The Anticholinergic Drug Effect on Decreasing Cognitive in Geriatric Patients at Kota Surakarta General Hospital

https://doi.org/10.22146/jmpf.33257

Nurlena Ikawati(1*), Fita Rahmawati(2)

(1) Graduate Program of Faculty of Pharmacy, Universitas Gadjah Mada
(2) Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


This leads the geriatric patients to receive multiple drugs regimen (polypharmacy) which include using anticholinergic drugs. Risk of anticholinergics drug use is associated with cognitive impairments that have been demonstrated in experimental and cohort studies. The objective of this study is to determine the profile of anticholinergic drug use and its impact on cognitive reduction in elderly patients at Outpatient Unit Department of Kota Surakarta General Hospital. This study used cohort design. Data were collected through patient medication records and direct interviews to measure the cognitive status of patients using a six-item cognitive impairment test questionnaire (6-CIT). This study divided the respondents into two group; 178 patients (50,6%) took anticholinergic agents, and 174 patients (49,4%) did not use the anticholinergic drugs. Data analysis used Chi-square comparative test and linear regression test with SPSS (Statistical Package for Social Science). The results showed 136 patients or 58,12% use level one anticholinergic drug. The most widely used anticholinergic are diazepam (13,9%) and furosemide (12,5%). The anticholinergic drugs were extensively used by patients who suffer circulatory system diseases as much as 171 (32,1%), followed by endocrine disease, nutrition and metabolic diseases were 83 (15,6%). The number between women and men who take anticholinergics is not significantly different, 91 (51.41%) for women. Whereas by age, the number of most anticholinergic prescribed for patients who are 60 to 74 years is 124 patients (69,66%). There was a significant correlation between anticholinergic drug use in decreasing cognitive function of the geriatric at Outpatient Unit Department of Kota Surakarta General Hospital (p <0,005) proven by r value 0.631.

Keywords


Anticholinergic; cognitive function; geriatric patient; six-item cognitive impairment test questionnaire

Full Text:

PDF


References

Kersten H, Wyller TB. Anticholinergic Drug Burden in Older People’s Brain - How well is it Measured? Basic Clin Pharmacol Toxicol. 2014;114(2):151-159. doi:10.1111/bcpt.12140.

Campbell N, Boustani M, Limbil T, et al. The cognitive impact of anticholinergics : A clinical review. Clin Interv Aging. 2009;4:225-233.

Lampela P, Paajanen T, Hartikainen S, Huupponen R. Central Anticholinergic Adverse Effects and Their Measurement. Drugs and Aging. 2015;32(12):963-974. doi:10.1007/s40266-015-0321-6.

Lo Coco D, Lopez G, Corrao S. Cognitive impairment and stroke in elderly patients. Vasc Health Risk Manag. 2016;12:105-116. doi:10.2147/VHRM.S75306.

Carpenter CR, Despain B, Keeling TN, Shah M, Rothenberger M. The six-item screener and AD8 for the detection of cognitive impairment in geriatric emergency department patients. Ann Emerg Med. 2011;57(6):653-661. doi:10.1016/j.annemergmed.2010.06.560.

Cai X, Campbell N, Khan B, Callahan C, Boustani M. Long-term anticholinergic use and the aging brain. Alzheimer’s Dement. 2013;9(4):377-385. doi:10.1016/j.jalz.2012.02.005.

Jacob S. Polypharmacy in the management of patients with schizophrenia on risperidone in a tertiary-care hospital in Malaysia. Ment Heal Fam Med. 2013;10:37-43.

Salahudeen MS, Hilmer SN, Nishtala PS. Comparison of anticholinergic risk scales and associations with adverse health outcomes in older people. J Am Geriatr Soc. 2015;63(1):85-90. doi:10.1111/jgs.13206.

Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR. The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol. 2006;46:1481-1486. doi:10.1177/0091270006292126.

Johnell K, Fastbom J. Concurrent use of anticholinergic drugs and cholinesterase inhibitors: register-based study of over 700,000 elderly patients. Drugs Aging. 2008;25(10):871-877. doi:25106 [pii].

Persaud M, Holroyd-Leduc JM. Anticholinergic medications in the older adult: A hidden burden. Can Geriatr Soc J C. 2014;4(2):4-7. www.cmegeriatrics.ca.

He Z, Ball PA. Can medication management review reduce anticholinergic burden (ACB) in the elderly? Encouraging results from a theoretical model. Int Psychogeriatrics C Int Psychogeriatr Assoc. 2013;25(9):1425-1431. doi:10.1017/S1041610213000872.

Mufson EJ, Counts SE, Perez SE, Ginsberg SD. Cholinergic system during the progression of Alzheimer’s disease: therapeutic implications. Expert Rev Neurother. 2008;8(11):1703-1718. doi:10.1586/14737175.8.11.1703.

Kar S, Slowikowski SPM, Westaway D, Mount HTJ. Interactions between β-amyloid and central cholinergic neurons : implications for Alzheimer ’ s disease. J Psychiatry Neurosci. 2014;29(6):427-442.

Shah RC, Janos AL, Kline JE, et al. Cognitive Decline in Older Persons Initiating Anticholinergic Medications. PLoS One. 2013;8(5):4-9. doi:10.1371/journal.pone.0064111.

Salahudeen MS, Hilmer SN, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015;63(1):85-90. doi:10.1111/jgs.13206.



DOI: https://doi.org/10.22146/jmpf.33257

Article Metrics

Abstract views : 1266 | views : 46468

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats