Japanese Anticholinergic Risk Scale and Domain-Specific Functional Outcomes in Older Poststroke Patients
Abstract
Aim: International anticholinergic burden scales may incompletely capture country-specific prescribing patterns and drug availability. Although the Japanese Anticholinergic Risk Scale (JARS) reflects Japanese clinical practice, its prognostic relevance in poststroke patients remains unclear. We examined whether JARS was associated with functional outcomes across activities of daily living (ADL), cognition, swallowing, nutrition, and muscle strength in older patients after stroke.
Methods: This retrospective cohort study enrolled consecutive patients aged ≥ 65 years undergoing poststroke rehabilitation. Anticholinergic burden was assessed using JARS at admission. The primary outcome was Functional Independence Measure (FIM)-motor at discharge. Secondary outcomes were FIM-cognitive, Food Intake Level Scale, Geriatric Nutritional Risk Index (GNRI), and handgrip strength at discharge. Multivariable linear regression was performed for total JARS and, as an exploratory analysis, psychotropic drug-derived JARS, with adjustment for relevant covariates. p-values were adjusted across the five outcomes using the Benjamini-Hochberg false discovery rate (FDR) procedure.
Results: Among 747 patients (median age, 80.0 years; 51% men), 484 (64.8%) had a JARS score of ≥ 1. Total JARS was not associated with discharge FIM-motor score (B = 0.032, 95% CI -0.799 to 0.862), FIM-cognitive score, FILS, or handgrip strength. However, higher total JARS was negatively associated with GNRI at discharge…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 747 participants or records.
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