The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study

Chris Fox, Gill Livingston, Ian D. Maidment, Simon Coulton, David G. Smithard, Malaz Boustani, Cornelius Katona

Research output: Contribution to journalArticle

Abstract

Objective - to examine the effect of medications with anticholinergic effects on cognitive impairment and deterioration in Alzheimer's dementia (AD).
Methods - cognitive function was measured at baseline and at 6- and 18-month follow-up using the Mini-Mental State Exam (MMSE), the Severe Impairment Battery (SIB) and the Alzheimer's Disease Assessment Battery, Cognitive subsection (ADAS-COG) in a cohort study of 224 participants with AD. Baseline anticholinergic Burden score (ABS) was measured using the Anticholinergic Burden scale and included all prescribed and over the counter medication.
Results - the sample was 224 patients with Alzheimer's dementia and 71.4% were women. Their mean age was 81.0 years [SD 7.4 (range 55–98)]. The mean number of medications taken was 3.6 (SD 2.4) and the mean anticholinergic load was 1.1 (SD 1.4, range 0–7). The total number of drugs taken and anticholinergic load correlated (rho = 0.44; P < 0.01). There were no differences in MMSE and other cognitive functioning at either 6 or 18 months after adjusting for baseline cognitive function, age, gender and use of cholinesterase inhibitors between those with, and those without high anticholinergenic load.
Conclusions - medications with anticholinergic effect in patients with AD were not found to effect deterioration in cognition over the subsequent 18 months. Our study did not support a continuing effect of these medications on people with AD who are established on them.
LanguageEnglish
Article numberafr102
Pages730-735
Number of pages6
JournalAge and Ageing
Volume40
Issue number6
DOIs
Publication statusPublished - 19 Sep 2011

Fingerprint

Cholinergic Antagonists
Alzheimer Disease
Cognition
Cholinesterase Inhibitors
Cohort Studies
Pharmaceutical Preparations

Bibliographical note

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Age Ageing following peer review. The definitive publisher-authenticated version ox, C., Livingston, G. , Maidment, I. D., Coulton, S., Smithard, D. G., Boustani, M., & Katona, C. (2011). The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age and ageing, 40(6), 730-735 is available online at: http://ageing.oxfordjournals.org/content/40/6/730

Keywords

  • aged
  • 80 and over
  • Alzheimer disease
  • cholinergic antagonists
  • cognition disorders
  • cohort studies
  • Disease Progression
  • drug dose-response relationship
  • female
  • follow-up studies
  • Great Britain
  • humans
  • longitudinal studies
  • male
  • middle aged
  • severity of illness index
  • teatment outcome
  • dementia and anticholinergic burden
  • elderly
  • cognitive impairment

Cite this

Fox, C., Livingston, G., Maidment, I. D., Coulton, S., Smithard, D. G., Boustani, M., & Katona, C. (2011). The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age and Ageing, 40(6), 730-735. [afr102]. https://doi.org/10.1093/ageing/afr102
Fox, Chris ; Livingston, Gill ; Maidment, Ian D. ; Coulton, Simon ; Smithard, David G. ; Boustani, Malaz ; Katona, Cornelius. / The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. In: Age and Ageing. 2011 ; Vol. 40, No. 6. pp. 730-735.
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abstract = "Objective - to examine the effect of medications with anticholinergic effects on cognitive impairment and deterioration in Alzheimer's dementia (AD). Methods - cognitive function was measured at baseline and at 6- and 18-month follow-up using the Mini-Mental State Exam (MMSE), the Severe Impairment Battery (SIB) and the Alzheimer's Disease Assessment Battery, Cognitive subsection (ADAS-COG) in a cohort study of 224 participants with AD. Baseline anticholinergic Burden score (ABS) was measured using the Anticholinergic Burden scale and included all prescribed and over the counter medication. Results - the sample was 224 patients with Alzheimer's dementia and 71.4{\%} were women. Their mean age was 81.0 years [SD 7.4 (range 55–98)]. The mean number of medications taken was 3.6 (SD 2.4) and the mean anticholinergic load was 1.1 (SD 1.4, range 0–7). The total number of drugs taken and anticholinergic load correlated (rho = 0.44; P < 0.01). There were no differences in MMSE and other cognitive functioning at either 6 or 18 months after adjusting for baseline cognitive function, age, gender and use of cholinesterase inhibitors between those with, and those without high anticholinergenic load. Conclusions - medications with anticholinergic effect in patients with AD were not found to effect deterioration in cognition over the subsequent 18 months. Our study did not support a continuing effect of these medications on people with AD who are established on them.",
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Fox, C, Livingston, G, Maidment, ID, Coulton, S, Smithard, DG, Boustani, M & Katona, C 2011, 'The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study' Age and Ageing, vol. 40, no. 6, afr102, pp. 730-735. https://doi.org/10.1093/ageing/afr102

The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. / Fox, Chris; Livingston, Gill; Maidment, Ian D.; Coulton, Simon; Smithard, David G.; Boustani, Malaz; Katona, Cornelius.

In: Age and Ageing, Vol. 40, No. 6, afr102, 19.09.2011, p. 730-735.

Research output: Contribution to journalArticle

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T1 - The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study

AU - Fox, Chris

AU - Livingston, Gill

AU - Maidment, Ian D.

AU - Coulton, Simon

AU - Smithard, David G.

AU - Boustani, Malaz

AU - Katona, Cornelius

N1 - This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Age Ageing following peer review. The definitive publisher-authenticated version ox, C., Livingston, G. , Maidment, I. D., Coulton, S., Smithard, D. G., Boustani, M., & Katona, C. (2011). The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age and ageing, 40(6), 730-735 is available online at: http://ageing.oxfordjournals.org/content/40/6/730

PY - 2011/9/19

Y1 - 2011/9/19

N2 - Objective - to examine the effect of medications with anticholinergic effects on cognitive impairment and deterioration in Alzheimer's dementia (AD). Methods - cognitive function was measured at baseline and at 6- and 18-month follow-up using the Mini-Mental State Exam (MMSE), the Severe Impairment Battery (SIB) and the Alzheimer's Disease Assessment Battery, Cognitive subsection (ADAS-COG) in a cohort study of 224 participants with AD. Baseline anticholinergic Burden score (ABS) was measured using the Anticholinergic Burden scale and included all prescribed and over the counter medication. Results - the sample was 224 patients with Alzheimer's dementia and 71.4% were women. Their mean age was 81.0 years [SD 7.4 (range 55–98)]. The mean number of medications taken was 3.6 (SD 2.4) and the mean anticholinergic load was 1.1 (SD 1.4, range 0–7). The total number of drugs taken and anticholinergic load correlated (rho = 0.44; P < 0.01). There were no differences in MMSE and other cognitive functioning at either 6 or 18 months after adjusting for baseline cognitive function, age, gender and use of cholinesterase inhibitors between those with, and those without high anticholinergenic load. Conclusions - medications with anticholinergic effect in patients with AD were not found to effect deterioration in cognition over the subsequent 18 months. Our study did not support a continuing effect of these medications on people with AD who are established on them.

AB - Objective - to examine the effect of medications with anticholinergic effects on cognitive impairment and deterioration in Alzheimer's dementia (AD). Methods - cognitive function was measured at baseline and at 6- and 18-month follow-up using the Mini-Mental State Exam (MMSE), the Severe Impairment Battery (SIB) and the Alzheimer's Disease Assessment Battery, Cognitive subsection (ADAS-COG) in a cohort study of 224 participants with AD. Baseline anticholinergic Burden score (ABS) was measured using the Anticholinergic Burden scale and included all prescribed and over the counter medication. Results - the sample was 224 patients with Alzheimer's dementia and 71.4% were women. Their mean age was 81.0 years [SD 7.4 (range 55–98)]. The mean number of medications taken was 3.6 (SD 2.4) and the mean anticholinergic load was 1.1 (SD 1.4, range 0–7). The total number of drugs taken and anticholinergic load correlated (rho = 0.44; P < 0.01). There were no differences in MMSE and other cognitive functioning at either 6 or 18 months after adjusting for baseline cognitive function, age, gender and use of cholinesterase inhibitors between those with, and those without high anticholinergenic load. Conclusions - medications with anticholinergic effect in patients with AD were not found to effect deterioration in cognition over the subsequent 18 months. Our study did not support a continuing effect of these medications on people with AD who are established on them.

KW - aged

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KW - female

KW - follow-up studies

KW - Great Britain

KW - humans

KW - longitudinal studies

KW - male

KW - middle aged

KW - severity of illness index

KW - teatment outcome

KW - dementia and anticholinergic burden

KW - elderly

KW - cognitive impairment

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DO - 10.1093/ageing/afr102

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Fox C, Livingston G, Maidment ID, Coulton S, Smithard DG, Boustani M et al. The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age and Ageing. 2011 Sep 19;40(6):730-735. afr102. https://doi.org/10.1093/ageing/afr102