Journal ArticleDOI
Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study
Chris Fox,Kathryn Richardson,Ian Maidment,Ian Maidment,George M. Savva,Fiona E. Matthews,David G. Smithard,David G. Smithard,Simon Coulton,Cornelius Katona,Malaz Boustani,Carol Brayne +11 more
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TLDR
Whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative is investigated.Abstract:
PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI) 50.03‐0.64, P 5.03) than not taking anticholinergics, whereas the use of possible anticholinergics at baseline was not associated with further decline (0.02, 95% CI 5 0.14‐0.11, P 5.79). Twoyear mortality was greater for those taking definite (OR 51.68; 95% CI 51.30‐2.16; Po.001) and possible (OR 51.56; 95% CI 51.36‐1.79;Po.001) anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. J Am Geriatr Soc 2011.read more
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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines
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Journal ArticleDOI
Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study.
Shelly L. Gray,Melissa L. Anderson,Sascha Dublin,Joseph T. Hanlon,Rebecca A. Hubbard,Rod L. Walker,Onchee Yu,Paul K. Crane,Eric B. Larson +8 more
TL;DR: In this paper, the authors examined whether cumulative anticholinergic use is associated with a higher risk for incident dementia and found a 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease.
Journal ArticleDOI
Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review
TL;DR: There is not one standardised tool for measuring anticholinergic burden, and Citation analysis of the individual scales showed that the Anticholinerential Cognitive Burden (ACB) scale was the most frequently validated expert based anticholergic scale for adverse outcomes.
Journal ArticleDOI
Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study
Carol Coupland,Trevor Hill,Tom Dening,Richard Morriss,Michael Moore,Julia Hippisley-Cox,Julia Hippisley-Cox +6 more
TL;DR: There were statistically significant associations of dementia risk with exposure to anticholinergic antidepressants, antiparkinson drugs, antipsychotic drugs, bladder antimuscarinics, and antiepileptic drugs after adjusting for confounding variables.
Journal ArticleDOI
Clinical practice with anti-dementia drugs: A revised (third) consensus statement from the British Association for Psychopharmacology
John T. O'Brien,Clive Holmes,Matthew Jones,Roy W. Jones,Gill Livingston,Ian G. McKeith,Peter Mittler,Peter Passmore,Craig W. Ritchie,Louise Robinson,Elizabeth L Sampson,John-Paul Taylor,Alan J. Thomas,Alistair Burns +13 more
TL;DR: The British Association for Psychopharmacology coordinated a meeting of experts to review and revise its previous 2011 guidelines for clinical practice with anti-dementia drugs, with the consensus statement focusing on medication.
References
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Journal ArticleDOI
Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales
Margaret M. Esiri,Fiona E. Matthews,Carol Brayne,P. G. Ince,F. E. Matthews,John H. Xuereb,J C Broome,J McKenzie,M Rossi,Ian G. McKeith,James Lowe,J H Morris +11 more
TL;DR: Alleged Alzheimer-type and vascular pathology were the major pathological correlates of cognitive decline in this elderly sample, as expected, but most patients had mixed disease, challenging conventional dementia diagnostic criteria in this setting.
Journal ArticleDOI
Impact of anticholinergics on the aging brain: a review and practical application
TL;DR: Criteria for assessing anticholinergic burden with a simple scale may represent a useful noninvasive tool to optimize geriatric pharmacotherapy and establish therapeutic guidelines in the presence of cognitive antICHolinergic adverse effects.
Journal ArticleDOI
Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study
Marie-Laure Ancelin,Sylvaine Artero,Florence Portet,Anne-Marie Dupuy,Jacques Touchon,Karen Ritchie +5 more
TL;DR: Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia.
Journal ArticleDOI
ADAMs family members as amyloid precursor protein α-secretases
TL;DR: How upregulation of α‐secretase activity by muscarinic agonists, cholesterol‐lowering drugs, steroid hormones, non‐steroidal anti‐inflammatory drugs, and metal ions may explain some of the therapeutic actions of these agents in Alzheimer's disease is discussed.
Journal ArticleDOI
The cognitive impact of anticholinergics: a clinical review.
Noll L. Campbell,Malaz Boustani,Tony Limbil,Carol A. Ott,Chris Fox,Ian Maidment,Cathy C. Schubert,Stephanie Munger,Donna M. Fick,David C. Miller,Rajesh Gulati +10 more
TL;DR: All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia, and recognition of certain medications may represent a potential tool to improve cognition.