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Baseline anticholinergic burden from medications predicts poorer baseline and long-term health-related quality of life in 16 675 men and women of EPIC-Norfolk prospective population-based cohort study.

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Yrjana, Kaisa R 
Neal, Samuel R 
Soiza, Roy L 
Keevil, Victoria 
Luben, Robert N 


PURPOSE: Previous studies investigating the association between anticholinergic burden (ACB) and health-related quality of life (HRQoL) showed conflicting results and focused on older adults or specific patient groups only. METHODS: Participants from the European Prospective Investigation of Cancer-Norfolk study were divided into three groups according to their ACB from medications at baseline, representing ACB scores of 0, 1 and ≥2. Outcomes of interest were the physical and mental component summary scores (PCS and MCS) of the Short Form-36, collected at 18 months from the baseline and again after a mean 13 years of follow-up. Linear regression and logistic regression for cross-sectional and longitudinal associations between ACB and HRQoL were constructed adjusting for potential confounders. RESULTS: A total of 16 675 participants, mean age 58.9 ± 9.1 years (55.6% female) and 7133 participants, mean age at follow-up 69.1 ± 8.7 years (56.8% female), were included in the cross-sectional and longitudinal analyses, respectively. In cross-sectional analysis, higher anticholinergic burden was associated with higher odds of being in the lowest quartile of PCS (ACB = 1; OR, 1.85[1.64, 2.09] and ACB ≥ 2:2.19[1.85, 2.58] and MCS (ACB = 1:1.47[1.30, 1.66] and ACB ≥ 2:1.68[1.42, 1.98]). In longitudinal analysis, higher anticholinergic burden was similarly associated with higher odds of being in the lowest quartile of PCS (ACB = 1:1.56[1.24, 1.95] and ACB ≥ 2:1.48[1.07, 2.03]) compared with ACB 0 group. The association with MCS scores did not reach statistical significance. CONCLUSION: The use of anticholinergic medications is associated with both short and long-term poorer physical functions but association with mental functioning appears more short-term.



anticholinergic burden, antimuscarinic, health-related quality of life, mental functional health, pharmacoepidemiology, physical functional health, Aged, Cholinergic Antagonists, Cohort Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life

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Pharmacoepidemiol Drug Saf

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Medical Research Council (MC_UU_12015/1)
Medical Research Council (MR/N003284/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Medical Research Council (G1000143)
Medical Research Council (G0500300)
Medical Research Council (G0401527)
Medical Research Council (G0401527/1)