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.
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。