EFFECT OF ANTICHOLINERGIC MEDICATIONS ON COGNITIVE FUNCTION OF HOSPITALIZED ELDERLY PATIENTS

Lansia berisiko tinggi mengalami gangguan kognitif karena antikolinergik sering digunakan untuk berbagai kondisi medis. Tujuan dari penelitian ini adalah untuk menguji profil obat antikolinergik, dan untuk menguji pengaruh obat antikolinergik terhadap fungsi kognitif pada pasien lanjut usia rawat inap. Rancangan penelitian ini adalah penelitian cross sectional retrospektif yang dilakukan di Yogyakarta dan Jawa Tengah. Jumlah subyek adalah 535 (lima ratus tiga puluh lima) lansia yang dirawat di rumah sakit berusia AƒÂ¢A¯Â?½A‚Â¥60 tahun. Beban antikolinergik diukur dengan menggunakan Anticholinergic Drug Scale (ADS). Fungsi kognitif diukur dengan menggunakan 6 CIT (Six Cognitive Impairment Test). Korelasi antara skor ADS dan 6 CIT dilakukan dengan menggunakan analisis regresi logistik. Prevalensi penggunaan antikolinergik adalah 61,7% (n=330), dimana 39,3% (n=210) menggunakan obat antikolinergik tunggal dan 22,4% (n=120) menggunakan multipel antikolinergik. Profil penggunaan obat antikolinergik menunjukkan 37 jenis obat antikolinergik, dimana obat yang paling sering dilaporkan adalah furosemid (n=106), ranitidin (n=83) dan kaptopril (n=65). Rata-rata total ADS untuk pasien yang menggunakan obat antikolinergik adalah 1,72 Aƒi?½A‚± 0,093 (CI = 1,53-1,90). Hasil 6 CIT adalah 12,68 Aƒi?½A‚± 7,828. Analisis regresi logistik multivariat menunjukkan bahwa Fungsi Kognitif (6 CIT) dipengaruhi oleh penggunaan obat antikolinergik, pendidikan dan konsumsi kafein. Kekuatan korelasi dapat dilihat dari OR (Odd Ratio), dari yang terkuat adalah penggunaan antikolinergik (OR=1,780; p=0,006), konsumsi kafein (OR=0,443; p=0,001) dan yang terakhir adalah pendidikan (OR= 0,243; p=0,001). The elderly were in high risk of cognitive impairment because anticholinergics were widely used for many medical condition. The objective of this research were to examine the profile of anticholinergic medications, and to examine the effect of anticholinergic medications on cognitive function in hospitalized elderly patients. The design of this research was observational retrospective cross sectional study which conducted in Yogyakarta and Central Java. The participants were 535 (five hundred and thirty five) hospitalized elderly patients aged 60 and older. The Anticholinergic burden was measured using the Anticholinergic Drug Scale (ADS). Cognitive impairment was measured using 6 CIT (Six Cognitive Impairment Test). The correlation between the score of ADS and 6 CIT were assesed using logistic regression analysis. The prevalence of anticholinergic use was 61.7 % (n = 330), in which 39.3 % (n=210) were taking single anticholinergic medications and 22.4 % (n=120) were using multiple anticholinergic medications. The profile of anticholinergic use indicated 37 type of anticholinergic medications, in which the most frequently reported medications were furosemide ( n=106) , ranitidine (n=83) and captopril (n=65). The result of compiled ADS, for those participants using anticholinergic medication, mean total ADS was 1,72 Aƒi?½A‚± 0.093 ( CI = 1.53 AƒÂ¢A¯Â?½A¯Â?½ 1.90). The result of 6 CIT was 12,68 Aƒi?½A‚± 7.828. The multivariate logistic regression analysis indicated Cognitive Function (6 CIT) was affected by the use of anticholinergic medication adjusted by education and caffein consumption, .The strength of correlation can be seen from the OR (Odd Ratio), from the strongest were the use of anticholinergic (OR =1.780; p = 0.006), caffeine consumption (OR = 0.443; p = 0.001) and the last was education (OR = 0.243; p = 0.001). Conclusions : Anticholinergic medications had significant effect on cognitive impairment on elderly patients