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.
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.
| Original language | English |
|---|---|
| Article number | afr102 |
| Pages (from-to) | 730-735 |
| Number of pages | 6 |
| Journal | Age and Ageing |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 19 Sept 2011 |
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/40/6/730Keywords
- 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