Anticholinergic drugs and cognitive impairment in the elderly

Med Clin (Barc). 2018 Aug 22;151(4):141-144. doi: 10.1016/j.medcli.2018.01.014. Epub 2018 Mar 7.
[Article in English, Spanish]

Abstract

Objective: Describe the prevalence of the anticholinergic drugs (AD) used in patients who consult in regard to loss of memory. Assess the cognitive and functional repercussion of these drugs.

Patients and methods: Retrospective review of the clinic history of the patients who consulted the clinic in 2015 and 2016. We used the Anticholinergic Cognitive Burden Scale. We explored cognition with the Mini Mental State Examination (MMSE) and function with the Barthel Index and the Lawton and Brody Scale. We compared the difference of scale scores between the patients exposed and not exposed to AD.

Results: Sample size of 610 patients (mean age=81.1years), 71% female. 37.2% of patients took AD. The mean (SD) difference between exposed and not exposed patients and the year-on-year worsening rate of the Barthel Index and the Lawton and Brody Scale and MMSE were -4 (4.5), -0.3 (0.4) and -1 (0.9), respectively.

Conclusions: One third of patients who consulted for cognitive loss are taking AD. Patients exposed to AD show a greater tendency to impairment.

Keywords: Antagonistas colinérgicos; Cholinergic antagonists; Cognición; Cognition; Demencia; Dementia; Polifarmacia; Polypharmacy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinergic Antagonists / adverse effects*
  • Cholinergic Antagonists / therapeutic use
  • Cholinesterase Inhibitors / therapeutic use
  • Cognitive Dysfunction / chemically induced*
  • Female
  • Humans
  • Male
  • Mental Status and Dementia Tests
  • Middle Aged
  • Retrospective Studies

Substances

  • Cholinergic Antagonists
  • Cholinesterase Inhibitors