Anticholinergic Drug Burden and Risk of Incident MCI and Dementia: A Population-based Study
Ariel Gildengers1, Gary P Stoehr2, Xinhui Ran3
1Departments of Psychiatry.
Objective:
We investigated whether anticholinergic drug use was related to developing mild cognitive impairment (MCI) or dementia in older adults at the population level.
Methods:
We used an Anticholinergic Rating (ACR) scale, Clinical Dementia Rating, APOE genotype, and number of prescription medications. We examined time to incident MCI and incident dementia in a population-based cohort (n=1959). We assessed whether developing MCI or dementia was associated with (1) any anticholinergic drug use, (2) total ACR score, or (3) number of anticholinergic drugs taken.
Results:
Taking any anticholinergic drug was significantly associated with higher risk of developing MCI; however, higher ACR score or higher number of anticholinergic drugs, compared with lower, were not associated with greater risk of developing MCI. We found no significant relationship between anticholinergic use and developing dementia. The relationship between anticholinergic use and cognitive outcome was not affected by APOE genotype.
Conclusions:
Among cognitively normal older adults in a population-based sample, anticholinergic drug use is independently associated with subsequently developing MCI, but not dementia. Thus, anticholinergic drug use may influence risk of MCI that is nonprogressive to dementia and potentially be a modifiable risk factor for MCI.
Insights
Anticholinergic drug use increases the risk of developing mild cognitive impairment (MCI) in older adults, but not dementia. This finding suggests anticholinergic use may be a modifiable risk factor for MCI.
Area of Science:
- Gerontology
- Pharmacology
- Neuroscience
Background:
- Anticholinergic drugs are commonly prescribed for older adults.
- Cognitive impairment, including mild cognitive impairment (MCI) and dementia, is a growing public health concern in aging populations.
Purpose of the Study:
- To investigate the association between anticholinergic drug use and the risk of developing mild cognitive impairment (MCI) or dementia in older adults.
- To determine if the total score on the Anticholinergic Rating (ACR) scale or the number of anticholinergic drugs used influences cognitive outcomes.
- To examine whether APOE genotype affects the relationship between anticholinergic use and cognitive decline.
Main Methods:
- A population-based cohort study of 1959 older adults was conducted.
- Anticholinergic drug use was assessed using the Anticholinergic Rating (ACR) scale and the number of prescribed anticholinergic medications.
- Time to incident MCI and dementia was analyzed, considering factors like Clinical Dementia Rating and APOE genotype.
Main Results:
- Any use of anticholinergic drugs was significantly associated with an increased risk of developing MCI.
- Higher total ACR scores or a greater number of anticholinergic drugs did not correlate with a higher risk of MCI.
- No significant association was found between anticholinergic drug use and the development of dementia.
- APOE genotype did not modify the relationship between anticholinergic use and cognitive outcomes.
Conclusions:
- Anticholinergic drug use is independently linked to a higher risk of developing MCI in cognitively normal older adults.
- The observed association suggests that anticholinergic use may contribute to MCI that does not progress to dementia.
- Anticholinergic drug use represents a potential modifiable risk factor for mild cognitive impairment.
More Related Videos
12:18A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
06:23The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
Related Concept Videos
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
01:22Alzheimer's Disease: Treatment
01:30Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
01:30Indirect-Acting Cholinergic Agonists: Pharmacological Actions
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
01:30Dementia
The progression of dementia is generally gradual....