Background: The cumulative effects of multiple medications with anticholinergic and sedative properties, referred to as anticholinergic and sedative burdens, can result in adverse effects in older adults. This study aimed to evaluate the exposure of older adult patients to anticholinergic and sedative medications.
Objectives: To evaluate the exposure of hospitalized older adults to anticholinergic and sedative medications, quantify their cumulative medication burden, and assess its association with clinical outcomes.
Methods: This cross-sectional study included 597 older adult patients (aged ≥60 years) admitted to geriatric inpatient wards. The anticholinergic burden was assessed using the CRIDECO scale, and the Drug Burden Index (DBI) was used to quantify the cumulative anticholinergic and sedative burden. The data obtained were categorically assessed and are represented as [n (%)]. Associations between medication burden and health outcomes were analyzed using appropriate statistical tests.
Results: The mean age of the participants was 72.80 ± 7.41 years (range: 60–99 years). Among them, 147 patients (29.17%) were administered at least one anticholinergic medication, with a mean cumulative Anticholinergic Cognitive Burden (ACB) score of 2.49 ± 2.00. A total of 259 patients (51.39%) had an ACB score of ≥3. The majority of patients (94.34%, n = 549) had a cumulative DBI score of ≥1, with a mean DBI score of 3.14 ± 1.55 (range: 0.50–8.81). Linear regression analyses demonstrated that both ACB and DBI were significant predictors of length of hospitalization (ACB: B = 0.230, p = 0.002; DBI: B = 0.307, p = 0.001). DBI was significantly associated with the Charlson Comorbidity Score (B = 0.126, p = 0.001), whereas ACB was not (p = 0.359). Logistic regression revealed that ACB scores significantly predicted dementia (OR = 1.111, p = 0.047).
Conclusions: This study highlights the high prevalence (94.34%) of anticholinergic and sedative medication use among hospitalized older-adult patients and its association with adverse health outcomes. The strong correlation between medication burden and hospitalization length (p < 0.01) emphasizes the need for regular medication reviews and targeted deprescribing strategies to reduce medication burden in this vulnerable population.
