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Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study.
J Am Geriatr Soc. 2011 Aug; 59(8):1477-83.JA

Abstract

OBJECTIVES

To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative.

DESIGN

A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993.

SETTING

Community-dwelling and institutionalized participants.

PARTICIPANTS

Thirteen thousand four participants aged 65 and older.

MEASUREMENTS

Baseline use of possible or definite anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years.

RESULTS

At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking anticholinergics, whereas the use of possible anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P<.001) and possible (OR=1.56; 95% CI=1.36-1.79; P<.001) anticholinergics.

CONCLUSION

The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.

Authors+Show Affiliations

Department of Psychiatry, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK. chris.fox@uea.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21707557

Citation

Fox, Chris, et al. "Anticholinergic Medication Use and Cognitive Impairment in the Older Population: the Medical Research Council Cognitive Function and Ageing Study." Journal of the American Geriatrics Society, vol. 59, no. 8, 2011, pp. 1477-83.
Fox C, Richardson K, Maidment ID, et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc. 2011;59(8):1477-83.
Fox, C., Richardson, K., Maidment, I. D., Savva, G. M., Matthews, F. E., Smithard, D., Coulton, S., Katona, C., Boustani, M. A., & Brayne, C. (2011). Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. Journal of the American Geriatrics Society, 59(8), 1477-83. https://doi.org/10.1111/j.1532-5415.2011.03491.x
Fox C, et al. Anticholinergic Medication Use and Cognitive Impairment in the Older Population: the Medical Research Council Cognitive Function and Ageing Study. J Am Geriatr Soc. 2011;59(8):1477-83. PubMed PMID: 21707557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. AU - Fox,Chris, AU - Richardson,Kathryn, AU - Maidment,Ian D, AU - Savva,George M, AU - Matthews,Fiona E, AU - Smithard,David, AU - Coulton,Simon, AU - Katona,Cornelius, AU - Boustani,Malaz A, AU - Brayne,Carol, Y1 - 2011/06/24/ PY - 2011/6/29/entrez PY - 2011/6/29/pubmed PY - 2011/10/25/medline SP - 1477 EP - 83 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 59 IS - 8 N2 - OBJECTIVES: To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. DESIGN: A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. SETTING: Community-dwelling and institutionalized participants. PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking anticholinergics, whereas the use of possible anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P<.001) and possible (OR=1.56; 95% CI=1.36-1.79; P<.001) anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/21707557/Anticholinergic_medication_use_and_cognitive_impairment_in_the_older_population:_the_medical_research_council_cognitive_function_and_ageing_study_ L2 - https://doi.org/10.1111/j.1532-5415.2011.03491.x DB - PRIME DP - Unbound Medicine ER -