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Association of Anticholinergic Risk Score With Functional Status in Patients Preparing for Pelvic Reconstructive Surgery

Brueseke, Taylor J. MD; de la Luz Nieto, Maria MD; Pulliam, Samantha MD; Wu, Jennifer M. MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: April 20, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000587
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Objectives Anticholinergic medication use has been associated with cognitive impairment and other functional limitations, particularly in older patients. The anticholinergic risk score (ARS) can be used to measure a patient's cumulative exposure to medications with anticholinergic properties. Our primary objective was to evaluate the correlation between ARS and functional status, as measured by instrumental activities of daily living (IADL), in patients preparing to undergo urogynecologic surgery. The secondary objective was to examine the correlation between ARS and physical function in this same cohort.

Methods This was a planned cross-sectional analysis of a prospective cohort study to evaluate the impact of urogynecologic surgery on functional status. The ARS was calculated by summing the ARSs of each patient's medications and classified as high (ARS > 5) or low (ARS ≤ 5). A patient's ability to live independently was determined using the IADL questionnaire. The patient's physical function status was determined using the functional comorbidity index.

Results One hundred twenty-two patients were evaluated. A total of 89.3% of subjects had a low and 10.7% had a high ARS score. For our primary outcome, high ARS was associated with low IADL in logistic regression controlling for age and formal education level (odds ratio, 8.0; 95% confidence interval, 1.4–46.9). For our secondary outcome, ARS was not associated with the functional comorbidity index (P = 0.24).

Conclusions These data support recognition of ARS as a potential risk factor for low functional status in patients planning urogynecologic surgery.

From the Division of Urogynecology and Reconstructive Surgery, Department of Ob/Gyn, University of North Carolina, Chapel Hill, Chapel Hill, NC.

Correspondence: Taylor Brueseke, MD, University of California, Irvine, 333 City Blvd W, Orange, CA 92868. E-mail: tbruesek@uci.edu.

The authors have declared they have no conflicts of interest.

This work was presented as a poster at American Urogyencologic Society in Denver, Colo, from September 27 to October 1, 2016.

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