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Könnecke, J.K.* ; Bößneck, N.L.* ; Drebka, A.* ; Scholl, A.J.* ; Degen, M.* ; Ebert, N.* ; Heier, M. ; Keil, T.* ; Leitzmann, M.* ; Mikolajczyk, R.* ; Velásquez, I.M.* ; Obi, N.* ; Pendt, P.* ; Pischon, T.* ; Sallam, N. ; Schöttker, B.* ; Woeckel, M. ; Bachmeier, B.E.*

Anticholinergic burden in the German National Cohort (NAKO): Patterns of anticholinergic drug exposure and utilization.

Explor. Res. Clin. Soc. Pharm. 24:100869 (2026)
Verlagsversion DOI
Open Access Gold
Creative Commons Lizenzvertrag
Background: Medication-related anticholinergic burden (AB) has been studied mainly in older adults and selectedpatient populations, whereas population-based evidence across adulthood remains limited, particularlyregarding over-the-counter (OTC) drug use and utilization patterns.Objective: To characterize the frequency, distribution, and pharmacological drivers of AB in the German NationalCohort (NAKO).Methods: We conducted a cross-sectional analysis of NAKO baseline data collected in 2014–2019 from partici-pants aged 19–75 years recruited through age- and sex-stratified random sampling from population registries. ABwas quantified from participant-reported seven-day medication use using the German Anticholinergic BurdenScale; cumulative scores ≥ 1 and ≥ 3 defined any and high burden, respectively. Descriptive analyses charac-terized AB by age, sex, drug class, prescription status, and utilization pattern; logistic regression assessed asso-ciations of AB with age, sex, and polypharmacy.Results: Among 199,813 participants (median age 51 years; 50.4% women), 17.4% had any and 3.0% had highAB, with exposure in all analyzed age groups. Any and high AB were associated with female sex (aOR = 1.09,95% CI 1.06–1.12 and aOR = 1.44, 95% CI 1.37–1.53, respectively), most older age groups, and polypharmacy.Nervous system drugs contributed most to aggregate AB. Medications obtained OTC accounted for over one tenthof the sample's burden, with a greater relative contribution in younger age groups. Most anticholinergic drugswere used on a scheduled basis, with daily and long-term use predominating.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Anticholinergic Burden ; Anticholinergic Agents ; Medication Use ; German National Cohort ; Older Adults ; Polypharmacy
ISSN (print) / ISBN 2667-2766
e-ISSN 2667-2766
Zeitschrift Exploratory Research in Clinical and Social Pharmacy
Quellenangaben Band: 24, Heft: , Seiten: , Artikelnummer: 100869 Supplement: ,
Verlag Elsevier
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Epidemiology (EPI)