registered drug information, are included in the study. The investigator calculated the DBI as the sum of all sedatives and anticholinergics taken continuously for at least four weeks prior to admission and evaluated the ACB score. Practice Impact: Due to accompanying chronic diseases and symptoms, cholinergic and/or sedative-loaded drugs are often prescribed to dementia patients. In this study, İnvestigators emphasized that in addition to the cholinergic loads of the drugs used, their sedative loads and the drug doses they use are also important. Avoiding prescribing these medications to patients with dementia will protect them from malnutrition and its negative consequences.
Interventions
None listed
Sponsors
Sultan Keskin Demircan
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to 100 Years
Inclusion criteria
* Clinical diagnosis of any type of demantia * Must be able to swallow tablets * Must be recorded data of medications and doses
Exclusion criteria
* Psychiatric disorders * Mild cognitive impairment * End-stage diseases (renal, liver, cardiac) * Uncontrolled thyroid functions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with malnutrition, malnutrition risk and healthy | Baseline | Based on the MNA-SF score, each participant was assigned to one of the following three groups: malnutrition (score between 0 and 7), malnutrition risk (score between 8 and 11), and healthy (score from 12 to 14). |
| Number of participants with high DBI (Drug Burden Index) score | Baseline | Medications taken consistently at least four weeks prior to admission were considered to be in current use. DBI of drugs containing sedative and cholinergic load was calculated The following formula was used to calculate the DBI = D/ (δ +D), where D represents the daily dose consumed by participants and δ is the minimum recommended is the minimum daily dose that has been established in accordance with the adult dose authorized by the US Food and Drug Administration (FDA) and Turkish authorities in the product information of the drug. Each participant's total DBI score was determined by adding the DBI values for each substance with anticholinergic or sedative effects. Patients were classified as none (DBI=0), low exposure (0\<DBI\<1), or high exposure (DBI ≥1). |
| Number of participants with high ACB (Anti Cholinergic Burden) score | Baseline | Medications taken consistently at least four weeks prior to admission were considered to be in current use.The anticholinergic drug exposure in each patient was assessed by a clinician using the Anticholinergic Cognitive Burden Scale, which grades the anticholinergic activity of each drug into three categories: absence (ACB = 0), possible (ACB = 1), and definite (either ACB = 2 or ACB = 3). The scores for each drug were added up to determine the patient's overall ACB score. All patients were then categorized into three groups: none (ACB score of 0), low to moderate exposure (ACB score of 1 or 2), or high exposure (ACB score of 3 or above) |
Countries
Turkey (Türkiye)
Outcome results
None listed