Evidence map›Paper›PMID 34463739›Full record

ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2022

Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls.

Andrea L Rosso, Zachary A Marcum, Xiaonan Zhu, Nicolaas Bohnen, Caterina Rosano

Open access · greenAbstract read
In one paragraph

Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 87% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

5 authors at 3 institutions in 1 country.

Andrea L RossoDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.
Zachary A MarcumDepartment of Pharmacy, University of Washington, Seattle, USA.
Xiaonan ZhuDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.
Nicolaas BohnenDepartment of Radiology, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Caterina RosanoDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-0909-1506
University of Pittsburgh · USUniversity of Michigan · USUniversity of Washington · US

Funding

VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JENNIFER S BRACH · 2004 to 2026
$28.6M
Neurobiological drivers of mobility resilience: the dopaminergic systemU01AG061393 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BOHNEN, NICOLAAS IDA, ROSANO, CATERINA · 2018 to 2022
$6.2M
Peripheral Nerve Function Decline in an Aged CohortR01AG028050 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STROTMEYER, ELSA S. · 2007 to 2015
$3.5M
Brain anatomical correlates of mobility control in the oldest oldR01AG029232 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROSANO, CATERINA · 2007 to 2011
$2.7M
End of Life in the Very OldR01NR012459 · NINR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ALBERT, STEVEN M, LUNNEY, JUNE R · 2011 to 2015
$2.7M
Restoring Central Motor Control to Improve Community Mobility of Older AdultsR01AG057671 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROSSO, ANDREA L · 2018 to 2021
$2.5M
DYNAMICS OF HEALTH .AGING . AND BODY COMPOSITION /Pittsburgh/-260962101N01AG062101 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1996 to 2004
$996k
Novel Brain Neuroimaging Markers of Age-Related Mobility ImpairmentK23AG028966 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROSANO, CATERINA · 2006 to 2008
$643k
Environmental Challenges and the Aging Brain: Implications for Community MobilityK01AG053431 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ROSSO, ANDREA L · 2016 to 2020
$509k
NIA NIH HHS K01 AG053431NIA NIH HHS K23 AG028966NIA NIH HHS N01-AG-6-2101NIA NIH HHS P30 AG024827NIA NIH HHS R01 AG028050NIA NIH HHS R01 AG029232NIA NIH HHS R01 AG057671NIA NIH HHS U01 AG061393NINR NIH HHS R01 NR012459
6 · The paper itself

Abstract

backgroundAnticholinergic medications are associated with fall risk. Higher dopaminergic signaling may provide resilience to these effects. We tested interactions between anticholinergic medication use and dopaminergic genotype on risk for recurrent falls over 10 years.

methodsParticipants in the Health, Aging, and Body Composition (Health ABC) study (n = 2 372, mean age = 73.6; 47.8% men; 60.0% White) without disability or anticholinergic use at baseline were followed for up to 10 years for falls. Medication use was documented in 7 of 10 years. Highly anticholinergic medications were defined by Beers criteria, 2019. Recurrent falls were defined as ≥2 in the 12 months following medication assessment. Generalized estimating equations tested the association of anticholinergic use with recurrent falls in the following 12 months, adjusted for demographics, health characteristics, and anticholinergic use indicators. Effect modification by dopaminergic genotype (catechol-O-methyltransferase [COMT]; Met/Met, higher dopamine signaling, n = 454 vs Val carriers, lower dopamine signaling, n = 1 918) was tested and analyses repeated stratified by genotype.

resultsDuring follow-up, 841 people reported recurrent falls. Anticholinergic use doubled the odds of recurrent falls (adjusted odds ratio [OR] [95% CI] = 2.09 [1.45, 3.03]), with suggested effect modification by COMT (p = .1). The association was present in Val carriers (adjusted OR [95% CI] = 2.16 [1.44, 3.23]), but not in Met/Met genotype (adjusted OR [95% CI] = 1.70 [0.66, 4.41]). Effect sizes were stronger when excluding baseline recurrent fallers.

conclusionHigher dopaminergic signaling may provide protection against increased 12-month fall risk from anticholinergic use. Assessing vulnerability to the adverse effects of anticholinergic medications could help in determination of risk/benefit ratio for prescribing and deprescribing anticholinergics in older adults.

Indexed as

Catechol O-MethyltransferaseCholinergic AntagonistsAgedDopamineFemaleGenotypeHumansMaleCatechol O-MethyltransferaseCholinergic AntagonistsDopamineAnticholinergic medicationsDopamineEpidemiologyFalls

Identifiers

PMID34463739
PMCPMC9071487
OpenAlexW3197386872

What OpenQuestion holds

Textmetadata
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.