Anticholinergic burden quantified using the Japanese risk scale as a predictor of frailty and sarcopenia among community-dwelling older adults: A 9-year Kashiwa cohort study

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International Pub Date : 2025-03-06 DOI:10.1111/ggi.70012

Tomoki Tanaka, Masahiro Akishita, Taro Kojima, Bo-Kyung Son, Katsuya Iijima

{"title":"Anticholinergic burden quantified using the Japanese risk scale as a predictor of frailty and sarcopenia among community-dwelling older adults: A 9-year Kashiwa cohort study","authors":"Tomoki Tanaka, Masahiro Akishita, Taro Kojima, Bo-Kyung Son, Katsuya Iijima","doi":"10.1111/ggi.70012","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>Given the adverse effects of anticholinergic drugs and the necessity for medication evaluation tools in the aging population, a comprehensive scale to assess the total anticholinergic burden in Japan was developed. We examined the longitudinal association between the anticholinergic burden, quantified using the Japanese Anticholinergic Drug Risk Scale, and the development of frailty and sarcopenia in older adults.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this longitudinal population-based cohort study, 2044 older residents without long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data were collected in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Medications were identified through interviews and assessed with the Screening Tool for Older Persons' Appropriate Prescriptions for the Japanese. The anticholinergic burden was quantified using the Japanese Anticholinergic Risk Scale. We evaluated new-onset frailty and sarcopenia using the Cardiovascular Health Study Index and Asian Working Group for Sarcopenia 2019 criteria, respectively.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 1549 participants without sarcopenia or frailty at baseline (age 72.5 ± 5.5 years; 49.1% women; median follow-up 6.0 years), 274 and 230 developed new-onset frailty and sarcopenia, respectively, during follow-up. After adjusting for potential confounders, an anticholinergic burden score ≥3 was strongly associated with new-onset frailty and sarcopenia (adjusted hazard ratio [95% confidence interval]: 2.45 [1.52–3.94] and 2.01 [1.20–3.35], respectively).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Anticholinergic burden is a predictor of frailty and sarcopenia in community-dwelling older adults. Effective evaluation and management of anticholinergic burden using the Japanese Anticholinergic Drug Risk Scale are crucial for promoting healthy aging and mitigating adverse health outcomes. <b>Geriatr Gerontol Int 2025; 25: 520–527</b>.</p>\n </section>\n </div>","PeriodicalId":12546,"journal":{"name":"Geriatrics & Gerontology International","volume":"25 4","pages":"520-527"},"PeriodicalIF":2.4000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ggi.70012","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Geriatrics & Gerontology International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ggi.70012","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Given the adverse effects of anticholinergic drugs and the necessity for medication evaluation tools in the aging population, a comprehensive scale to assess the total anticholinergic burden in Japan was developed. We examined the longitudinal association between the anticholinergic burden, quantified using the Japanese Anticholinergic Drug Risk Scale, and the development of frailty and sarcopenia in older adults.

Methods

In this longitudinal population-based cohort study, 2044 older residents without long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data were collected in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Medications were identified through interviews and assessed with the Screening Tool for Older Persons' Appropriate Prescriptions for the Japanese. The anticholinergic burden was quantified using the Japanese Anticholinergic Risk Scale. We evaluated new-onset frailty and sarcopenia using the Cardiovascular Health Study Index and Asian Working Group for Sarcopenia 2019 criteria, respectively.

Results

Of the 1549 participants without sarcopenia or frailty at baseline (age 72.5 ± 5.5 years; 49.1% women; median follow-up 6.0 years), 274 and 230 developed new-onset frailty and sarcopenia, respectively, during follow-up. After adjusting for potential confounders, an anticholinergic burden score ≥3 was strongly associated with new-onset frailty and sarcopenia (adjusted hazard ratio [95% confidence interval]: 2.45 [1.52–3.94] and 2.01 [1.20–3.35], respectively).

Conclusions

Anticholinergic burden is a predictor of frailty and sarcopenia in community-dwelling older adults. Effective evaluation and management of anticholinergic burden using the Japanese Anticholinergic Drug Risk Scale are crucial for promoting healthy aging and mitigating adverse health outcomes. Geriatr Gerontol Int 2025; 25: 520–527.

Abstract Image

查看原文本刊更多论文

使用日本风险量表量化抗胆碱能负荷，作为社区居住老年人虚弱和肌肉减少症的预测指标：一项为期9年的柏华队列研究

目的：考虑到抗胆碱能药物的不良反应及老年人群需要药物评价工具，编制日本抗胆碱能总负担的综合量表。我们研究了使用日本抗胆碱能药物风险量表量化的抗胆碱能负担与老年人虚弱和肌肉减少症的发展之间的纵向关联。方法：在这项以人口为基础的纵向队列研究中，从日本柏西的一个社区随机选择了2044名没有长期护理需求的老年居民。基线数据于2012年收集，并于2013年、2014年、2016年、2018年和2021年进行随访。通过访谈确定药物，并使用日本老年人适当处方筛选工具进行评估。采用日本抗胆碱能风险量表对抗胆碱能负荷进行量化。我们分别使用心血管健康研究指数和亚洲肌少症工作组2019标准评估新发虚弱和肌少症。结果：在1549名基线时没有肌肉减少症或虚弱的参与者中(年龄72.5±5.5岁；49.1%的女性;中位随访时间为6.0年)，274例和230例在随访期间分别出现新发虚弱和肌肉减少症。在校正潜在混杂因素后，抗胆碱能负荷评分≥3分与新发虚弱和肌肉减少症密切相关（校正风险比[95%可信区间]分别为2.45[1.52-3.94]和2.01[1.20-3.35]）。结论：抗胆碱能负荷是社区老年人虚弱和肌肉减少症的预测因子。使用日本抗胆碱能药物风险量表有效评估和管理抗胆碱能负担对于促进健康老龄化和减轻不良健康后果至关重要。Geriatr Gerontol 2025；••: ••-••.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.