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Anticholinergics Exposure and the Risk of Cognitive Decline

Boustani, M., Fox, C., Richardson, K., Sawa, G.M., Smithard, D., Coulton, Simon, Katona, C., Maidment, I., Brayne, C. (2011) Anticholinergics Exposure and the Risk of Cognitive Decline. In: Journal of the American Geriatrics Society. 59 (S1). S68-S69. Blackwell Publishing (doi:10.1111/j.1532-5415.2011.03416.x) (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) (KAR id:42680)

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Official URL
http://dx.doi.org/10.1111/j.1532-5415.2011.03416.x

Abstract

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)
DOI/Identification number: 10.1111/j.1532-5415.2011.03416.x
Subjects: R Medicine > RC Internal medicine > RC321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine > RC952 Geriatrics
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Coulton
Date Deposited: 26 Aug 2014 12:55 UTC
Last Modified: 16 Feb 2021 12:55 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/42680 (The current URI for this page, for reference purposes)
Coulton, Simon: https://orcid.org/0000-0002-7704-3274
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