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Association Between Anticholinergic Drug Use and Health-Related Quality of Life in Community-Dwelling Older Adults

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Abstract

Background

The use of drugs with anticholinergic properties (AC drugs) has been associated with decreased functioning and impaired cognition in older adults. Studies assessing the association between AC-drug use and health-related quality of life (HRQoL) show conflicting results.

Objective

The aim was to evaluate the association between AC-drug use and HRQoL in community-dwelling older adults.

Methods

The NuAge cohort study enrolled 1793 men and women aged 68–82 years. The participants were free of disabilities in activities of daily living, not cognitively impaired at recruitment and followed annually for 3 years (December 2003–May 2005). AC-drug exposure was assessed using the Anticholinergic Cognitive Burden Scale (ACBS). HRQoL was assessed using the physical (PCS) and mental (MCS) component summaries of the 36-item Short Form Survey (SF-36) questionnaire. The association between AC drug and HRQoL was determined by a mixed model analysis using four annual time points.

Results

At recruitment the mean age was 74.4 ± 4.2 years, 52% were female and 33% of participants were prescribed at least one AC drug. The mean PCS and MCS (/100) scores were 49.0 ± 8.2 and 54.9 ± 8.1, respectively. In the mixed model analysis, an increase of 1 on the ACBS was associated with a decrease of −0.50 (95% CI −0.68 to −0.31) in the PCS and an increase of 0.19 (95% CI 0.01–0.37) in the MCS.

Conclusions

In a cohort of generally healthy community-dwelling older adults, AC-drug exposure was associated with a statistically significant decrease in the PCS and increase in the MCS throughout the entire follow-up period. However, the effects on the PCS and MCS were small and likely not clinically relevant.

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Acknowledgements

The authors are grateful to Samuel Laroche for his help in linking the anticholinergic drug scores with the Health Canada database.

Author information

Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada

    Benoit Cossette, Maimouna Bagna, Gabrielle P. Lefebvre & Hélène Payette

  2. Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada

    Benoit Cossette, Maimouna Bagna, Modou Sene & Hélène Payette

  3. Department of Pharmacy, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada

    Benoit Cossette

  4. Département de médecine sociale et préventive, Université Laval, Quebec City, Québec, Canada

    Caroline Sirois

  5. Centre d’excellence sur le vieillissement de Québec, Quebec City, Québec, Canada

    Caroline Sirois

  6. Institut national de santé publique du Québec, Quebec City, Québec, Canada

    Caroline Sirois

  7. Department of Mathematics, Université de Sherbrooke, Sherbrooke, Canada

    Olivier Germain

  8. Division of Geriatric Medicine, McGill University, Montréal, Canada

    José A. Morais

  9. Centre Hospitalier de l’Université de Montréal Research Center, Montréal, Canada

    Pierrette Gaudreau

  10. Department of Medicine, University of Montréal, Montréal, Canada

    Pierrette Gaudreau

Authors
  1. Benoit Cossette
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Contributions

BC, MB, and HP designed the study; BC, MS, and OG analyzed the data; BC, MB, MS, CS, GPL, OG, and HP interpreted the data; BC drafted the manuscript; MB, MS, CS, GPL, OG, JAM, PG and HP critically reviewed the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Benoit Cossette.

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Funding

This work was supported by the Quebec Network for Research on Aging. The NuAge study was funded by the Canadian Institutes for Health Research (CIHR) (MOP-62842) and the Quebec Network for Research on Aging, a network financed by the Fonds de Recherche du Québec–Santé. The funding organizations had no involvement in the study design, data collection, analysis and interpretation, writing of the manuscript and submission for publication.

Conflict of interest

Benoit Cossette, Maimouna Bagna, Modou Sene, Caroline Sirois, Gabrielle P. Lefebvre, Olivier Germain, José A. Morais, Pierrette Gaudreau and Hélène Payette declare they have no conflicts of interest that are directly relevant to the content of this study.

Ethics approval

This study was approved by the Centre de santé et de services sociaux—Institut universitaire de gériatrie de Sherbrooke ethics committee. Consent was obtained from all research participants at the outset of the NuAge study.

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Cossette, B., Bagna, M., Sene, M. et al. Association Between Anticholinergic Drug Use and Health-Related Quality of Life in Community-Dwelling Older Adults. Drugs Aging 34, 785–792 (2017). https://doi.org/10.1007/s40266-017-0486-2

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  • DOI: https://doi.org/10.1007/s40266-017-0486-2

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