Associations Between Midlife Anticholinergic Medication Use and Subsequent Cognitive Decline: A British Birth Cohort...

Area of Science:

• Neuroscience
• Gerontology
• Pharmacology

Background:

• Anticholinergic medication use is a known risk factor for cognitive decline and dementia.
• The impact of repeated or long-term anticholinergic exposure on cognitive trajectories requires further investigation.

Purpose of the Study:

• To examine the association between repeated anticholinergic medication exposure and cognitive decline in a prospective birth cohort.
• To determine if cognitive decline associated with anticholinergic use can be reversed upon medication reduction.

Main Methods:

• Utilized data from the Medical Research Council (MRC) National Survey of Health and Development, a British birth cohort.
• Quantified anticholinergic exposure using the Anticholinergic Cognitive Burden Scale (ACBS) from ages 53 to 69.
• Assessed global cognition (ACE-III), verbal memory (WLT), and processing speed (TLST) using regression models, adjusting for covariates.

Main Results:

• Anticholinergic exposure was cross-sectionally associated with lower global cognitive scores at age 69.
• Longitudinal analysis revealed that both mild-moderate and high ACBS scores were linked to lower verbal memory (WLT) scores.
• Processing speed (TLST) decline was associated with contemporaneous anticholinergic use, while verbal memory decline was linked to both historical and contemporaneous use.

Conclusions:

• Anticholinergic exposure during mid and later life is associated with diminished cognitive function.
• The negative impact on verbal memory persisted even when anticholinergic medication use was reduced, indicating lasting effects.
• Processing speed was specifically affected by current anticholinergic use, not past use.