Anticholinergic Cognitive Burden in Older People Over Acute Admission.

To evaluate the change of geriatric anticholinergic cognitive burden (ACB) over acute admission for fall, fracture, or altered mental status (AMS) with a secondary endpoint of associated 30-day all-cause readmission.
Retrospective, single-center chart review.
An academic, 636-bed level-I trauma and tertiary care hospital in Texas.
Participants at least 65 years of age admitted for acute fall, fracture, or AMS between January 1, 2014, and August 31, 2018. A total of 265 participants were included; average age was 83 years, with 56% female.
Change in ACB of home medications from hospital admission to discharge.
At admission, ACB averaged 2.6 with 43.4% of participants having clinically significant scores, defined as ACB greater than or equal to 3. Overall, ACB decreased by 0.1 by discharge with 63.8% and 13.9% of participants having no change and increases in their ACB over admission, respectively. Clinically significant anticholinergic burden at discharge was significantly associated with 30-day all-cause readmission (P<0.001).
Anticholinergic burden in older people admitted for fall, fracture, or AMS is not consistently intervened upon in this acute care setting. Strategies to optimize deprescribing in this setting are needed.