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

Nancy Raitano Lee1, Goldie A McQuaid2, Haila Jiddou1

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Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|October 13, 2025
PubMed
Summary
This summary is machine-generated.

Anticholinergic (AC) medication use may worsen cognitive challenges in young adults with Down syndrome (DS). This highlights a potential modifiable risk factor for cognitive decline in the DS population.

Keywords:
Down syndromeanticholinergic medicationcognitive declinedementia screeningexecutive functionintellectual disabilitymodifiable risk factor

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Genetics

Background:

  • Anticholinergic (AC) medication is a known risk factor for cognitive impairment in the general population.
  • Down syndrome (DS) is associated with a high prevalence of dementia.
  • The impact of AC medication on cognition in individuals with DS has not been previously studied.

Purpose of the Study:

  • To investigate the association between anticholinergic medication use and cognitive function in young adults with Down syndrome.
  • To identify potential modifiable risk factors for cognitive deterioration in the DS population.

Main Methods:

  • A study involving 108 young adults with DS (aged 18-39 years).
  • Family members reported on medication use, executive function, and cognitive/behavioral changes using a dementia screener.
  • Medications were assessed for anticholinergic potency using the CRIDECO Anticholinergic Load Scale (CALS).

Main Results:

  • Forty percent of participants were using at least one medication with a CALS AC potency of ≥1.
  • Individuals taking AC medications exhibited greater executive function difficulties.
  • These individuals also showed more reported changes in cognition and behavior compared to non-users.

Conclusions:

  • Anticholinergic medication use may be a modifiable risk factor for cognitive decline in adults with Down syndrome.
  • Further research, especially longitudinal studies including older adults with DS, is warranted.
  • Identifying such risk factors is crucial for managing dementia risk in the DS population.