METHODS: This nationwide cohort study included 42,132 older people aged ≥ 65 years who underwent Korean National Health Insurance Service health examinations from 2007 to 2008. Odds ratios (ORs) and 95% confidence intervals (CIs) for abnormal Timed Up and Go (TUG) test results were assessed using multivariate logistic regression analyses. Hazard ratios (HRs) and 95% CIs for all-cause mortality until the end of 2015 were estimated using multivariable Cox proportional hazards regression analysis.
RESULTS: Of the participants, 37.19% had abnormal TUG test results, and 7.66% of those died during the 5.7-year mean follow-up. The abnormal TUG test results OR increased by 27% among individuals with Korean Anticholinergic Burden Scale (KABS) scores ≥ 3 (OR 1.27, 95% CI 1.02-1.58) compared to those with KABS scores of 0. The HRs for all-cause mortality increased for individuals with higher KABS scores (P for trend < 0.001) or chronic polypharmacy (P for trend < 0.001) compared to those for individuals without these conditions. The combination of a higher KABS or chronic polypharmacy and abnormal TUG test results increased the risk of all-cause mortality (All P for trend < 0.001).
CONCLUSIONS: Anticholinergic drug burden shows a better association with functional decline than chronic polypharmacy, and the use of medications and functional decline may be important risk factors for all-cause mortality among older people.
方法:这项全国性的队列研究包括42,132名年龄≥65岁的老年人,他们从2007年到2008年接受了韩国国民健康保险服务健康检查。使用多变量逻辑回归分析评估异常定时和定时(TUG)测试结果的赔率(OR)和95%置信区间(CI)。使用多变量Cox比例风险回归分析估计2015年底前全因死亡率的危险比(HR)和95%CI。
结果:在参与者中,37.19%的TUG检测结果异常,7.66%的患者在5.7年平均随访期间死亡。韩国抗胆碱能负担量表(KABS)评分≥3(OR1.27,95%CI1.02-1.58)的个体与KABS评分为0的个体相比,异常TUG测试结果OR增加了27%。与没有这些疾病的个体相比,具有较高KABS评分(趋势<0.001)或慢性多重用药(趋势<0.001)的个体的全因死亡率的HR增加。较高的KABS或慢性多重用药和异常的TUG测试结果的组合增加了全因死亡的风险(所有趋势P<0.001)。
结论:抗胆碱能药物负荷显示与功能减退的相关性比慢性多药更好,药物的使用和功能下降可能是老年人全因死亡的重要危险因素。