{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:13:46Z","timestamp":1792059226669,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aging Medicine"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Polypharmacy is a growing phenomenon associated with adverse effects in older adults. We assessed the potential confounding effects of cumulative anticholinergic burden (ACB) in patients who were hospitalized with falls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A noninterventional, prospective cohort study of unselected, acute admissions aged \u2265\u200965\u2009years. Data were derived from electronic patient health records. Results were analyzed to determine the frequency of polypharmacy and degree of ACB and their relationship to falls risk. Primary outcomes were polypharmacy, defined as prescription of 5 or more regular oral medications, and ACB score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Four hundred eleven (411) consecutive subjects were included, mean age 83.8\u2009\u00b1\u20098.0\u2009years: 40.6% men. There were 38.4% patients who were admitted with falls. Incidence of polypharmacy was 80.8%, (88.0% and 76.3% among those admitted with and without fall, respectively). Incidence of ACB score of 0, 1, 2, \u2265\u20093 was 38.7%, 20.9%, 14.6%, and 25.8%, respectively. On multivariate analysis, age [odds ratio (OR)\u2009=\u20091.030, 95% CI:1.000\u2009~\u20091.050,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.049], ACB score (OR\u2009=\u20091.150, 95% CI:1.020\u2009~\u20091.290,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025), polypharmacy (OR\u2009=\u20092.140, 95% CI:1.190\u2009~\u20093.870,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012), but not Charlson Comorbidity Index (OR\u2009=\u20090.920, 95% CI:0.810\u2009~\u20091.040,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.172) were significantly associated with higher falls rate. Of patients admitted with falls, 29.8% had drug\u2010related orthostatic hypotension, 24.7% had drug\u2010related bradycardia, 37.3% were prescribed centrally acting drugs, and 12.0% were taking inappropriate hypoglycemic agents.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Polypharmacy results in cumulative ACB and both are significantly associated with falls risk in older adults. The presence of polypharmacy and each unit rise in ACB score have a stronger effect of increasing falls risk compared to age and comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/agm2.12250","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T07:58:13Z","timestamp":1680681493000},"page":"116-123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Polypharmacy and cumulative anticholinergic burden in older adults hospitalized with fall"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5516-3497","authenticated-orcid":false,"given":"Ho Lun","family":"Wong","sequence":"first","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Weaver","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Marsh","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khine Oo","family":"Mon","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Dapito","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouad R.","family":"Amin","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"},{"name":"Al Azhar University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0986-5927","authenticated-orcid":false,"given":"Amit K. J.","family":"Mandal","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos G.","family":"Missouris","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Frimley Health NHS Trust  Slough UK"},{"name":"University of Nicosia Medical School  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0621-2"},{"key":"e_1_2_15_3_1","volume-title":"Medication safety in polypharmacy","year":"2019"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0795-2"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2006.03.002"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15317"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181efc6c6"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-016-0579-5"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.580152"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-019-00731-3"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2012.02.005"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03262280"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1315"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr233"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2017.06.002"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03491.x"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00050.2017"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-100732"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.14141"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-02994-x"},{"key":"e_1_2_15_21_1","volume-title":"Falls: Assessment and Prevention of Falls in Older People (CG161)","author":"NICE","year":"2013"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420986211016645"}],"container-title":["AGING MEDICINE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/agm2.12250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T11:21:46Z","timestamp":1692444106000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/agm2.12250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,5]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/agm2.12250"],"URL":"https:\/\/doi.org\/10.1002\/agm2.12250","archive":["Portico"],"relation":{},"ISSN":["2475-0360","2475-0360"],"issn-type":[{"value":"2475-0360","type":"print"},{"value":"2475-0360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,5]]},"assertion":[{"value":"2023-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}