Anticholinergic Drug Use in Elderly Patients: Compliance with STOPP-START and BEERS Criteria in Spain-A Descriptive Study.

Abstract

Introduction: Dementia is the most prevalent neurodegenerative disorder. Several studies have demonstrated an association between anticholinergic drug use and an increased risk of cognitive and physical impairment. However, anticholinergic drugs are commonly prescribed for various clinical conditions, and their cumulative effects, referred to as anticholinergic burden, can contribute to cognitive decline and dementia. Although the causal relationship remains inconclusive, a higher anticholinergic burden is linked to a greater risk of cognitive deterioration.

Objective: This study aims to assess the compliance of patients aged ≥ 65 years with the STOPP-START and Beers criteria concerning the concurrent use of medications with high anticholinergic potency in situations where their use is not clinically justified.

Methods: This observational descriptive study was conducted using data from the Spanish Database for Pharmacoepidemiological Research (BIFAP). The study population comprised male and female patients aged ≥ 65 years.

Results: Of the 81,405 patients who developed dementia during the study period, 46.7% had been exposed to multiple anticholinergic drugs. Among them, 81.1% used these drugs sequentially, while 18.9% used two or more simultaneously. The absolute risk of developing dementia was 6.5% in patients who met the STOPP-START and BEERS criteria, compared to 13.4% in those who did not.

Conclusion: Although a high anticholinergic burden is a risk factor for cognitive decline, the unjustified concurrent use of multiple anticholinergic drugs remains uncommon among the elderly population in Spain.