Fox, C. and Richardson, K. and Maidment, I. and Sawa, G. and Matthews, F. and Smithard, D. and Coulton, S. and Katona, C. and Boustani, M. and Brayne, C. (2011) Anticholinergic medication use and cognitive impairment in the older population: The Medical Research Council Cognitive Function and Ageing Study. Journal of the American Geriatrics Society, 59 (8). pp. 1477-1483. ISSN 0002-8614 .
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OBJECTIVES: To determine 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. DESIGN: A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. SETTING: Community-dwelling and institutionalized participants. 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)=0.03–0.64, P=.03) than not taking anticholinergics, whereas the use of possible anticholinergics at baseline was not associated with further decline (0.02, 95% CI=−0.14–0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30–2.16; P<.001) and possible (OR=1.56; 95% CI=1.36–1.79; P<.001) anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.
|Uncontrolled keywords:||anticholinergic activity;cognitive impairment;elderly|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC952 Geriatrics
|Divisions:||Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies|
|Depositing User:||Tony Rees|
|Date Deposited:||25 Jun 2012 15:26|
|Last Modified:||15 Feb 2013 12:20|
|Resource URI:||http://kar.kent.ac.uk/id/eprint/29696 (The current URI for this page, for reference purposes)|
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