[PSYCHOTROPHIC AND ANTICHOLINERGIC DRUG BURDEN AMONG ELDERLY ISRAELI PATIENTS INVOLVED IN TRAFFIC ACCIDENTS].

Introduction: The population is ageing. This trend is expected to cause an increase in the number of driver licenses among the elderly, and in their mobility. The effect of medications on driving capability may be significant.

Objectives: To characterize the comorbidities among elderly patients involved in traffic accidents who were hospitalized at Beilinson Hospital and the psychotropic drugs taken prior to the accident, to assess the prevalence of anticholinergic drug load in this population and to examine its effect on clinical outcomes after the accident among the drivers.

Methods: This is a retrospective cross-sectional study of the elderly over the age of 65, who were involved in a traffic accident between the years 2005-2015 (drivers and pedestrians) and were hospitalized. For each patient, a Charlson comorbidity index score was calculated and 3 months pre-accident drug dispensing data were extracted. The evaluation of the anticholinergic drug load for each patient was performed using the Anticholinergic Cognitive Burden (ACB) scale.

Results: The study included 291 patients (98 drivers, 193 pedestrians). Pedestrians were injured more severely in comparison to the drivers' subgroup. The population received an average of 8.1 systemic drugs during the 3 months period prior to the accident. Approximately 36.7% were prescribed psychotropic medication (27.1%, 16.4% and 2.4% benzodiazepines, antidepressants and antipsychotics respectively); 32.3% had significant anticholinergic load (ACB score> 1). No significant differences were found in the prevalence of use of psychotropic drugs and/or ACB score between pedestrian and drivers or with post-accident clinical outcomes between drivers with high versus low anticholinergic drug load.

Conclusions: The prevalence of psychotropic and anticholinergic drug burden is high among elderly involved in traffic accidents. Pre-accident anti-cholinergic drug load does not affect clinical outcomes after the accident. Elderly pedestrians are injured more severely than elderly drivers.