Association between anticholinergic and sedative medications and physical functioning: data from the Canadian longitudinal study on aging (CLSA).

Abstract

Purpose: The cumulative use of anticholinergic and sedative medications has been associated with lower physical function in older adults. This study aimed to identify which physical function attributes are most impacted in subgroups aged 45-64 and 65-85 years.

Methods: Baseline data from 30,097 community-living Canadians in the Canadian Longitudinal Study on Aging were analysed using a cross-sectional design. Anticholinergic and sedative medications use was quantified using the Drug Burden Index (DBI). Physical functioning was measured via the timed 4-meter walk, Timed Up and Go (TUG), single leg balance, chair rise and grip strength. Physical functioning profiles were generated using latent profile analysis of the five tests. Associations between DBI scores and physical functioning were assessed through linear regression and multinomial logistic regression.

Results: The mean age of participants was 63.0, 50.9% were female, 18.3% had a DBI score 0 < DBI < 1 and 8.7% a DBI score ≥ 1. Adjusted regression models showed the greatest reduction in standardized scores for the TUG test among participants with DBI ≥ 1 (β: -6.05; -6.77 to - 5.33) relative to DBI = 0. Latent profile analysis indicated that the two profiles with the poorest physical functioning were associated with higher odds of exposure to 0 < DBI < 1 and DBI ≥ 1, whereas the profile reflecting the best functioning was associated with reduced odds of exposure to DBI ≥ 1. Associations of similar magnitude were observed across age strata (45-64 and 65-85 years).

Conclusion: Cumulative anticholinergic and sedative medication burden was inversely associated with physical functioning. These findings were consistent across middle-aged and older adults.