The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies
Abstract INTRODUCTION Little is known regarding the relationship between anticholinergic medications and frailty in dementia with Lewy bodies (DLB). METHODS Anticholinergic Cognitive Burden Scale (ACB) and Claims‐based Frailty Index scores were calculated for 12 months prior to the dementia diagnosi...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
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| Online Access: | https://doi.org/10.1002/dad2.70034 |
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| author | Kathryn A. Wyman‐Chick Matthew J. Barrett Michael J. Miller Lana Sargent Ella A. B. Chrenka Joseph P. M. Kane Samuel J. Crowley Jennifer L. Kuntz Sotirios A. Parashos John T. Schousboe Huong Nguyen Ann M. Werner Rebecca C. Rossom |
| author_facet | Kathryn A. Wyman‐Chick Matthew J. Barrett Michael J. Miller Lana Sargent Ella A. B. Chrenka Joseph P. M. Kane Samuel J. Crowley Jennifer L. Kuntz Sotirios A. Parashos John T. Schousboe Huong Nguyen Ann M. Werner Rebecca C. Rossom |
| author_sort | Kathryn A. Wyman‐Chick |
| collection | DOAJ |
| description | Abstract INTRODUCTION Little is known regarding the relationship between anticholinergic medications and frailty in dementia with Lewy bodies (DLB). METHODS Anticholinergic Cognitive Burden Scale (ACB) and Claims‐based Frailty Index scores were calculated for 12 months prior to the dementia diagnosis using electronic medical record and claims data. Logistic regression was used to estimate the association between ACB and odds of frailty. RESULTS Compared to controls (n = 525), a diagnosis of DLB (n = 175; adjusted odds ratio [aOR]: 15.1, 95% confidence interval [CI]: 7.0–33.9) or Alzheimer's disease (AD: n = 525; aOR = 7.7, 95% CI: 4.4–13.7) was associated with an increased odds of frailty. Patients with DLB had greater prescriptions for anticholinergic medications than patients with AD (pB < 0.001; 23% vs 9.7%). ACB was positively correlated with frailty for all groups (r = 0.30 to 0.47, p < 0.001). DISCUSSION Cumulative anticholinergic burden may be a modifiable predictor of frailty among older adults, including those newly diagnosed with dementia. Highlights Patients with newly diagnosed dementia with Lewy bodies (DLB) are more likely to have prescriptions for anticholinergic medications relative to patients newly diagnosed with Alzheimer's disease (AD) and older adults without documented cognitive impairment. In the year prior to a documented dementia diagnosis, 74% of patients with DLB and 66% of patients with AD had evidence of frailty. Anticholinergic medication burden was associated with frailty among all older adults in the study, including those without a dementia diagnosis. |
| format | Article |
| id | doaj-art-abdffae4dae44b3dbbe2aaf45869d644 |
| institution | DOAJ |
| issn | 2352-8729 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring |
| spelling | doaj-art-abdffae4dae44b3dbbe2aaf45869d6442025-08-20T02:50:51ZengWileyAlzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring2352-87292024-10-01164n/an/a10.1002/dad2.70034The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodiesKathryn A. Wyman‐Chick0Matthew J. Barrett1Michael J. Miller2Lana Sargent3Ella A. B. Chrenka4Joseph P. M. Kane5Samuel J. Crowley6Jennifer L. Kuntz7Sotirios A. Parashos8John T. Schousboe9Huong Nguyen10Ann M. Werner11Rebecca C. Rossom12HealthPartners Institute Bloomington Minnesota USAVirginia Commonwealth University Richmond Virginia USAMid Atlantic Permanente Research Institute Rockville Maryland USAVirginia Commonwealth University Richmond Virginia USAHealthPartners Institute Bloomington Minnesota USACenter for Public Health, Institute of Clinical Sciences Belfast B, Royal Victoria Hospital, Queens University Belfast Belfast Northern IrelandMedical University of South Carolina Charleston South Carolina USAKaiser Permanente Center for Health Research Portland Oregon USAHealthPartners Institute Bloomington Minnesota USAHealthPartners Institute Bloomington Minnesota USADepartment of Research and Evaluation Kaiser Permanente Southern California Pasadena California USAHealthPartners Institute Bloomington Minnesota USAHealthPartners Institute Bloomington Minnesota USAAbstract INTRODUCTION Little is known regarding the relationship between anticholinergic medications and frailty in dementia with Lewy bodies (DLB). METHODS Anticholinergic Cognitive Burden Scale (ACB) and Claims‐based Frailty Index scores were calculated for 12 months prior to the dementia diagnosis using electronic medical record and claims data. Logistic regression was used to estimate the association between ACB and odds of frailty. RESULTS Compared to controls (n = 525), a diagnosis of DLB (n = 175; adjusted odds ratio [aOR]: 15.1, 95% confidence interval [CI]: 7.0–33.9) or Alzheimer's disease (AD: n = 525; aOR = 7.7, 95% CI: 4.4–13.7) was associated with an increased odds of frailty. Patients with DLB had greater prescriptions for anticholinergic medications than patients with AD (pB < 0.001; 23% vs 9.7%). ACB was positively correlated with frailty for all groups (r = 0.30 to 0.47, p < 0.001). DISCUSSION Cumulative anticholinergic burden may be a modifiable predictor of frailty among older adults, including those newly diagnosed with dementia. Highlights Patients with newly diagnosed dementia with Lewy bodies (DLB) are more likely to have prescriptions for anticholinergic medications relative to patients newly diagnosed with Alzheimer's disease (AD) and older adults without documented cognitive impairment. In the year prior to a documented dementia diagnosis, 74% of patients with DLB and 66% of patients with AD had evidence of frailty. Anticholinergic medication burden was associated with frailty among all older adults in the study, including those without a dementia diagnosis.https://doi.org/10.1002/dad2.70034Alzheimer's diseaseanticholinergicearly‐stage dementiafrailtyLewy bodymild cognitive impairment |
| spellingShingle | Kathryn A. Wyman‐Chick Matthew J. Barrett Michael J. Miller Lana Sargent Ella A. B. Chrenka Joseph P. M. Kane Samuel J. Crowley Jennifer L. Kuntz Sotirios A. Parashos John T. Schousboe Huong Nguyen Ann M. Werner Rebecca C. Rossom The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring Alzheimer's disease anticholinergic early‐stage dementia frailty Lewy body mild cognitive impairment |
| title | The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies |
| title_full | The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies |
| title_fullStr | The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies |
| title_full_unstemmed | The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies |
| title_short | The relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with Lewy bodies |
| title_sort | relationship between anticholinergic burden and frailty in the year preceding a diagnosis of dementia with lewy bodies |
| topic | Alzheimer's disease anticholinergic early‐stage dementia frailty Lewy body mild cognitive impairment |
| url | https://doi.org/10.1002/dad2.70034 |
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