Skip to main content

Advertisement

SpringerLink
Log in

Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study

  • Short Communication
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Background

Centrally acting medications cause cognitive slowing and incoordination, which could reduce older people’s physical activity levels. This association has not been studied previously.

Objectives

The aim of this study was to examine the association between opioid, hypnotic and anticholinergic medication, and objectively measured physical activity, in a cohort of older people.

Methods

We used data from the Physical Activity Cohort Scotland, a representative cohort of community-dwelling older people aged 65 years and over who were assessed at baseline and again 2–3 years later. Objective physical activity was measured using Stayhealthy RT3 accelerometers over 7 days. Baseline medication use (opioid use, hypnotic use, modified Anticholinergic Risk Scale [mARS]) was obtained from linked, routinely collected community prescribing records. Cross-sectional and longitudinal associations between baseline medication use and both baseline activity and change in activity over time were analysed using unadjusted and adjusted linear regression models.

Results

Overall, 310 participants were included in the analysis; mean age 77 years (standard deviation 7). No association was seen between baseline use of any medication class and baseline physical activity levels in unadjusted or adjusted models. For change in activity over time, there was no difference between users and non-users of hypnotics or opioids. Higher anticholinergic burden was associated with a steeper decline in activity over the follow-up period (mARS 0: − 7051 counts/24 h/year; mARS 1–2: − 15,942 counts/24 h/year; mARS ≥ 3: − 19,544 counts/24 h/year; p = 0.03) and this remained robust to multiple adjustments.

Conclusion

Anticholinergic burden is associated with greater decline in objectively measured physical activity over time in older people, a finding not seen with hypnotic or opioid use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380:219–29.

    Article  PubMed  PubMed Central  Google Scholar 

  2. McMurdo MET, Argo I, Crombie IK, Feng Z, Sniehotta FF, Vadiveloo T, et al. Social, environmental and psychological factors associated with objective physical activity levels in the over 65s. PLoS One. 2012;7(2):e31878.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Department of Health. Health Survey for England (2000). London: The Stationery Office; 2001.

    Google Scholar 

  4. Heseltine R, Skelton DA, Kendrick D, Morris RW, Griffin M, Haworth D, et al. “Keeping Moving”: factors associated with sedentary behaviour among older people recruited to an exercise promotion trial in general practice. BMC Fam Pract. 2015;16:67.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T. Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act. 2011;8:121–31.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Clarke CL, Witham MD. The effects of medication on activity and rehabilitation of older people—opportunities and risks. Rehab Process Outcome. 2017;6:1–7.

    Google Scholar 

  7. Taipale HT, Bell JS, Gnjidic D, Sulkava R, Hartikainen S. Sedative load among community-dwelling people aged 75 years or older: association with balance and mobility. J Clin Psychopharmacol. 2012;32(2):218–24.

    Article  PubMed  Google Scholar 

  8. Scottish Government Model of Care Polypharmacy Working Group. Polypharmacy guidance. 2nd ed. Edinburgh: Scottish Government; 2015.

    Google Scholar 

  9. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The Anticholinergic Risk Scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008;168(5):508–13.

    Article  PubMed  Google Scholar 

  11. Richardson K, Fox C, Maidment I, Steel N, Loke YK, Arthur A, et al. Anticholinergic drugs and risk of dementia: case–control study. BMJ. 2018;360:k1315.

    Article  Google Scholar 

  12. Clarke CL, Sniehotta FF, Vadiveloo T, Argo IS, Donnan PT, McMurdo MET, et al. Factors associated with change in objectively measured physical activity in older people: data from the physical activity cohort Scotland study. BMC Geriatr. 2017;17:180.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sumukadas D, Laidlaw S, Witham MD. Using the RT3 accelerometer to measure everyday activity in functionally impaired older people. Aging Clin Exp Res. 2008;20:15–8.

    Article  PubMed  Google Scholar 

  14. McMurdo ME, Sugden J, Argo I, Boyle P, Johnston DW, Sniehotta FF, et al. Do pedometers increase physical activity in sedentary older women? A randomized controlled trial. J Am Geriatr Soc. 2010;58:2099–106.

    Article  PubMed  Google Scholar 

  15. Kochersberger G, McConnell E, Kuchibhatla MN, Pieper C. The reliability, validity and stability of a measure of physical activity in the elderly. Arch Phys Med Rehabil. 1996;77:793–5.

    Article  PubMed  CAS  Google Scholar 

  16. Sumukadas D, McMurdo ME, Mangoni AA, Guthrie B. Temporal trends in anticholinergic medication prescription in older people: repeated cross-sectional analysis of population prescribing data. Age Ageing. 2014;43:515–21.

    Article  PubMed  Google Scholar 

  17. Lowry E, Woodman RJ, Soiza RL, Mangoni AA. Associations between the Anticholinergic Risk Scale score and physical function: potential implications for adverse outcomes in older hospitalized patients. J Am Med Dir Assoc. 2011;12:565–72.

    Article  PubMed  Google Scholar 

  18. Rojo-Sanchís AM, Vélez-Díaz-Pallarés M, Muñoz García M, Delgado Silveira E, Bermejo Vicedo T, Cruz-Jentoft A. Reduction of anticholinergic burden in older patients admitted to a multidisciplinary geriatric acute care unit. Eur Geriatr Med. 2017;8:492–5.

    Article  Google Scholar 

  19. Pasina L, Djade CD, Lucca U, Nobili A, Tettamanti M, Franchi C, et al. Association of anticholinergic burden with cognitive and functional status in a cohort of hospitalized elderly: comparison of the Anticholinergic Cognitive Burden scale and Anticholinergic Risk Scale. Drugs Aging. 2013;30:103–12.

    Article  PubMed  CAS  Google Scholar 

  20. ISD Scotland. The Scottish Index of Medical Deprivation (SIMD). http://www.isdscotland.org/Products-and-Services/GPD-Support/Deprivation/SIMD/. Accessed 29 Dec 2017.

  21. Fox KR, Hillsdon M, Sharp D, Cooper AR, Coulson JC, Davis M, et al. Neighbourhood deprivation and physical activity in UK older adults. Health Place. 2011;17:633–40.

    Article  PubMed  CAS  Google Scholar 

  22. Fox C, Smith T, Maidment I, Chan WY, Bua N, Myint PK, et al. Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review. Age Ageing. 2014;43:604–15.

    Article  PubMed  Google Scholar 

  23. Zia A, Kamaruzzaman S, Myint PK, Tan MP. Anticholinergic burden is associated with recurrent and injurious falls in older individuals. Maturitas. 2016;84:32–7.

    Article  PubMed  Google Scholar 

  24. Myint PK, Fox C, Kwok CS, Luben RN, Wareham NJ, Khaw KT. Total anticholinergic burden and risk of mortality and cardiovascular disease over 10 years in 21,636 middle-aged and older men and women of EPIC-Norfolk prospective population study. Age Ageing. 2015;44:219–25.

    Article  PubMed  Google Scholar 

  25. Kolla BP, Lovely JK, Mansukhani MP, Morgenthaler TI. Zolpidem is independently associated with increased risk of inpatient falls. J Hosp Med. 2013;8:1–6.

    Article  PubMed  Google Scholar 

  26. Dansie EJ, Turk DC, Martin KR, Van Domelen DR, Patel KV. Association of chronic widespread pain with objectively measured physical activity in adults: findings from the National Health and Nutrition Examination survey. J Pain. 2014;15:507–15.

    Article  PubMed  Google Scholar 

  27. Bonnefoy M, Normand S, Pachiaudi C, Lacour JR, Laville M, Kostka T. Simultaneous validation of ten physical activity questionnaires in older men: a doubly labelled water study. J Am Geriatr Soc. 2001;49(1):28–35.

    Article  PubMed  CAS  Google Scholar 

  28. Colbert LH, Matthews CE, Havighurst TC, Kyungmann K, Schoeller DA. Comparative validity of physical activity measures in older adults. Med Sci Sports Exerc. 2011;43:867–76.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bostock CV, Soiza RL, Magoni AA. Associations between different measures of anticholinergic drug exposure and Barthel Index in older hospitalized patients. Ther Adv Drug Saf. 2013;4:235–45.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Perry MA, Hendrick PA, Hale L, Baxter GD, Milosavljevic S, Dean SG, et al. Utility of the RT3 triaxial accelerometer in free living: An investigation of adherence and data loss. Appl Ergon. 2010;41:469–76.

    Article  PubMed  Google Scholar 

  31. Hendrick P, Milosavljevic S, Hale L, Hurley DA, McDonough SM, Herbison P, et al. Does a patient’s physical activity predict recovery from an episode of acute low back pain? A prospective cohort study. BMC Musculoskelet Disord. 2013;14:126.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Witham MD, Fulton RL, Greig CA, Johnston DW, Lang CC, van der Pol M, et al. Efficacy and cost of an exercise program for functionally impaired older patients with heart failure. Circ Heart Fail. 2012;5:209–16.

    Article  PubMed  Google Scholar 

  33. Sumukadas D, Witham MD, Struthers AD, McMurdo MET. Effect of perindopril on physical function in elderly people with functional impairment: a randomized controlled trial. CMAJ. 2007;177:867–74.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, University of Dundee, Dundee, UK

    Clare L. Clarke, Thenmalar Vadiveloo, Peter T. Donnan & Miles D. Witham

  2. Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, UK

    Falko F. Sniehotta

  3. Ageing and Health, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK

    Miles D. Witham

Authors
  1. Clare L. Clarke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Falko F. Sniehotta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thenmalar Vadiveloo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter T. Donnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miles D. Witham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miles D. Witham.

Ethics declarations

Funding

Funding for this study was provided by the Chief Scientist Office, Scottish Government Grants CZH/4/518 and CZG/2/569 and Tenovus Scotland Grant number T15/48.

Conflict of interest

Peter Donnan has received grants from Shire Pharmaceuticals, Gilead Sciences and Novo Nordisk, all outside the submitted work, and is a member of the New Drugs Committee for the Scottish Medicines Consortium. Clare Clarke, Falko Sniehotta, Thenmalar Vadiveloo and Miles Witham declare that they have no conflicts of interest potentially relevant to the content of this study.

Ethical Approval

This study was approved by the Tayside Committee on Medical Research Ethics (09/S1401/57 and 12/ES/0016).

Informed Consent

Written informed consent was obtained from all study participants at baseline and at follow-up.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clarke, C.L., Sniehotta, F.F., Vadiveloo, T. et al. Association Between Objectively Measured Physical Activity and Opioid, Hypnotic, or Anticholinergic Medication Use in Older People: Data from the Physical Activity Cohort Scotland Study. Drugs Aging 35, 835–842 (2018). https://doi.org/10.1007/s40266-018-0578-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40266-018-0578-7

Search

Navigation