An analysis of 13,607 hospitalizations among patients aged 60 years or older in 2024 found that cumulative anticholinergic and CNS-active drug burdens were associated with delirium, cognitive impairment, falls or fractures, as well as longer stays, mortality, and higher costs.
Key findings
- Low and high anticholinergic burdens occurred in 30.24% and 63.65% of hospitalizations; low and high CNS-active burdens occurred in 49.17% and 21.99%. High anticholinergic burden was associated with the composite outcome at aOR 8.40 (95% CI 3.46-20.38), while low and high CNS burdens had aORs of 4.67 and 32.64.
Why this matters globally
Polypharmacy in older adults is a global concern. The findings support examining cumulative burden rather than isolated drugs and may inform pharmacist review or decision-support alerts, although intervention studies are required to show that such programs reduce harm.
Thai researcher contribution
The University of Phayao and Buddhachinaraj Hospital applied international medication-burden criteria to a large Thai real-world hospital dataset, producing locally relevant evidence for older-patient medication safety.
Limitations to consider
The retrospective hospitalization design is vulnerable to confounding by indication, illness severity, and medications initiated after symptoms began. Repeat admissions may represent the same patient, the composite outcome can obscure component differences, and some odds-ratio confidence intervals are wide.
Verify the original sources
British Journal of Clinical PharmacologyRead the original article↗DOI: 10.1002/bcp.70682