Evidence map›Paper›PMID 26419732›Full record

Trial reportThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2015

Anticholinergic Exposure During Rehabilitation: Cognitive and Physical Function Outcomes in Patients with Delirium Superimposed on Dementia.

Ann Kolanowski, Jacqueline Mogle, Donna M Fick, Noll Campbell, Nikki Hill, Paula Mulhall, Liza Behrens, Elise Colancecco, Malaz Boustani, Linda Clare

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
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  5. Review
  6. Review
  7. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Ann KolanowskiCollege of Nursing, Penn State, University Park, PA, USA. Electronic address: amk20@psu.edu.
Jacqueline MogleCollege of Nursing, Penn State, University Park, PA, USA.
Donna M FickCollege of Nursing, Penn State, University Park, PA, USA.
Noll CampbellDepartment of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, USA.
Nikki HillCollege of Nursing, Penn State, University Park, PA, USA.
Paula MulhallCollege of Nursing, Penn State, University Park, PA, USA.
Liza BehrensCollege of Nursing, Penn State, University Park, PA, USA.
Elise ColanceccoCollege of Nursing, Penn State, University Park, PA, USA.
Malaz BoustaniRegenstrief Institute, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Linda ClareREACH: The Centre for Research in Ageing and Cognitive Health, College of Life and Environmental Sciences, Department of Psychology, Washington Singer Laboratories, Exeter, UK.
Pennsylvania State University · USIndiana University – Purdue University Indianapolis · USPurdue University West Lafayette · USSinger (United States) · US

Funding

RESERVE for Delirium Superimposed on Dementia (DSD)R01NR012242 · NINR · PENNSYLVANIA STATE UNIVERSITY, THE · PI FICK, DONNA MARIE, KOLANOWSKI, ANN M · 2010 to 2014
$2.1M
Evaluating the Adverse Cognitive Effects of MedicationsK23AG044440 · NIA · PURDUE UNIVERSITY · PI CAMPBELL, NOLL L. · 2014 to 2018
$728k
NIA NIH HHS K23 AG044440NINR NIH HHS R01 NR012242NINR NIH HHS R01 NR012242 02
6 · The paper itself

Abstract

objectivesWe examined the association between anticholinergic medication exposure and subsequent cognitive and physical function in patients with delirium superimposed on dementia during rehabilitation. We also examined length of stay and discharge disposition by anticholinergic medication exposure.

designIn this secondary analysis we used control group data from an ongoing randomized clinical trial. SETTING/

participantsParticipants with delirium and dementia were enrolled at admission to post-acute care. These 99 participants had a mean age of 86.11 (±6.83) years; 67.6% were women; 98% were Caucasian; and 33% were positive for at least one APOE e4 allele. MEASURES: We obtained daily measures of cognitive and physical function using: Digit Span; memory, orientation and attention items from the Montreal Cognitive Assessment; CLOX; the Confusion Assessment Method; and the Barthel Index. Anticholinergic medication exposure was measured weekly using the Anticholinergic Cognitive Burden Scale.

resultsUsing multilevel models for time we found that greater use of clinically relevant anticholinergic medications in the previous week reduced cognitive and physical function, as measured by Digit Span Backwards and the Barthel index, in the current week. There was no effect of anticholinergic medication use on delirium severity, and APOE status did not moderate any outcomes. Greater use of clinically relevant anticholinergic medications was related to longer length of stay but not discharge disposition.

conclusionsFor vulnerable older adults, anticholinergic exposure represents a potentially modifiable risk factor for poor attention, working memory, physical function, and greater length of stay during rehabilitation.

Indexed as

Activities of Daily LivingHealth StatusAged, 80 and overAttentionCholinergic AntagonistsCognitionDeliriumDementiaFemaleHumansLength of StayMaleMemoryRisk FactorsCholinergic AntagonistsAnticholinergic exposurecognitiondementiaphysical functionpost-acute care

Identifiers

PMID26419732
PMCPMC4691545
OpenAlexW1118593757

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.