Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
The aim of this study is to determine the prevalence of use and long-term use (=180 days) of proton pump inhibitors (PPIs) and associated factors among community-dwellers with and without Alzheimer's disease (AD).
MEDALZ cohort encompassed all persons who received a verified diagnosis of AD in Finland during the years 2005-2011 and their age-, sex-, and region of residence-matched comparison persons, including 69,353 persons with and 69,353 persons without AD. Data was derived from several Finnish administrative registers. A mathematical modelling method, PRE2DUP, was used for converting dispensing data to drug use periods (when regular PPI use started and ended). Morbid conditions and concomitant drugs associated with use and long-term use of PPIs were assessed with logistic regression models.
Use of PPIs was more common among comparison persons than persons with AD (39.0 and 35.8%, respectively, p
Cites: Am J Med. 2010 Jun;123(6):496-501 PMID 20569750
It is unknown whether cognitive status or diagnosed cognitive decline affects estrogen use.
We assessed how common systemic estrogen use was among community-dwellers with Alzheimer's disease (AD) and a matched comparison cohort without AD.
This study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005-2011 (N?=?46,116; index cases) and an equally sized matched comparison cohort without AD. Follow-up began on the matching date (date of the AD diagnosis of the index case). Data on systemic estrogen use were obtained from the prescription register. Use initiation and discontinuation were assessed.
Altogether 3.1% of women with AD and 4.3% of women without AD used estrogen during the follow-up period. Only?