Thirty-two-year trends in anticholinergic burden and associated mortality among US older adults: a population-based study.

Background Anticholinergic burden (AB) is linked to adverse health outcomes and mortality among older adults. Yet, the national trends in AB and its long-term mortality risk are not well-defined. Methods We analysed data from 16 188 older adults in the National Health and Nutrition Examination Surve...

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Publicado en:Age & Ageing Vol. 55; no. 2; pp. 1 - 11
Autores principales: Wei, Kai, Sun, Shuimei, Chen, Chun, Yang, Yanping, Li, Dongmei, Liu, Yan, Tang, Cailin, Jiang, Wenbin, Bai, Xue, Hu, Kui
Formato: Artículo
Publicado: Oxford University Press / USA Feb2026
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2026
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      pub: Oxford University Press / USA
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        10.1093/ageing/afag049
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        atl: Thirty-two-year trends in anticholinergic burden and associated mortality among US older adults: a population-based study.
      aug:
        au:
          Wei, Kai
          Sun, Shuimei
          Chen, Chun
          Yang, Yanping
          Li, Dongmei
          Liu, Yan
          Tang, Cailin
          Jiang, Wenbin
          Bai, Xue
          Hu, Kui
        affil:
          Department of Pharmacy, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
          Department of Pharmacy, Guizhou Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Guiyang, Guizhou, China
          Department of Clinical Laboratory, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
          Department of Pharmacy, Guizhou Provincial People's Hospital, Guiyang, Guizhou, ChinaDepartment of Pharmacy, Guizhou Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Guiyang, Guizhou, China
          Department of Cardiovascular Surgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
      su:
        United States
        Drug side effects
        Causes of death
        Old age
        Cardiovascular disease related mortality
        Mortality risk factors
        Parasympathomimetic agents
        Risk assessment
        Research funding
        Logistic regression analysis
        Descriptive statistics
        Disease prevalence
        Confidence intervals
        Tumors
        Data analysis software
        Proportional hazards models
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        subj:
          Drug side effects
          Causes of death
          Old age
          United States
          Cardiovascular disease related mortality
          Mortality risk factors
          Parasympathomimetic agents
          Risk assessment
          Research funding
          Logistic regression analysis
          Descriptive statistics
          Disease prevalence
          Confidence intervals
          Tumors
          Data analysis software
          Proportional hazards models
      keyword:
        anticholinergic agents
        anticholinergic burden
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        https://dx.doi.org/10.1093/ageing/afag049
        inLanguage:en
        mortality
        national health and nutrition examination survey
        older adult
        older adults
        prevalence
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41785066/
        weight measurement scales
        anticholinergic agents
        anticholinergic burden
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        https://dx.doi.org/10.1093/ageing/afag049
        inLanguage:en
        mortality
        national health and nutrition examination survey
        older adult
        older adults
        prevalence
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41785066/
        weight measurement scales
      ab: Background Anticholinergic burden (AB) is linked to adverse health outcomes and mortality among older adults. Yet, the national trends in AB and its long-term mortality risk are not well-defined. Methods We analysed data from 16 188 older adults in the National Health and Nutrition Examination Survey (NHANES) spanning 32 years. AB was assessed using the 2023 American Geriatrics Society Beers Criteria® and four validated scales (ARS, ADS, ACB and ACSBC). Age-standardised prevalence trends were examined using survey-weighted logistic regression. Mortality outcomes were ascertained through linkage to the National Death Index and analysed with Cox proportional hazards models to estimate adjusted hazard ratios (HRs). Results From 1988–94 to 2017–March 2020, the prevalence of any strong anticholinergic medication use and high AB (score ≥ 3) declined significantly across all scales (all P  < .05). During a median follow-up of 81 months, 9006 deaths (49.3%) occurred. After comprehensive adjustment for covariates, high AB was independently associated with elevated all-cause mortality (ADS: HRs 1.65, 95% CI 1.51–1.81; ACB: HRs 1.54, 95% CI 1.41–1.68), cardiovascular mortality (ADS: HRs 1.94, 95% CI 1.71–2.20; ACB: HRs 1.66, 95% CI 1.46–1.88) and cancer mortality (ADS: HRs 1.40, 95% CI 1.18–1.68; ACB: HRs 1.31, 95% CI 1.09–1.57). Conclusions While the prevalence of AB among US older adults has declined over the past three decades, high exposure remains a strong, independent predictor of all-cause, cardiovascular and cancer mortality. These findings highlight the ongoing need for safer prescribing and sustained deprescribing initiatives in geriatric care.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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