Anticholinergic Use Linked to Faster Physical Decline in Older Adults, finds research
Researchers have found in a new cohort study that higher exposure to anticholinergic medications was associated with an accelerated decline in physical performance. This decline was clinically meaningful, highlighting the importance of minimizing anticholinergic use to support healthy aging. The study was published in JAMA Network by Shelly L. and colleagues.
The research was performed in the Adult Changes in Thought (ACT) study, a longitudinal population-based cohort from Kaiser Permanente Washington. Data were accrued from February 1994 through March 2020, and analysis was between January 2023 and December 2024. There were 4283 participants aged 65 years or more included in the analysis. Eligibility criteria included having at least two study visits and a minimum of 10 years of enrollment before the study index date. Of the total sample, 4210 individuals (58.6% women, mean age 74.3 years) were included in the gait speed analysis, while 4200 (58.5% women, mean age 74.5 years) contributed to the grip strength evaluation. The average follow-up time was 8.2 years.
The investigators assessed anticholinergic exposure in multiple dimensions. Two traditional measures presumed constant effects of constant exposure:
• 10-year Total Standardized Daily Dose (TSDD)
• 2-year mean Standardized Daily Dose (mSDD)
The study also used WCE models to account for time-varying effects over varying windows (2, 4, 6, 8, or 10 years). These models were intended to express the dynamic interaction between exposure duration and physical deterioration. The main outcomes were gait speed (meters per second) and grip strength (kilograms). Generalized Estimating Equations (GEE) adjusted linear models compared the rate of decline by exposure group, and model fit was examined with the quasi-information criterion (QIC).
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