Evidence map›Paper›PMID 37856064›Full record

ArticleDrugs & aging2023

Low-Income Older Adults' Vulnerability to Anticholinergic Medication-Associated Frailty.

Lana Sargent, Kristin M Zimmerman, Almutairi Mohammed, Matthew J Barrett, Huma Nawaz, Kathryn Wyman-Chick, Marissa Mackiewicz, Youssef Roman, Patricia Slattum, Sally Russell and 5 more

Abstract read
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In one paragraph

Article in Drugs & aging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

15 authors.

Lana SargentSchool of Nursing, Virginia Commonwealth University, 1100 E Leigh St., Richmond, VA, 23298, USA. lsargent@vcu.edu.ORCID 0000-0001-5555-9985
Kristin M ZimmermanInstitute for Inclusion, Inquiry, and Innovation (iCubed): Health and Wellness in Aging Populations Core, Richmond, VA, 23298, USA.
Almutairi MohammedDepartment of Pharmacy Practice, College of Pharmacy, Qassim University, 51452, Buraydah, Saudi Arabia.
Matthew J BarrettDepartment of Neurology, Virginia Commonwealth University, Richmond, VA, 23298, USA.
Huma NawazDepartment of Neurology, Virginia Commonwealth University, Richmond, VA, 23298, USA.
Kathryn Wyman-ChickHealthPartners Neuroscience Center, St. Paul, MN, 55130, USA.
Marissa MackiewiczGeriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, 410 N 12th St., Richmond, VA, 23298, USA.
Youssef RomanGeriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, 410 N 12th St., Richmond, VA, 23298, USA.
Patricia SlattumGeriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, 410 N 12th St., Richmond, VA, 23298, USA.
Sally RussellSchool of Nursing, Virginia Commonwealth University, 1100 E Leigh St., Richmond, VA, 23298, USA.
Dave L DixonDepartment of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 N 12th St., Richmond, VA, 23298, USA.
Sarah K LagemanDepartment of Neurology, Virginia Commonwealth University, Richmond, VA, 23298, USA.
Sarah HobgoodSchool of Medicine, Department of Geriatrics, Virginia Commonwealth University, 1101 E. Marshall St., Richmond, VA, 23298, USA.
Leroy R ThackerSchool of Medicine, Department of Biostatistics, Virginia Commonwealth University, 830 East Main Street, Richmond, VA, 23298, USA.
Elvin T PriceGeriatric Pharmacotherapy Program, School of Pharmacy, Virginia Commonwealth University, 410 N 12th St., Richmond, VA, 23298, USA.

Funding

African American Cardiovascular pharmacogenetic CONsorTium (ACCOuNT): discovery and translationU54MD010723 · NIMHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MELTZER, DAVID O, PERERA, MINOLI A · 2016 to 2020
$9.5M
Resources and DisseminationP30AG066619 · NIA · UNIVERSITY OF CHICAGO · PI Vincent Joseph Hotz, DAVID O MELTZER · 2020 to 2026
$6.8M
NIA NIH HHS P30 AG066619NIMHD NIH HHS U54 MD010723
6 · The paper itself

Abstract

backgroundA growing body of research supports the negative impact of anticholinergic drug burden on physical frailty. However, prior research has been limited to homogeneous white European populations, and few studies have evaluated how anticholinergic burden tools compare in their measurement function and reliability with minority community-dwelling adult populations. This study investigated the association between anticholinergic drug exposure and frailty by conducting a sensitivity analysis using multiple anticholinergic burden tools in a diverse cohort.

methodsA comprehensive psychometric approach was used to assess the performance of five clinical Anticholinergic Burden Tools: Anticholinergic Cognitive Burden Scale (ACB), Anticholinergic Drug Scale (ADS), average daily dose, total standardized daily doses (TSDD), and Cumulative Anticholinergic Burden scale (CAB). Spearman correlation matrix and intraclass correlation coefficients (ICC) were used to determine the association among the variables. Ordinal logistic regression is used to evaluate the anticholinergic burden measured by each scale to determine the prediction of frailty. Model performance is determined by the area under the curve (AUC).

resultsThe cohort included 80 individuals (mean age 69 years; 55.7% female, 71% African American). All anticholinergic burden tools were highly correlated (p < 0.001), ICC3 0.66 (p < 0.001, 95% confidence interval (CI) 0.53-0.73). Among individuals prescribed anticholinergics, 33% were robust, 44% were prefrail, and 23% were frail. All five tools predicted prefrail and frail status (p < 0.05) with low model misclassification rates for frail individuals (AUC range 0.78-0.85).

conclusionAnticholinergic burden tools evaluated in this cohort of low-income African American older adults were highly correlated and predicted prefrail and frail status. Findings indicate that clinicians can select the appropriate instrument for the clinic setting and research question while maintaining confidence that all five tools will produce reliable results. Future anticholinergic research is needed to unravel the association between interventions such as deprescribing on incident frailty in longitudinal data.

Indexed as

FrailtyAgedCholinergic AntagonistsFemaleHumansIndependent LivingMaleReproducibility of ResultsCholinergic Antagonists

Identifiers

PMID37856064

What OpenQuestion holds

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Registered trials

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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.