TY - JOUR
T1 - A Preliminary Study of Anticholinergic Burden and Relationship to a Quality of Life Indicator, Engagement in Activities, in Nursing Home Residents With Dementia
AU - Kolanowski, Ann
AU - Fick, Donna M.
AU - Campbell, Judy
AU - Litaker, Mark
AU - Boustani, Malaz
N1 - Funding Information:
A.K. acknowledges support from The National Institute of Nursing Research: R01 NR008910.
Funding Information:
D.M.F. is supported in part by a grant from the National Institute on Aging: R03 AG023216.
Funding Information:
J.C. acknowledges support from the Hartford Building Academic Geriatric Nursing Capacity Scholarship and the University of Florida Alumni Fellowship. M.B. is supported by a grant (K23 AG 26770–01) from the John A. Hartford Foundation, the Atlantic Philanthropies, the Starr Foundation, and the National Institute on Aging.
PY - 2009/5
Y1 - 2009/5
N2 - Objectives: (1) To describe the anticholinergic burden experienced by nursing home residents with dementia using the Anticholinergic Cognitive Burden (ACB) Scale; and (2) to determine the association of anticholinergic burden and engagement in activity. Design: Cross-sectional, using baseline data from an ongoing clinical trial. Setting: Nine nursing homes in Pennsylvania. Participants: Eighty-seven nursing home residents with dementia. Measurements: The ACB Scale was used to classify the severity of each resident's prescribed drugs' anticholinergic activity on cognition. Engagement in activity was measured by direct observation using a standard instrument. Results: Across 775 observations, subjects were active approximately 54% of the time, doing nothing 24% of the time, and asleep over 21% of the time. Seventy-one (81.6%) subjects were prescribed at least one drug with anticholinergic properties and 32 (36.7%) were prescribed at least one drug with severe anticholinergic properties. On average, subjects had a total ACB score of 2.55 (± 1.9). Mental status (MMSE) and dependency (PGDRS) were associated with engagement, but use of anticholinergic drugs was not. Conclusion: Nursing home residents are prescribed many drugs with anticholinergic properties. The ACB Scale has utility as a tool to alert practitioners to high anticholinergic burden, who can then use this information when choosing between equally efficacious medications. Further study using larger samples of persons with dementia in earlier stages of the disease, and use of intense measurement designs are needed to more clearly determine the association of ACB with quality of life indicators.
AB - Objectives: (1) To describe the anticholinergic burden experienced by nursing home residents with dementia using the Anticholinergic Cognitive Burden (ACB) Scale; and (2) to determine the association of anticholinergic burden and engagement in activity. Design: Cross-sectional, using baseline data from an ongoing clinical trial. Setting: Nine nursing homes in Pennsylvania. Participants: Eighty-seven nursing home residents with dementia. Measurements: The ACB Scale was used to classify the severity of each resident's prescribed drugs' anticholinergic activity on cognition. Engagement in activity was measured by direct observation using a standard instrument. Results: Across 775 observations, subjects were active approximately 54% of the time, doing nothing 24% of the time, and asleep over 21% of the time. Seventy-one (81.6%) subjects were prescribed at least one drug with anticholinergic properties and 32 (36.7%) were prescribed at least one drug with severe anticholinergic properties. On average, subjects had a total ACB score of 2.55 (± 1.9). Mental status (MMSE) and dependency (PGDRS) were associated with engagement, but use of anticholinergic drugs was not. Conclusion: Nursing home residents are prescribed many drugs with anticholinergic properties. The ACB Scale has utility as a tool to alert practitioners to high anticholinergic burden, who can then use this information when choosing between equally efficacious medications. Further study using larger samples of persons with dementia in earlier stages of the disease, and use of intense measurement designs are needed to more clearly determine the association of ACB with quality of life indicators.
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U2 - 10.1016/j.jamda.2008.11.005
DO - 10.1016/j.jamda.2008.11.005
M3 - Article
C2 - 19426941
AN - SCOPUS:67349224750
SN - 1525-8610
VL - 10
SP - 252
EP - 257
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 4
ER -
