Objectives: 

To investigate the characteristics of anticholinergic use in the elderly with Alzheimer disease (AD) compared with those in the non-AD elderly.

Methods: 

Using the Korean National Health Insurance Service Elderly cohort database, 388,629 adults aged 70 years and older in 2012 were included. The use of strong anticholinergic agents (ACs) in 2012 was quantified by standardized prescribed doses. Univariate and multivariate logistic regression models were applied to examine the level of their heavy use (≥90 doses of the prescribed amount in 2012) in patients with AD and potential explanations of the heavy use.

Results: 

Antihistamines and antidepressants were the most prescribed strong ACs among non-AD and AD elderly, respectively. The heavy use of strong ACs was more prevalent in patients with AD than in non-AD elderly [odds ratio (95% confidence interval)=1.48 (1.41-1.56)]. When the morbidities associated with AD were adjusted for, odds ratio were reduced [0.91 (0.85-0.96)].

Conclusions: 

Heavy use of strong ACs was more prevalent in patients with AD than in non-AD elderly. Multiple ACs for treating multimorbidities in AD were mainly attributable to their heavy use. In patients with AD, the integrated management of medications for reducing the preventable heavy use of these drugs should be reinforced.

中文翻译：

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在韩国患有老年痴呆症的老年人中使用抗胆碱能药物：一项基于人群的研究。

目标： 

为了研究阿尔茨海默病（AD）老年人与非AD老年人的抗胆碱能使用特征。

方法： 

使用韩国国民健康保险服务老年人群数据库，纳入了2012年388,629名70岁及以上的成年人。通过标准处方剂量对2012年使用的强抗胆碱药（AC）进行了量化。应用单因素和多因素logistic回归模型检查AD患者的重度使用水平（2012年≥90剂量的规定剂量）以及对重度使用的潜在解释。

结果： 

在非AD和AD老年人中，抗组胺药和抗抑郁药是最常用的强AC。与非AD老年人相比，AD患者中强AC的大量使用更为普遍[几率（95％置信区间）= 1.48（1.41-1.56）]。调整与AD相关的发病率后，优势比降低[0.91（0.85-0.96）]。

结论： 

在AD患者中，大量使用强AC比在非AD老年人中更为普遍。多种AC用于治疗AD多发病的原因主要是大量使用AC 。对于患有AD的患者，应加强药物综合管理以减少可预防的大量使用。