Tags

Type your tag names separated by a space and hit enter

Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study.
Arch Intern Med. 2009 Jul 27; 169(14):1317-24.AI

Abstract

BACKGROUND

Despite the high intake of medications with anticholinergic properties by community-dwelling elderly persons, the effects on cognitive decline and dementia have rarely been evaluated.

METHODS

Participants were 4128 women and 2784 men 65 years or older from a population-based cohort recruited from 3 French cities. Cognitive performance, clinical diagnosis of dementia, and anticholinergic use were evaluated at baseline and 2 and 4 years later.

RESULTS

A total of 7.5% of the participants reported anticholinergic drug use at baseline. Multivariate-adjusted logistic regression indicated that women reporting use of anticholinergic drugs at baseline showed greater decline over 4 years in verbal fluency scores (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.11-1.79) and in global cognitive functioning (OR, 1.22; 95% CI, 0.96-1.55) than women not using anticholinergic drugs. In men, an association was found with decline in visual memory (OR, 1.63; 95% CI, 1.08-2.47) and to a lesser extent in executive function (OR, 1.47; 95% CI, 0.89-2.44). Notable interactions were observed in women between anticholinergic use and age, apolipoprotein E, or hormone therapy. A 1.4- to 2-fold higher risk of cognitive decline was observed for those who continuously used anticholinergic drugs but not for those who had discontinued use. The risk of incident dementia over the 4-year follow-up period was also increased in continuous users (hazard ratio [HR], 1.65; 95% CI, 1.00-2.73) but not in those who discontinued the use of anticholinergic drugs (HR, 1.28; 95% CI, 0.59-2.76).

CONCLUSIONS

Elderly people taking anticholinergic drugs were at increased risk for cognitive decline and dementia. Discontinuing anticholinergic treatment was associated with a decreased risk. Physicians should carefully consider prescription of anticholinergic drugs in elderly people, especially in the very elderly and in persons at high genetic risk for cognitive disorder.

Authors+Show Affiliations

Inserm, U888, Université Montpellier 1, Montpellier, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19636034

Citation

Carrière, Isabelle, et al. "Drugs With Anticholinergic Properties, Cognitive Decline, and Dementia in an Elderly General Population: the 3-city Study." Archives of Internal Medicine, vol. 169, no. 14, 2009, pp. 1317-24.
Carrière I, Fourrier-Reglat A, Dartigues JF, et al. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Arch Intern Med. 2009;169(14):1317-24.
Carrière, I., Fourrier-Reglat, A., Dartigues, J. F., Rouaud, O., Pasquier, F., Ritchie, K., & Ancelin, M. L. (2009). Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Archives of Internal Medicine, 169(14), 1317-24. https://doi.org/10.1001/archinternmed.2009.229
Carrière I, et al. Drugs With Anticholinergic Properties, Cognitive Decline, and Dementia in an Elderly General Population: the 3-city Study. Arch Intern Med. 2009 Jul 27;169(14):1317-24. PubMed PMID: 19636034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. AU - Carrière,Isabelle, AU - Fourrier-Reglat,Annie, AU - Dartigues,Jean-François, AU - Rouaud,Olivier, AU - Pasquier,Florence, AU - Ritchie,Karen, AU - Ancelin,Marie-Laure, PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2009/8/11/medline SP - 1317 EP - 24 JF - Archives of internal medicine JO - Arch Intern Med VL - 169 IS - 14 N2 - BACKGROUND: Despite the high intake of medications with anticholinergic properties by community-dwelling elderly persons, the effects on cognitive decline and dementia have rarely been evaluated. METHODS: Participants were 4128 women and 2784 men 65 years or older from a population-based cohort recruited from 3 French cities. Cognitive performance, clinical diagnosis of dementia, and anticholinergic use were evaluated at baseline and 2 and 4 years later. RESULTS: A total of 7.5% of the participants reported anticholinergic drug use at baseline. Multivariate-adjusted logistic regression indicated that women reporting use of anticholinergic drugs at baseline showed greater decline over 4 years in verbal fluency scores (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.11-1.79) and in global cognitive functioning (OR, 1.22; 95% CI, 0.96-1.55) than women not using anticholinergic drugs. In men, an association was found with decline in visual memory (OR, 1.63; 95% CI, 1.08-2.47) and to a lesser extent in executive function (OR, 1.47; 95% CI, 0.89-2.44). Notable interactions were observed in women between anticholinergic use and age, apolipoprotein E, or hormone therapy. A 1.4- to 2-fold higher risk of cognitive decline was observed for those who continuously used anticholinergic drugs but not for those who had discontinued use. The risk of incident dementia over the 4-year follow-up period was also increased in continuous users (hazard ratio [HR], 1.65; 95% CI, 1.00-2.73) but not in those who discontinued the use of anticholinergic drugs (HR, 1.28; 95% CI, 0.59-2.76). CONCLUSIONS: Elderly people taking anticholinergic drugs were at increased risk for cognitive decline and dementia. Discontinuing anticholinergic treatment was associated with a decreased risk. Physicians should carefully consider prescription of anticholinergic drugs in elderly people, especially in the very elderly and in persons at high genetic risk for cognitive disorder. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/19636034/Drugs_with_anticholinergic_properties_cognitive_decline_and_dementia_in_an_elderly_general_population:_the_3_city_study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinternmed.2009.229 DB - PRIME DP - Unbound Medicine ER -