PDF(Pubmed)
Abstract：
Older adults are frequently exposed to medicines with systemic anticholinergic properties, which are linked to increased risk of negative health outcomes. The association between systemic anticholinergics and lung function has not been reported. The aim of this study was to investigate if exposure to systemic anticholinergics influences lung function in older adults. Participants of the southernmost centres of the Swedish National study on Aging and Care (SNAC) were followed from 2001 to 2021. In total, 2936 subjects (2253 from Good Aging in Skåne and 683 from SNAC-B) were included. An extensive medical examination including spirometry assessments was performed during the study visits. The systemic anticholinergic burden was described using the anticholinergic cognitive burden scale. The effect of new use of systemic anticholinergics on the annual change in forced expiratory volume (FEV1s) was estimated using mixed models. During follow-up, 802 (27.3%) participants were exposed to at least one systemic anticholinergic medicine. On average, the FEV1s of participants without systemic anticholinergic exposure decreased 37.2 ml/year (95% CI [33.8; 40.6]) while participants with low and high exposure lose 47.2 ml/year (95% CI [42.4; 52.0]) and 43.7 ml/year (95% CI [25.4; 62.0]). A novel association between new use of medicines with systemic anticholinergic properties and accelerated decrease in lung function in older adults was found. The accelerated decrease is comparable to that observed in smokers. Studies are needed to further explore this potential side effect of systemic anticholinergics.
摘要：
老年人经常接触具有全身性抗胆碱能特性的药物，这与负面健康结果的风险增加有关。尚未报道全身性抗胆碱能药物与肺功能之间的关联。这项研究的目的是调查暴露于全身性抗胆碱能药物是否会影响老年人的肺功能。从2001年到2021年，对瑞典国家衰老与护理研究（SNAC）最南端中心的参与者进行了跟踪。总的来说,包括2936名受试者（Skóne良好老化的2253名和SNAC-B的683名）。在研究访视期间进行了广泛的医学检查，包括肺活量测定评估。使用抗胆碱能认知负担量表描述了全身性抗胆碱能负担。使用混合模型估算了新使用全身性抗胆碱能药物对用力呼气量（FEV1）年度变化的影响。随访期间,802例（27.3%）参与者接受了至少一种全身性抗胆碱能药物治疗。平均而言,没有全身抗胆碱能暴露的参与者的FEV1下降37.2ml/年(95%CI[33.8;40.6]),而低和高暴露的参与者的FEV1下降47.2ml/年(95%CI[42.4;52.0])和43.7ml/年(95%CI[25.4;62.0]).发现了具有全身性抗胆碱能特性的药物的新使用与老年人肺功能加速下降之间的新关联。加速的减少与在吸烟者中观察到的相当。需要研究进一步探索全身性抗胆碱能药物的这种潜在副作用。
