title: Anticholinergic drugs and their effects on delirium and mortality in the elderly.
abstract: OBJECTIVE
  To investigate the use of drugs with anticholinergic properties (DAPs) and their associations with delirium and mortality among elderly patients with comorbidities.
  
  
  METHODS
  425 patients (≥70 years of age) in geriatric wards and nursing homes were assessed. The use of DAPs was retrieved from their medical records. Delirium was diagnosed according to the DSM-IV criteria.
  
  
  RESULTS
  Of the 341 patients (80.2%) treated with multiple DAPs (≥2), 92 patients (27.0%) suffered from delirium, whereas 14 of 84 patients (16.7%) without DAP treatment had delirium (p = 0.050). In a logistic regression analysis with age, gender, and Charlson Comorbidity Index as covariates, DAP treatment did not predict delirium (odds ratio 1.67, 95% confidence interval 0.87-3.21). The 2-year mortality was 49.3% (n = 168) in DAP users and 35.7% (n = 30) in non-users, respectively (p = 0.026). In the Cox proportional hazard model adjusted for age, gender, and comorbidity, DAPs did not predict mortality (hazard ratio 1.12, 95% confidence interval 0.75-1.68).
  
  
  CONCLUSIONS
  The use of DAPs is very frequent among frail inpatients with comorbidities, but their use has no independent prognostic significance.
authors.affiliation: Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Luukkanen
authors.forename: J
authors.initials: J
authors.lastname: Uusvaara
authors.forename: J V
authors.initials: JV
authors.lastname: Laurila
authors.forename: T E
authors.initials: TE
authors.lastname: Strandberg
authors.forename: M M
authors.initials: MM
authors.lastname: Raivio
authors.forename: R S
authors.initials: RS
authors.lastname: Tilvis
authors.forename: K H
authors.initials: KH
authors.lastname: Pitkälä