Table 5. ORs for Total Cumulative Use of Different Types of Anticholinergic Drugs in the 1 to 11 Years Before the Index Date.
| Drug Type | Study Participants, No. (%) | Odds Ratio (95%CI) | |||
|---|---|---|---|---|---|
| Case Patients (n = 58 769) | Controls (n = 225 574) | Unadjusted | Adjusted for the Other Drug Typesa | Fully Adjustedb | |
| Antihistamines, TSDDs | |||||
| Nonuse | 52 312 (89.0) | 202 429 (89.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 4987 (8.5) | 18 187 (8.1) | 1.05 (1.02-1.09) | 1.02 (0.98-1.05) | 1.03 (0.99-1.07) |
| 91-365 | 923 (1.6) | 3105 (1.4) | 1.14 (1.06-1.23) | 1.06 (0.99-1.15) | 1.03 (0.95-1.12) |
| 366-1095 | 280 (0.5) | 1022 (0.5) | 1.06 (0.93-1.22) | 0.98 (0.85-1.12) | 1.02 (0.88-1.18) |
| >1095 | 267 (0.5) | 831 (0.4) | 1.22 (1.06-1.41) | 1.14 (0.99-1.31) | 1.14 (0.98-1.34) |
| Antidepressants, TSDDs | |||||
| Nonuse | 42 831 (72.9) | 173 014 (76.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 5098 (8.7) | 19 402 (8.6) | 1.08 (1.04-1.11) | 1.04 (1.01-1.08) | 1.02 (0.98-1.06) |
| 91-365 | 3463 (5.9) | 11 931 (5.3) | 1.20 (1.15-1.24) | 1.14 (1.10-1.19) | 1.12 (1.07-1.17) |
| 366-1095 | 2227 (3.8) | 6749 (3.0) | 1.35 (1.29-1.42) | 1.27 (1.20-1.33) | 1.25 (1.18-1.32) |
| >1095 | 5150 (8.8) | 14 478 (6.4) | 1.47 (1.42-1.52) | 1.34 (1.29-1.39) | 1.29 (1.24-1.34) |
| Antivertigo/Antiemetics, TSDDs | |||||
| Nonuse | 44 800 (76.2) | 176 584 (78.3) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 11 427 (19.4) | 41 159 (18.3) | 1.10 (1.07-1.12) | 1.06 (1.03-1.08) | 1.05 (1.02-1.08) |
| 91-365 | 1574 (2.7) | 5026 (2.2) | 1.23 (1.16-1.31) | 1.14 (1.08-1.21) | 1.14 (1.07-1.21) |
| 366-1095 | 617 (1.1) | 1659 (0.7) | 1.47 (1.34-1.61) | 1.33 (1.21-1.47) | 1.41 (1.27-1.56) |
| >1095 | 351 (0.6) | 1146 (0.5) | 1.20 (1.06-1.35) | 1.06 (0.94-1.20) | 1.08 (0.94-1.24) |
| Antiparkinson Agents, TSDDs | |||||
| Nonuse | 58 477 (99.5) | 225 047 (99.8) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 68 (0.1) | 179 (0.1) | 1.43 (1.08-1.90) | 1.04 (0.78-1.38) | 1.01 (0.73-1.39) |
| 91-365 | 50 (0.1) | 59 (0) | 3.29 (2.25-4.81) | 2.07 (1.40-3.05) | 1.68 (1.09-2.58) |
| 366-1095 | 39 (0.1) | 71 (0) | 2.08 (1.40-3.09) | 1.29 (0.86-1.94) | 1.03 (0.66-1.61) |
| >1095 | 135 (0.2) | 218 (0.1) | 2.39 (1.93-2.97) | 1.61 (1.29-2.03) | 1.52 (1.16-2.00) |
| Antipsychotics, TSDDs | |||||
| Nonuse | 56 957 (96.9) | 222 174 (98.5) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 388 (0.7) | 882 (0.4) | 1.71 (1.51-1.93) | 1.56 (1.38-1.76) | 1.44 (1.25-1.66) |
| 91-365 | 332 (0.6) | 695 (0.3) | 1.90 (1.66-2.17) | 1.67 (1.46-1.91) | 1.41 (1.21-1.65) |
| 366-1095 | 304 (0.5) | 490 (0.2) | 2.45 (2.12-2.83) | 2.15 (1.85-2.49) | 2.09 (1.76-2.47) |
| >1095 | 788 (1.3) | 1333 (0.6) | 2.29 (2.09-2.50) | 1.89 (1.72-2.07) | 1.70 (1.53-1.90) |
| Bladder Antimuscarinics, TSDDs | |||||
| Nonuse | 51 905 (88.3) | 206 796 (91.7) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 2139 (3.6) | 7005 (3.1) | 1.21 (1.15-1.27) | 1.18 (1.12-1.24) | 1.19 (1.13-1.26) |
| 91-365 | 1417 (2.4) | 4078 (1.8) | 1.38 (1.30-1.47) | 1.33 (1.25-1.41) | 1.35 (1.27-1.45) |
| 366-1095 | 1244 (2.1) | 2941 (1.3) | 1.71 (1.59-1.83) | 1.63 (1.52-1.74) | 1.65 (1.53-1.78) |
| >1095 | 2064 (3.5) | 4754 (2.1) | 1.73 (1.64-1.82) | 1.65 (1.57-1.74) | 1.65 (1.56-1.75) |
| Skeletal Muscle Relaxants, TSDDs | |||||
| Nonuse | 58 340 (99.3) | 224 006 (99.3) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 372 (0.6) | 1380 (0.6) | 1.08 (0.96-1.22) | 1.01 (0.89-1.14) | 0.98 (0.86-1.11) |
| 91-365 | 39 (0.1) | 115 (0.1) | 1.38 (0.95-1.99) | 1.17 (0.81-1.70) | 1.12 (0.77-1.65) |
| 366-1095 | 9 (0) | 41 (0) | 0.90 (0.44-1.88) | 0.84 (0.40-1.75) | 0.99 (0.46-2.10) |
| >1095 | 9 (0) | 32 (0) | 1.09 (0.52-2.29) | 0.90 (0.42-1.91) | 1.10 (0.47-2.55) |
| Gastrointestinal Antispasmodics, TSDDs | |||||
| Nonuse | 54 733 (93.1) | 210 093 (93.1) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 2765 (4.7) | 10 914 (4.8) | 0.97 (0.93-1.01) | 0.90 (0.86-0.94) | 0.90 (0.85-0.94) |
| 91-365 | 722 (1.2) | 2686 (1.2) | 1.05 (0.96-1.14) | 0.94 (0.86-1.02) | 0.93 (0.85-1.02) |
| 366-1095 | 267 (0.5) | 938 (0.4) | 1.11 (0.97-1.27) | 0.98 (0.85-1.12) | 0.93 (0.80-1.09) |
| >1095 | 282 (0.5) | 943 (0.4) | 1.19 (1.04-1.36) | 1.03 (0.90-1.18) | 1.04 (0.90-1.20) |
| Antiarrhythmics, TSDDs | |||||
| Nonuse | 58 720 (99.9) | 225 402 (99.9) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 9 (0) | 37 (0) | 0.88 (0.42-1.84) | 0.88 (0.42-1.84) | 0.74 (0.33-1.64) |
| 91-365 | 7 (0) | 20 (0) | 1.38 (0.58-3.28) | 1.35 (0.57-3.22) | 1.25 (0.44-3.53) |
| 366-1095 | 10 (0) | 27 (0) | 1.22 (0.58-2.56) | 1.16 (0.55-2.46) | 1.22 (0.56-2.66) |
| >1095 | 23 (0) | 88 (0) | 0.97 (0.61-1.55) | 0.99 (0.62-1.58) | 0.94 (0.56-1.55) |
| Antiepileptics, TSDDs | |||||
| Nonuse | 57 358 (97.6) | 221 082 (98) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 630 (1.1) | 2459 (1.1) | 0.98 (0.90-1.07) | 0.89 (0.81-0.97) | 0.88 (0.80-0.97) |
| 91-365 | 202 (0.3) | 592 (0.3) | 1.31 (1.12-1.54) | 1.17 (1.00-1.38) | 1.14 (0.95-1.36) |
| 366-1095 | 135 (0.2) | 359 (0.2) | 1.42 (1.16-1.74) | 1.25 (1.02-1.53) | 1.13 (0.90-1.41) |
| >1095 | 444 (0.8) | 1082 (0.5) | 1.58 (1.41-1.77) | 1.44 (1.28-1.61) | 1.39 (1.22-1.57) |
| Antimuscarinic Bronchodilators, TSDDs | |||||
| Nonuse | 54 891 (93.4) | 211 578 (93.8) | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1-90 | 1228 (2.1) | 4326 (1.9) | 1.10 (1.03-1.17) | 1.05 (0.99-1.13) | 0.99 (0.92-1.07) |
| 91-365 | 786 (1.3) | 2885 (1.3) | 1.05 (0.97-1.14) | 1.01 (0.93-1.09) | 0.97 (0.89-1.06) |
| 366-1095 | 742 (1.3) | 2719 (1.2) | 1.07 (0.99-1.16) | 1.02 (0.94-1.11) | 0.97 (0.88-1.06) |
| >1095 | 1122 (1.9) | 4066 (1.8) | 1.08 (1.01-1.16) | 1.05 (0.98-1.13) | 0.97 (0.90-1.05) |
Abbreviations: OR, odds ratio; TSDD, total standardized daily dose.
a
Adjusted for other anticholinergic drug types and matching by age, sex, general practice, and calendar time.
b
Adjusted for other anticholinergic drug types, body mass index, calculated as weight in kilograms divided by height in meters squared, smoking status, alcohol consumption, Townsend deprivation score, ethnic group, coronary heart disease, atrial fibrillation, heart failure, hypertension, hyperlipidemia, diabetes (type 1 and type 2), stroke, transient ischemic attack, subarachnoid hemorrhage, renal disease, asthma, chronic obstructive pulmonary disease, anxiety, depression, bipolar disorder, schizophrenia, severe head injury, cognitive decline/memory loss, antihypertensive drugs, aspirin, hypnotics, anxiolytic drugs, nonsteroidal antiinflammatory drugs, statins, and matching by age, sex, general practice, and calendar time.