Evidence map›Paper›PMID 36933080›Full record

Observational studyInternational journal of clinical pharmacy2023

Association of drug burden index with delirium in community-dwelling older adults with dementia: a longitudinal observational study.

Bilal Katipoglu, Sultan Keskin Demircan, Mehmet Ilkin Naharci

Registry-linked trialAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in International journal of clinical pharmacy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04973709 (Gulhane Training and Research Hospital), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% 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.

NCT04973709 unknown statusnot on this map

Gulhane Training and Research Hospital

TypeobservationalSponsorGulhane Training and Research HospitalRan2021 to 2025Enrolled714ConditionsDelirium in Old Age, Delirium Superimposed on Dementia, Delirium With DementiaArmsConfussion assessment method (CAM), Dementia diagnosis
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Delirium among older adults living at home: a systematic review of prevalence, incidence, and risk factors.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
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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

3 authors at 1 institution in 2 countries.

Bilal KatipogluDivision of Geriatrics, Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, 06010, Ankara, Turkey. drbilal07@gmail.com.ORCID http://orcid.org/0000-0002-7235-7979
Sultan Keskin DemircanDivision of Geriatrics, Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, 06010, Ankara, Turkey.ORCID http://orcid.org/0000-0002-1373-4359
Mehmet Ilkin NaharciDivision of Geriatrics, Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, 06010, Ankara, Turkey.ORCID http://orcid.org/0000-0003-2730-7144
Gülhane Askerî Tıp Akademisi · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Drug Burden Index (DBI) is a validated tool for assessing the dose-dependent cumulative exposure to sedative and anticholinergic medications. However, the increased risk of delirium superimposed dementia (DSD) with high DBI levels has not yet been investigated.

aimThis study aimed to examine the potential association between DBI scores and delirium in community-dwelling older adults with dementia.

methodA total of 1105 participants with cognitive impairment underwent a comprehensive geriatric assessment. Experienced geriatricians made the final diagnosis of delirium based on DSM-IV-TR and DSM-V. We calculated the DBI as the sum of all sedatives and anticholinergics taken continuously for at least four weeks before admission. Polypharmacy was defined as regular use of five or more medications. We classified the participants as having no exposure (DBI = 0), low exposure (0 < DBI < 1), and high exposure (DBI ≥ 1).

resultsOf the 721 patients with dementia, the mean age was 78.3 ± 6.7 years, and the majority were female (64.4%). In the whole sample, low and high exposures to anticholinergic and sedative medications at admission were 34.1% (n = 246) and 38.1% (n = 275), respectively. Patients in the high-exposure group had higher physical impairment (p = 0.01), higher polypharmacy (p = 0.01), and higher DBI scores (p = 0.01). In the multivariate Cox regression analysis, high exposure to anticholinergic and sedative medications increased the risk of delirium 4.09-fold compared to the no exposure group (HR = 4.09, CI: 1.63-10.27, p = 0.01).

conclusionHigh exposure to drugs with sedative and anticholinergic properties was common in community-dwelling older adults. A high DBI was associated with DSD, highlighting the need for an optimal prescription in this vulnerable population.

trial registrationThe trial was retrospectively registered at ClinicalTrials.gov. Identifier: NCT04973709 Registered on 22 July 2021.

Indexed as

DeliriumDementiaAgedAged, 80 and overCholinergic AntagonistsFemaleHumansHypnotics and SedativesIndependent LivingLongitudinal StudiesMaleCholinergic AntagonistsHypnotics and SedativesAdverse effectAnticholinergicDeliriumDementiaDrug burden indexOlder adultsRisk factorsSedatives

Identifiers

PMID36933080
OpenAlexW4327811461

What OpenQuestion holds

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Registered trials

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.