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Using multiple drugs with anticholinergic properties is common and might lead to cumulative anticholinergic toxicity and increased risk of cognitive impairment. Therefore, we sought to investigate the association between the Anticholinergic Cognitive Burden (ACB) Scale and cognitive performance among middle-aged and older adults.In this cross-sectional study with 13,065 participants from the baseline visit of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), mean age was 51.7 ± 9.0 years old, 55% women, and 53% white. The ACB was calculated based on the medications in use. We investigated the association of ACB with global cognition and memory, verbal fluency (VF), and trail-making test version B (TMT-B) z-scores, using multiple linear regression models adjusted for sociodemographic and clinical variables.Overall, 16% of participants had an ACB score greater than 0. ACB was associated with poor cognitive performance in all tests in crude analysis. After adjustment for sociodemographic characteristics, the association remained significant for the global cognitive score, as well as the memory and the TMT-B z-scores. However, after further adjustments for clinical variables, only trend associations of ACB with poor memory (β = - 0.02, 95% Cl = - 0.05, 0.00, p = 0.056) and the TMT-B z-scores (β = - 0.02, 95% Cl = - 0.04, 0.00, p = 0.054) were found. In stratified analyses by age groups, ACB was associated with poor cognitive performance on the TMT-B (β = - 0.03, 95% Cl = - 0.05, - 0.01, p = 0.005) in individuals aged less than 65 years old.Although the ACB was associated with poor executive function only among middle-aged adults in adjusted analysis, residual confounding may partly explain our results.

Introdução: As doenças comuns na velhice induzem ao uso de tratamentos farmacológicos, cujo sucesso depende da adesão do paciente. O uso concomitante de fármacos com propriedades anticolinérgicas por um mesmo indivíduo, situação comum em idosos, pode produzir toxicidade anticolinérgica cumulativa e aumentar o risco de reações adversas cognitivas. Objetivos: Investigar a influência da carga anticolinérgica sobre a adesão ao tratamento farmacológico prescrito e a cognição de idosos saudáveis. Métodos: Neste estudo observacional, transversal, descritivo e analítico, com 151 idosos da Universidade Aberta da Terceira Idade (UATI), foram coletados dados sociodemográficos, grau de adesão (Escala de Morisky), estado cognitivo (Mini Exame do Estado Mental, MEEM) e carga anticolinérgica cognitiva (ACB, associada a declínio cognitivo adverso ao tratamento farmacológico), estimada com base nos medicamentos em uso (Escala ACB). Para estimar a associação entre variáveis, utilizou-se testes de correlação (Spearman ou Person, conforme a distribuição dos dados), e qui-quadrado de Pearson ou exato de Fisher. Resultados: A maioria era do sexo feminino (72,2%), casada (38,1%), possuía 70 anos ou mais (54,7%) e ensino médio (41,7%), utilizava medicamentos prescritos (87,4%), apresentou grau de adesão moderado (39,7%; 6 a 7 pontos na Escala de Morisky) ao tratamento prescrito, o qual, na maioria, não exibia atividade anticolinérgica (ACB = 0 pontos em 56,2% dos participantes). Dos 151 participantes, 36,4% informaram praticar automedicação, a qual exibia atividade anticolinérgica severa (ACB 3 pontos em 63,6% dos que se automedicavam). Houve correlação significativa (p < 0,05) positiva entre adesão e idade (r = 0,2034; p = 0,0202), negativa entre adesão e ACB advinda da automedicação (r = -0,1748; p = 0,0457), e negativa entre cognição e ACB da automedicação (r = -0,2968; p = 0,0038). Conclusões: Observa-se que, quanto maior a idade, maior a adesão, porém, quanto mais alta a ACB advinda da automedicação, pior a cognição e menos aderente ao tratamento farmacológico prescrito Introduction: Common diseases in the elderly population increase the need of pharmacological treatments, and the success of pharmacotherapy depends on adherence. Concomitant use of drugs with anticholinergic properties by the same individual, which is common in the elderly, may produce cumulative anticholinergic toxicity and increase the risk of cognitive adverse reactions. Objectives: To investigate the influence of anticholinergic burden on adherence to prescribed pharmacological treatment and cognition of healthy elderly. Methods: In this observational, cross-sectional, descriptive and analytical study of 151 elderly of University of the Third Age (UATI), sociodemographic data, degree of adherence (Morisky Scale), cognitive status (Mini Mental State Examination, MMSE) and Anticholinergic Cognitive Burden (ACB) associated with cognitive decline were collected. adverse effect to pharmacological treatment), estimated based on the medications in use (ACB Scale). To estimate the association between variables, correlation tests (Spearman or Pearson, according to data distribution), and Pearson\'s chi-square or Fisher\'s exact test were used. Results: Most were female (72.2%), married (38.1%), 70 years old or older (54.7%) and high school (41.7%), using prescription drugs (87, 4%) presented moderate adherence (39.7%; 6 to 7 points on the Morisky Scale) to the prescribed treatment, which, in the majority, did not exhibit anticholinergic activity (ACB = 0 points in 56.2% of the participants).Of the 151 participants, 36.4% reported practicing self-medication, which exhibited severe anticholinergic activity (ACB 3 points in 63.6% of self-medication). There was a significant (p

Objective: to identify the prevalence of self-medication, the therapeutic classes used without medical prescription, the symptoms treated with such medication and associated factors among participants of an Open University of the Third Age (OU3A). Method: a cross-sectional, descriptive and analytical study was carried out, the sample of which was composed of 138 OU3A attendees. To estimate the association between the variables, prevalence ratios (PR), confidence intervals (95% CI), the chi-squared test and Fisher's exact test were used. Results: the majority were aged 60-69 years (61.6%), were female (75.4%), had a health plan (63%) and claimed to self-medicate (59.4%, 95% CI, 0-64.8). The most frequently mentioned therapeutic classes were analgesics (31.9%), muscle relaxants (13.8%), anti-inflammatories (13.0%) and first-generation antihistamines (7.2%). The most commonly reported self-medication symptoms were muscle and joint pain (21.0%), headaches (10.1%) and colds and flu (8.7%). There was a significant association (p = 0.049) among those who self-medicated more frequently and anti-inflammatory use (PR = 1.46, 95% CI = 1.10-1.99). The complaint of muscular and articular pain exhibited a significant association with the diagnosis of arthrosis (p = 0.003, RP = 3.75, 95% CI = 2.07-6.76) and hypothyroidism (p = 0.002, RP = 2.77 ; 95% CI = 1.50-5.10). Conclusion: the most frequently mentioned reasons for self-medicating were previous experience using the drug and the certainty that it is safe. Most of the above medications are potentially inappropriate for the elderly. However, the elderly consider them safe and are unaware of the risks to which they expose them. They may also be unaware that pain treated by self-medication may be related to pre-existing diseases, which require the appropriate professional and treatment.

Objectives: To estimate the prevalence of cardiometabolic diseases and their association with polypharmacy in elderly people at the University of the Third Age (Portuguese acronym: UnATI). Methods: A cross-sectional, descriptive, analytical study with 121 elderly patients. The prevalence ratio, Pearson’s Chi-square test and Fisher’s exact test were used as measures of association. Results: At the mean age of 68.3, most elderly had at least one cardiometabolic disease (82.6%), of which hypertension was the most prevalent (71.1%), and consumed prescription drugs of continuous use (92.6%). Almost half of the elderly (48.2%) used combinations of drugs, which suggests a high cardiovascular risk. Polypharmacy due to prescription was observed in almost one-third (28.6%) of the sample, associated with the use of antihypertensives (p=0.004), antidiabetics (p=0.000) or lipid-lowering agents (p