Anticholinergics and falls in older adults

Xu, Xiang Jiang and Tan, Maw Pin * (2022) Anticholinergics and falls in older adults. Expert Review of Clinical Pharmacology, 15 (3). pp. 285-294. ISSN 1751-2441

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Official URL: https://doi.org/10.1080/17512433.2022.2070474

Abstract

Introduction: The use of medications with anticholinergic (ACh) properties is associated with numerous adverse effects especially in older adults. Emerging evidence suggests the presence of long-term effects with ACh use. Areas covered: Our article presents an overview of ACh effects and falls in older individuals including examination of emerging evidence on ACh use and cumulative exposure on short-term and long-term falls risk. The databases CINAHL, MEDLINE, EMBASE, and Web of Science were searched for articles published from January 2002 to December 2021. Expert opinion: Anticholinergic side effects include muscle weakness, blurred vision, and mental confusion which are likely to lead to increased falls risk. Many commonly used medications such as beta-blockers, calcium-channel blockers, and antihistamines are now known to have mild ACh properties. With polypharmacy now considered unavoidable in older patients, the cumulative effects of the use of multiple drugs with mild ACh properties may also lead to increased falls risk. The relationship between ACh drugs and falls may also be irreversible as ACh effects may extend beyond the period of drug use, due to cognitive and physical deconditioning following the initial exposure to ACh drugs. Future long-term studies with accurate quantification of cumulative ACh exposure and measurement of actual falls outcomes are urgently required.

Item Type: Article
Uncontrolled Keywords: Anticholinergic syndrome; accidental falls; aged; drug-related side effects and adverse reactions; polypharmacy;
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RS Pharmacy and materia medica
Divisions: Others > Non Sunway Academics
Sunway University > School of Medical and Life Sciences [formerly School of Healthcare and Medical Sciences until 2020] > Department of Medical Sciences
Depositing User: Ms Yong Yee Chan
Date Deposited: 04 Aug 2024 08:27
Last Modified: 04 Aug 2024 08:27
URI: http://eprints.sunway.edu.my/id/eprint/2990

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