Anticholinergics Exposure and the Risk of Cognitive Decline

Boustani, M. and Fox, C. and Richardson, K. and Sawa, G.M. and Smithard, D. and Coulton, Simon and Katona, C. and Maidment, I. and Brayne, C. (2011) Anticholinergics Exposure and the Risk of Cognitive Decline. In: Annual Scientific Meeting on the American-Geriatrics-Society, May 11-14, 2011, National Harbor, MD. (doi: (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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BACKGROUND: The role of modifiable risk factors for patients with dementia and at risk of dementia requires investigation with large population studies. OBJECTIVES: To examine the association between anticholinergic medication use and cognitive decline in the older population DESIGN: A two-year longitudinal study of participants enrolled in the Medical Research Council (MRC) Cognitive Function and Ageing Study (CFAS) between 1991 and 1993. SETTING: Community and institionalized participants. PARTICIPANTS: A sample of 13,004 participants aged 65 years and older. MEASUREMENTS: Baseline use of possible or definite anticholinergics as determined by the Anticholinergic Cognitive Burden (ACB) scale, and cognition as determined by the Mini-Mental State Examination (MMSE). The main outcome measure was decline on the mini-mental state examination 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 non-anticholinergic medications, number of co-morbid health conditions and cognitive performance at baseline, the use of medication with definite anticholinergic effects was associated with an additional reduction in MMSE score of 0.43 points (95% CI 0.11, 0.75; p<0.008) compared to those not taking anticholinergics, whereas the use of possible anticholinergics at baseline was not associated with further MMSE decline (estimate=0.00 95% CI -0.11, 0.11; p=0.98). Two year mortality was increased both for those taking definite anticholinergic medications (OR 1.68; 95% CI 1.30, 2.16; p<0.001) and for those taking possible anticholinergic medications (OR 1.56; 95% CI: 1.36, 1.79; p<0.001). CONCLUSION: The benefits of prescribing definite anticholinergics may lead to unintended negative consequences on both cognitive function and mortality among the older population.

Item Type: Conference or workshop item (Paper)
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
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: 26 Aug 2014 12:55 UTC
Last Modified: 26 Aug 2014 12:55 UTC
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