Anticholinergic Burden and Fracture-Specific Hospitalizations in Older Adults
| Scale and Score | Fracture-Specific Hospitalizations | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Aged 65–74 Years (n = 11,682) | Aged 75–84 Years (n = 6,567) | Aged ≥85 Years (n = 1,018) | |||||||
| No. | aOR (95% CI) | P Value | No. | aOR (95% CI) | P Value | No. | aOR (95% CI) | P Value | |
| ARS | |||||||||
| 0 (ref) | 9,224 | 1.00 | – | 5,133 | 1.00 | – | 847 | 1.00 | – |
| 1 | 683 | 1.61 (1.47–1.76) | <.001 | 458 | 1.49 (1.33–1.66) | <.001 | 59 | 1.02 (0.75–1.39) | .88 |
| 2 | 832 | 1.64 (1.48–1.81) | <.001 | 443 | 1.56 (1.37–1.79) | <.001 | 47 | 0.99 (0.63–1.55) | .96 |
| 3 | 610 | 1.64 (1.49–1.81) | <.001 | 365 | 1.64 (1.43–1.87) | <.001 | 41 | 1.19 (0.79–1.78) | .41 |
| ≥4 | 333 | 1.96 (1.72–2.23) | <.001 | 168 | 1.73 (1.44–2.07) | <.001 | 24 | 1.65 (1.03–2.66) | .04 |
| ACB | |||||||||
| 0 (ref) | 6,915 | 1.00 | – | 3,707 | 1.00 | – | 651 | 1.00 | – |
| 1 | 2,231 | 1.10 (1.02–1.18) | .009 | 1,310 | 1.17 (1.07–1.28) | <.001 | 164 | 1.00 (0.84–1.20) | .97 |
| 2 | 939 | 1.13 (1.04–1.23) | .006 | 575 | 1.18 (1.05–1.31) | .004 | 89 | 1.18 (0.94–1.48) | .16 |
| 3 | 756 | 1.34 (1.23–1.46) | <.001 | 474 | 1.37 (1.22–1.54) | <.001 | 62 | 1.28 (0.98–1.67) | .07 |
| ≥4 | 841 | 1.71 (1.57–1.86) | <.001 | 501 | 1.62 (1.45–1.82) | <.001 | 52 | 1.18 (0.89–1.58) | .25 |
| DBI-Ach | |||||||||
| 0 (ref) | 9,224 | 1.00 | – | 5,133 | 1.00 | – | 847 | 1.00 | – |
| 0< score ≤0.5 | 1,941 | 1.45 (1.38–1.53) | <.001 | 1,171 | 1.43 (1.34–1.52) | <.001 | 134 | 1.13 (0.94–1.37) | .19 |
| 0.5< score ≤1 | 517 | 1.67 (1.52–1.84) | <.001 | 263 | 1.48 (1.30–1.68) | <.001 | 37 | 1.60 (1.15–2.23) | .006 |
aOR = adjusted odds ratio; ACB = Anticholinergic Cognitive Burden scale; ARS = Anticholinergic Risk Scale; DBI-Ach = Drug Burden Index - Anticholinergic component; ref=reference group.
Note: In multivariate generalized estimating equation models. Total sample for analysis was 19,267. Refer to Table 2 notes for description of adjustment and scales.