Abstract：
BACKGROUND: Although depression and anticholinergic drug use are common comorbidities that impair health status in later life, there are insufficient data on their relationship. This study aimed to investigate the relationship between depressive symptoms and anticholinergic use in older individuals.
METHODS: Community-dwelling older adults (≥65 years) admitted to the tertiary referral geriatric outpatient clinic were included. Participants were evaluated for depressive symptoms using the Geriatric Depression Scale (GDS) with a cut-off score of ≥6 for depression. Exposure to anticholinergic drugs was assessed using the anticholinergic cognitive burden (ACB) scale and three subgroups were created: ACB = 0, ACB = 1, and ACB ≥ 2. The relationship between these two parameters was assessed using multivariate logistic regression analysis considering other potential variables.
RESULTS: The study included 1232 participants (mean age 78.4 ± 7.2 years and 65.2% female) and the prevalence of depression was 24%. After adjusting for potential confounders, compared to ACB = 0, having ACB ≥ 2 was related to depression symptoms (odds ratio (OR): 1.56, 95% CI: 1.04-2.35, P = 0.034), whereas having ACB = 1 did not increase the risk (OR: 1.27, 95% CI: 0.88-1.83, P = 0.205).
CONCLUSIONS: Our findings indicate that special attention should be paid to drug therapy in preventing depression in older adults, as exposure to a high anticholinergic load is negatively associated with psychological status.
METHODS: Community-dwelling older adults (≥65 years) admitted to the tertiary referral geriatric outpatient clinic were included. Participants were evaluated for depressive symptoms using the Geriatric Depression Scale (GDS) with a cut-off score of ≥6 for depression. Exposure to anticholinergic drugs was assessed using the anticholinergic cognitive burden (ACB) scale and three subgroups were created: ACB = 0, ACB = 1, and ACB ≥ 2. The relationship between these two parameters was assessed using multivariate logistic regression analysis considering other potential variables.
RESULTS: The study included 1232 participants (mean age 78.4 ± 7.2 years and 65.2% female) and the prevalence of depression was 24%. After adjusting for potential confounders, compared to ACB = 0, having ACB ≥ 2 was related to depression symptoms (odds ratio (OR): 1.56, 95% CI: 1.04-2.35, P = 0.034), whereas having ACB = 1 did not increase the risk (OR: 1.27, 95% CI: 0.88-1.83, P = 0.205).
CONCLUSIONS: Our findings indicate that special attention should be paid to drug therapy in preventing depression in older adults, as exposure to a high anticholinergic load is negatively associated with psychological status.
摘要：
背景：尽管抑郁症和抗胆碱能药物的使用是在以后生活中损害健康状况的常见合并症，关于他们关系的数据不足。这项研究旨在调查老年人抑郁症状与抗胆碱能药物使用之间的关系。
方法：纳入了在三级转诊老年门诊就诊的社区居住的老年人（≥65岁）。使用老年抑郁量表（GDS）对参与者的抑郁症状进行评估，抑郁症的截止评分≥6。使用抗胆碱能认知负担（ACB）量表评估抗胆碱能药物的暴露，并创建三个亚组：ACB=0，ACB=1和ACB≥2。考虑其他潜在变量，使用多变量逻辑回归分析评估这两个参数之间的关系。
结果：该研究包括1232名参与者（平均年龄78.4±7.2岁，65.2%为女性），抑郁症患病率为24%。在调整了潜在的混杂因素后，与ACB=0相比，ACB≥2与抑郁症状相关（比值比（OR）：1.56，95％CI：1.04-2.35，P=0.034），而ACB=1不会增加风险(OR:1.27,95%CI:0.88-1.83,P=0.205).
结论：我们的研究结果表明，在预防老年人抑郁症方面，应特别注意药物治疗，因为暴露于高抗胆碱能负荷与心理状态呈负相关。
方法：纳入了在三级转诊老年门诊就诊的社区居住的老年人（≥65岁）。使用老年抑郁量表（GDS）对参与者的抑郁症状进行评估，抑郁症的截止评分≥6。使用抗胆碱能认知负担（ACB）量表评估抗胆碱能药物的暴露，并创建三个亚组：ACB=0，ACB=1和ACB≥2。考虑其他潜在变量，使用多变量逻辑回归分析评估这两个参数之间的关系。
结果：该研究包括1232名参与者（平均年龄78.4±7.2岁，65.2%为女性），抑郁症患病率为24%。在调整了潜在的混杂因素后，与ACB=0相比，ACB≥2与抑郁症状相关（比值比（OR）：1.56，95％CI：1.04-2.35，P=0.034），而ACB=1不会增加风险(OR:1.27,95%CI:0.88-1.83,P=0.205).
结论：我们的研究结果表明，在预防老年人抑郁症方面，应特别注意药物治疗，因为暴露于高抗胆碱能负荷与心理状态呈负相关。
