2917 Anticholinergic burden, falls and mortality in a diverse elderly population in Kuala Lumpur

Abstract

Introduction Falls are a significant cause of morbidity and mortality throughout the world. This burden is greatest in elderly populations. Malaysia is experiencing a rapid demographic shift toward an ageing population, it has a low incidence of falling, but a high mortality to fall ratio. Identifying risk factors may guide future practice and prevent harm. Anticholinergic medication is associated with cognitive decline, mortality and falling. Methods Data were used from the Malaysian Elders Longitudinal Research study (MELoR), an ongoing study to assess geriatric health in Malaysia, to assess anticholinergic burden, falls, and mortality, from which 1472 participants were identified. The Anticholinergic Cognitive Burden (ACB) scale was used and participants were assigned positive (ACB ≥ 1) or negative (ACB = 0) ACB scores. Data analysis used bivariate and regression analysis to adjust for multicollinearity. Results A positive ACB score was identified in 300 (20.4%) participants. Cardiovascular medication accounted for around half the anticholinergic burden. A positive ACB score was a significant predictor for falling and mortality at five years after adjusting for age, sex and ethnicity. Incontinence and hearing loss remained the only significant predictors for both outcomes after regression analysis. Conclusion The impact of anticholinergic burden cannot be fully accounted for by comorbidities. Incontinence and hearing problems are both modifiable risk factors for falls and mortality. Further research into the diagnosis and management of these comorbidities in this population is recommended.