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Open AccessArticle

Anticholinergic Burden, Sleep Quality and Health Outcomes in Malaysian Aged Care Home Residents

Department of Pharmacy Practice, International Medical University, Kuala Lumpur 57000, Malaysia
Department of Pharmacy, University of Huddersfield, Huddersfield HD1 3DH, UK
School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
Authors to whom correspondence should be addressed.
Pharmacy 2019, 7(4), 143;
Received: 16 August 2019 / Revised: 21 October 2019 / Accepted: 21 October 2019 / Published: 23 October 2019
(This article belongs to the Special Issue Quality Use of Medicine in Aged Care Homes)
The use of anticholinergic medications by residents in aged care homes is associated with increased risk of adverse effects. These include cognitive impairment, sleep disturbances, and falls, and necessitate increased healthcare visits and the associated burden on healthcare systems. The objective of this study was to investigate associations between anticholinergic burden and health outcomes such as independence in activities for daily living, frailty, quality of life, and sleep quality. The study was conducted among residents in Malaysian aged care homes, aged 60 years and above. Anticholinergic burden was calculated using the Anticholinergic Cognitive Burden (ACB) scale. Health outcome measures included independence, assessed using the Katz Activities for Daily Living scale (Katz ADL); quality of life, assessed using the Older People’s Quality of Life Questionnaire (OPQOL); frailty, assessed using the Groningen Frailty Index (GFI); and sleep quality, measured using the Pittsburg Sleep Quality Index (PSQI). Just over one-third (36%) of the study population was exposed to at least one medication with anticholinergic effect. An increased anticholinergic cognitive burden was associated with frailty (p = 0.031), sleep latency (p = 0.007), and sleep disturbances (p = 0.015). Further studies are required to assess the effect of prolonged exposure to anticholinergic medications on health outcomes. View Full-Text
Keywords: anticholinergics; ADL; frailty; quality of life; sleep; aged homes anticholinergics; ADL; frailty; quality of life; sleep; aged homes
MDPI and ACS Style

Kumar, S.; Hasan, S.S.; Wong, P.S.; Chong, D.W.K.; Kairuz, T. Anticholinergic Burden, Sleep Quality and Health Outcomes in Malaysian Aged Care Home Residents. Pharmacy 2019, 7, 143.

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