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Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population?
Drugs Aging. 2014 Oct; 31(10):749-54.DA

Abstract

BACKGROUND/OBJECTIVES

Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF.

DESIGN

This was a cross-sectional, retrospective, single-center study.

SETTING

The study was conducted in an outpatient setting.

PARTICIPANTS

Patients who presented to a comprehensive heart failure clinic during a 1-month period were included.

MEASUREMENTS

The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden).

RESULTS

A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score.

CONCLUSION

We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Shaukat A
Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA, arslan.shaukat@gmail.com.
Habib A
No affiliation info available
Lane KA
No affiliation info available
Shen C
No affiliation info available
Khan S
No affiliation info available
Hellman YM
No affiliation info available
Boustani M
No affiliation info available
Malik AS
No affiliation info available

MeSH

AgedAgingCholinergic AntagonistsCognition DisordersCross-Sectional StudiesFemaleHealth Services for the AgedHeart FailureHumansIndianaMaleMiddle AgedRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25142050

Citation

Shaukat, Arslan, et al. "Anticholinergic Medications: an Additional Contributor to Cognitive Impairment in the Heart Failure Population?" Drugs & Aging, vol. 31, no. 10, 2014, pp. 749-54.
Shaukat A, Habib A, Lane KA, et al. Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population? Drugs Aging. 2014;31(10):749-54.
Shaukat, A., Habib, A., Lane, K. A., Shen, C., Khan, S., Hellman, Y. M., Boustani, M., & Malik, A. S. (2014). Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population? Drugs & Aging, 31(10), 749-54. https://doi.org/10.1007/s40266-014-0204-2
Shaukat A, et al. Anticholinergic Medications: an Additional Contributor to Cognitive Impairment in the Heart Failure Population. Drugs Aging. 2014;31(10):749-54. PubMed PMID: 25142050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population? AU - Shaukat,Arslan, AU - Habib,Amir, AU - Lane,Kathleen A, AU - Shen,Changyu, AU - Khan,Saba, AU - Hellman,Yaron M, AU - Boustani,Malaz, AU - Malik,Adnan S, PY - 2014/8/22/entrez PY - 2014/8/22/pubmed PY - 2015/5/15/medline SP - 749 EP - 54 JF - Drugs & aging JO - Drugs Aging VL - 31 IS - 10 N2 - BACKGROUND/OBJECTIVES: Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. DESIGN: This was a cross-sectional, retrospective, single-center study. SETTING: The study was conducted in an outpatient setting. PARTICIPANTS: Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. MEASUREMENTS: The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). RESULTS: A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. CONCLUSION: We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients. SN - 1179-1969 UR - https://www.unboundmedicine.com/medline/citation/25142050/Anticholinergic_medications:_an_additional_contributor_to_cognitive_impairment_in_the_heart_failure_population DB - PRIME DP - Unbound Medicine ER -