Anticholinergics, executive function, and cognitive/behavioral changes in Down syndrome

Anticholinergic (AC) medication use is considered a risk factor for cognitive impairment and deterioration in the general population; yet, this has not been examined in Down syndrome (DS), a disorder with high dementia rates.

Family members of 108 young adults with DS (18-39 years) reported on their loved one's medication use, executive function, and changes in cognition and behavior using a dementia screener. Medications were coded for their AC potency using the CRIDECO Anticholinergic Load Scale (CALS).

Forty percent of the sample was taking at least one medication with a CALS AC potency of ≥1. These individuals were reported to have greater executive function difficulties and more changes in cognition/behavior relative to those not taking AC medications.

AC medication use may represent a modifiable risk factor for cognitive deterioration in adults with DS; more research on this topic, particularly with older adults with DS, is needed.

Identifying modifiable risk factors for dementia in Down syndrome (DS) is critical. A risk factor studied in the general population is anticholinergic (AC) medication. This risk factor has not been studied in DS, a high-risk group. AC medication use was associated with everyday cognitive challenges in young adults with DS. Longitudinal studies across adulthood, including older adults with DS, are needed.