scholarly journals Analysis of anticholinergic and sedative medicine effects on physical function, cognitive function, appetite and frailty: a cross-sectional study in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029221 ◽  
Author(s):  
Renly Lim ◽  
Lisa M Kalisch Ellett ◽  
Imaina S Widagdo ◽  
Nicole L Pratt ◽  
Elizabeth Ellen Roughead

ObjectiveTo test the association between use of medicines with anticholinergic or sedative properties and physical function, cognitive function, appetite and frailty.Design, setting and participantsThis cross-sectional study analysed baseline data collected as part of the Australian Longitudinal Study of Ageing, a population-based cohort of 2087 participants aged 65 years or over living in South Australia.Main outcome measuresPhysical function was measured at baseline using measures including hand grip strength, walking speed, chair stands, activities of daily living and instrumental activities of daily living (IADL). Cognitive function was measured using Mini-Mental State Examination. Appetite was measured using Center for Epidemiologic Studies Depression question 2. Frailty was measured using frailty index. The association between use of anticholinergics or sedatives and physical or cognitive function, appetite, or frailty was assessed using analysis of covariance and ordinal or binary logistic regression.ResultsAlmost half of the population were using anticholinergics or sedatives (n=954, 45.7%). Use of anticholinergics was significantly associated with poorer grip strength, slower walking speed, poorer IADL and poorer appetite. Use of sedatives was significantly associated with poorer grip strength, slower walking speed and poorer IADL. We found no significant association between medicine use and cognitive function. Users of anticholinergics or sedatives were significantly more likely to be frail compared with non-users.ConclusionUse of medicines with anticholinergic or sedative properties is significantly associated with poorer physical function, poorer appetite and increased frailty. Early identification of signs and symptoms of deterioration associated with medicine use is particularly important in older people so that worsening frailty and subsequent adverse events are prevented.

2021 ◽  
Vol 9 (4) ◽  
pp. 3979-3984
Author(s):  
Samuel SE ◽  
◽  
Senapathi P ◽  
Shetty S ◽  
◽  
...  

Background: Higher BMI has been often attributed with decline in cognitive function, mortality, and morbidity in elderly. However, few studies have reported high BMI as protective towards cognition and Activities of Daily Living (ADL). Accurate quantification of the role of BMI in the incidence of cognition and performance is desirable in the face of the increasing prevalence of individuals with overweight and obesity and prolonged life span in the population. This study aimed to investigate the association of BMI with cognition and ADL in community living elderly. Method: A cross sectional study was conducted among community living elderly. BMI and KATZ index scores were recorded from the respondents. Data were analyzed using SPSS version and a p value of less than 0.05 was considered statistically significant. Results: A total of 53 respondents enrolled in this study and was predominated by (54.7%) males and (45.30%) females. Karl Pearson correlation coefficient test found a positive correlation (r= 0.33) between BMI and Cognition and was found to be statistically significant (p<0.05). Also, it was observed that moderately positive correlation exists between BMI and ADL (r =0.64) and was found to be statistically very highly significant (p<0.001) Conclusion: This study concluded that among elderly, higher BMI values were associated with better performance in daily activities and lower cognitive impairment. KEY WORDS: Elderly, Body mass index, Activities of Daily Living, Cognition.


Author(s):  
Júlia Cristina Leite Nóbrega ◽  
Juliana Barbosa Medeiros ◽  
Tácila Thamires de Melo Santos ◽  
Saionara Açucena Vieira Alves ◽  
Javanna Lacerda Gomes da Silva Freitas ◽  
...  

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.


2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.


2012 ◽  
Vol 13 (3) ◽  
pp. 741-750 ◽  
Author(s):  
Reza Amini ◽  
Robab Sahaf ◽  
Alireza Kaldi ◽  
Hamid Haghani ◽  
Keyvan Davatgaran ◽  
...  

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