Background. Anticholinergic (ACH) medications are among biologically plausible and potentially modifiable risk factors of delirium. But the epidemiological findings on its role in hospitalized elderly patients are conflicting. Objectives. To evaluate the association between use of ACH medications and delirium severity and the potential effect-modification on this association by dementia. Methods. A cohort of 278 medical inpatients aged 65 years and over with diagnosed delirium was prospectively followed up with the Delirium Index (DI) every 2--7 days up to 3 weeks in a primary acute care hospital. Their DI scores were associated with measures of ACH medication exposure in the previous day using the mixed linear regression model adjusting for potential confounders or effect modifiers. Results . A total of 47 potential ACH medications were used in the cohort (mean: 1.4 per patient per day). An increase in daily ACH medication exposure of one such medication was on average associated with a subsequent increase in delirium severity of 0.52 DI points (95% CI: 0.3--0.8) after adjusting for dementia, baseline DI score, length of follow-up and concurrent use of non-ACH medications. Dementia did not modify the association. Sensitivity analyses using alternative definitions of ACH medications or excluding antipsychotics did not change the results. Conclusions. Exposure to ACH medications is independently and specifically associated with a subsequent increase in symptom severity of delirium among elderly medical inpatients.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33406 |
| Date | January 2000 |
| Creators | Han, Ling, 1955- |
| Contributors | McCusker, Jane (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001771758, proquestno: MQ70714, Theses scanned by UMI/ProQuest. |
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