Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia

L. M. J. Sanders; T. Hortobágyi; G. van Staveren; K. Taxis; F. Boersma; H. C. Klein; W. J. R. Bossers; C. G. Blankevoort; E. J. A. Scherder; E. A. van der Zee; M. J. G. van Heuvelen

doi:10.1007/s00228-017-2319-y

Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia

L. M. J. Sanders^*, T. Hortobágyi, G. van Staveren, K. Taxis, F. Boersma, H. C. Klein, W. J. R. Bossers, C. G. Blankevoort, E. J. A. Scherder, E. A. van der Zee, M. J. G. van Heuvelen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose: The Drug Burden Index (DBI) is a tool to quantify the anticholinergic and sedative load of drugs. Establishing functional correlates of the DBI could optimize drug prescribing in patients with dementia. In this cross-sectional study, we determined the relationship between DBI and cognitive and physical functions in a sample of patients with dementMethods: ia.

Using performance-based tests, we measured physical and cognitive functions in 140 nursing home patients aged over 70 with all-cause dementia. We also determined anticholinergic DBI (AChDBI) and sedative DBI (SDBI) separately and in combination as total drug burden (TDB).

Results: Nearly one half of patients (48%) used at least one DBI-contributing drug. In 33% of the patients, drug burden was moderate (0 <TDB <1) whereas in 15%, drug burden was high (TDB ae 1). Multivariate models yielded no associations between TDB, AChDBI, and SDBI, and physical or cognitive function (all p > 0.05).

Conclusions: A lack of association between drug burden and physical or cognitive function in this sample of patients with dementia could imply that drug prescribing is more optimal for patients with dementia compared with healthy older populations. However, such an interpretation of the data warrants scrutiny as several dementia-related factors may confound the results of the study.

Original language	English
Pages (from-to)	1633-1642
Number of pages	10
Journal	European Journal of Clinical Pharmacology
Volume	73
Issue number	12
DOIs	https://doi.org/10.1007/s00228-017-2319-y
Publication status	Published - Dec-2017

Keywords

Drug Burden Index
Dementia
Inappropriate prescribing
Nursing home facilities
Medication
INAPPROPRIATE MEDICATION USE
DWELLING OLDER-PEOPLE
RESIDENTIAL AGED CARE
ANTICHOLINERGIC BURDEN
PROSPECTIVE COHORT
AUSTRALIAN MEN
INDEX
ADULTS
POLYPHARMACY
OUTCOMES

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Sanders, L. M. J., Hortobágyi, T., van Staveren, G., Taxis, K., Boersma, F., Klein, H. C., Bossers, W. J. R., Blankevoort, C. G., Scherder, E. J. A., van der Zee, E. A., & van Heuvelen, M. J. G. (2017). Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia. European Journal of Clinical Pharmacology, 73(12), 1633-1642. https://doi.org/10.1007/s00228-017-2319-y

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title = "Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia",

abstract = "Purpose: The Drug Burden Index (DBI) is a tool to quantify the anticholinergic and sedative load of drugs. Establishing functional correlates of the DBI could optimize drug prescribing in patients with dementia. In this cross-sectional study, we determined the relationship between DBI and cognitive and physical functions in a sample of patients with dementMethods: ia.Using performance-based tests, we measured physical and cognitive functions in 140 nursing home patients aged over 70 with all-cause dementia. We also determined anticholinergic DBI (AChDBI) and sedative DBI (SDBI) separately and in combination as total drug burden (TDB).Results: Nearly one half of patients (48%) used at least one DBI-contributing drug. In 33% of the patients, drug burden was moderate (0 0.05).Conclusions: A lack of association between drug burden and physical or cognitive function in this sample of patients with dementia could imply that drug prescribing is more optimal for patients with dementia compared with healthy older populations. However, such an interpretation of the data warrants scrutiny as several dementia-related factors may confound the results of the study.",

keywords = "Drug Burden Index, Dementia, Inappropriate prescribing, Nursing home facilities, Medication, INAPPROPRIATE MEDICATION USE, DWELLING OLDER-PEOPLE, RESIDENTIAL AGED CARE, ANTICHOLINERGIC BURDEN, PROSPECTIVE COHORT, AUSTRALIAN MEN, INDEX, ADULTS, POLYPHARMACY, OUTCOMES",

author = "Sanders, {L. M. J.} and T. Hortob{\'a}gyi and {van Staveren}, G. and K. Taxis and F. Boersma and Klein, {H. C.} and Bossers, {W. J. R.} and Blankevoort, {C. G.} and Scherder, {E. J. A.} and {van der Zee}, {E. A.} and {van Heuvelen}, {M. J. G.}",

year = "2017",

month = dec,

doi = "10.1007/s00228-017-2319-y",

language = "English",

volume = "73",

pages = "1633--1642",

journal = "European Journal of Clinical Pharmacology",

issn = "0031-6970",

publisher = "Springer Verlag",

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Sanders, LMJ, Hortobágyi, T, van Staveren, G, Taxis, K, Boersma, F, Klein, HC, Bossers, WJR, Blankevoort, CG, Scherder, EJA, van der Zee, EA & van Heuvelen, MJG 2017, 'Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia', European Journal of Clinical Pharmacology, vol. 73, no. 12, pp. 1633-1642. https://doi.org/10.1007/s00228-017-2319-y

TY - JOUR

T1 - Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia

AU - Sanders, L. M. J.

AU - Hortobágyi, T.

AU - van Staveren, G.

AU - Taxis, K.

AU - Boersma, F.

AU - Klein, H. C.

AU - Bossers, W. J. R.

AU - Blankevoort, C. G.

AU - Scherder, E. J. A.

AU - van der Zee, E. A.

AU - van Heuvelen, M. J. G.

PY - 2017/12

Y1 - 2017/12

N2 - Purpose: The Drug Burden Index (DBI) is a tool to quantify the anticholinergic and sedative load of drugs. Establishing functional correlates of the DBI could optimize drug prescribing in patients with dementia. In this cross-sectional study, we determined the relationship between DBI and cognitive and physical functions in a sample of patients with dementMethods: ia.Using performance-based tests, we measured physical and cognitive functions in 140 nursing home patients aged over 70 with all-cause dementia. We also determined anticholinergic DBI (AChDBI) and sedative DBI (SDBI) separately and in combination as total drug burden (TDB).Results: Nearly one half of patients (48%) used at least one DBI-contributing drug. In 33% of the patients, drug burden was moderate (0 0.05).Conclusions: A lack of association between drug burden and physical or cognitive function in this sample of patients with dementia could imply that drug prescribing is more optimal for patients with dementia compared with healthy older populations. However, such an interpretation of the data warrants scrutiny as several dementia-related factors may confound the results of the study.

AB - Purpose: The Drug Burden Index (DBI) is a tool to quantify the anticholinergic and sedative load of drugs. Establishing functional correlates of the DBI could optimize drug prescribing in patients with dementia. In this cross-sectional study, we determined the relationship between DBI and cognitive and physical functions in a sample of patients with dementMethods: ia.Using performance-based tests, we measured physical and cognitive functions in 140 nursing home patients aged over 70 with all-cause dementia. We also determined anticholinergic DBI (AChDBI) and sedative DBI (SDBI) separately and in combination as total drug burden (TDB).Results: Nearly one half of patients (48%) used at least one DBI-contributing drug. In 33% of the patients, drug burden was moderate (0 0.05).Conclusions: A lack of association between drug burden and physical or cognitive function in this sample of patients with dementia could imply that drug prescribing is more optimal for patients with dementia compared with healthy older populations. However, such an interpretation of the data warrants scrutiny as several dementia-related factors may confound the results of the study.

KW - Drug Burden Index

KW - Dementia

KW - Inappropriate prescribing

KW - Nursing home facilities

KW - Medication

KW - INAPPROPRIATE MEDICATION USE

KW - DWELLING OLDER-PEOPLE

KW - RESIDENTIAL AGED CARE

KW - ANTICHOLINERGIC BURDEN

KW - PROSPECTIVE COHORT

KW - AUSTRALIAN MEN

KW - INDEX

KW - ADULTS

KW - POLYPHARMACY

KW - OUTCOMES

U2 - 10.1007/s00228-017-2319-y

DO - 10.1007/s00228-017-2319-y

M3 - Article

C2 - 28921380

SN - 0031-6970

VL - 73

SP - 1633

EP - 1642

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

IS - 12

ER -

Relationship between drug burden and physical and cognitive functions in a sample of nursing home patients with dementia

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