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Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan.
Geriatr Gerontol Int. 2017 Apr; 17 Suppl 1:57-64.GG

Abstract

AIM

The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan.

METHODS

This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study. The medication lists for all participants were reviewed by the same physician, and the anticholinergic properties of the individual medications were evaluated by using the Anticholinergic Cognitive Burden scale. Cognitive decline was defined as the decrease of Mini-Mental State Examinations scores during the study period.

RESULTS

Overall, 139 persons (50.7%) had exposure to anticholinergic drugs at baseline (designated as AC[+]), and the most frequently used anticholinergic drugs were cardiovascular drugs (48.2%), antipsychotics (21.6%), theophylline (20.1%), antidepressants (12.2%), gastrointestinal drugs (11.5%) and antihistamines (8.6%). After adjusting for covariates, AC(+) participants had a significantly higher risk for short-term cognitive decline (OR 2.69, 95% CI 1.36-5.31). After excluding 30 participants using antipsychotics, non-antipsychotics AC(+)participants still had a significantly higher risk for short-term cognitive decline (OR 2.24, 95% CI 1.26-3.99).

CONCLUSIONS

Exposure to anticholinergic drugs significantly increased the risk for short-term cognitive decline among older men, and the adverse effects remained similar when antipsychotics were excluded for analysis. A further intervention study is required to evaluate whether reducing anticholinergic burden might improve cognitive function among older adults. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 57-64.

Authors+Show Affiliations

Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.Department of Medicine, Changhua Christian Hospital, Changhua, Taiwan.Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28436193

Citation

Wu, Yi-Hui, et al. "Association Between Using Medications With Anticholinergic Properties and Short-term Cognitive Decline Among Older Men: a Retrospective Cohort Study in Taiwan." Geriatrics & Gerontology International, vol. 17 Suppl 1, 2017, pp. 57-64.
Wu YH, Wang CJ, Hung CH, et al. Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan. Geriatr Gerontol Int. 2017;17 Suppl 1:57-64.
Wu, Y. H., Wang, C. J., Hung, C. H., Chen, L. Y., Lin, M. H., Wang, P. N., & Chen, L. K. (2017). Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan. Geriatrics & Gerontology International, 17 Suppl 1, 57-64. https://doi.org/10.1111/ggi.13032
Wu YH, et al. Association Between Using Medications With Anticholinergic Properties and Short-term Cognitive Decline Among Older Men: a Retrospective Cohort Study in Taiwan. Geriatr Gerontol Int. 2017;17 Suppl 1:57-64. PubMed PMID: 28436193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between using medications with anticholinergic properties and short-term cognitive decline among older men: A retrospective cohort study in Taiwan. AU - Wu,Yi-Hui, AU - Wang,Chih-Jen, AU - Hung,Cheng-Hao, AU - Chen,Liang-Yu, AU - Lin,Ming-Hsien, AU - Wang,Pei-Ning, AU - Chen,Liang-Kung, PY - 2017/02/01/accepted PY - 2017/4/25/entrez PY - 2017/4/25/pubmed PY - 2018/3/6/medline KW - anticholinergic drugs KW - cognitive decline KW - non-antipsychotics KW - veterans home SP - 57 EP - 64 JF - Geriatrics & gerontology international JO - Geriatr Gerontol Int VL - 17 Suppl 1 N2 - AIM: The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan. METHODS: This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study. The medication lists for all participants were reviewed by the same physician, and the anticholinergic properties of the individual medications were evaluated by using the Anticholinergic Cognitive Burden scale. Cognitive decline was defined as the decrease of Mini-Mental State Examinations scores during the study period. RESULTS: Overall, 139 persons (50.7%) had exposure to anticholinergic drugs at baseline (designated as AC[+]), and the most frequently used anticholinergic drugs were cardiovascular drugs (48.2%), antipsychotics (21.6%), theophylline (20.1%), antidepressants (12.2%), gastrointestinal drugs (11.5%) and antihistamines (8.6%). After adjusting for covariates, AC(+) participants had a significantly higher risk for short-term cognitive decline (OR 2.69, 95% CI 1.36-5.31). After excluding 30 participants using antipsychotics, non-antipsychotics AC(+)participants still had a significantly higher risk for short-term cognitive decline (OR 2.24, 95% CI 1.26-3.99). CONCLUSIONS: Exposure to anticholinergic drugs significantly increased the risk for short-term cognitive decline among older men, and the adverse effects remained similar when antipsychotics were excluded for analysis. A further intervention study is required to evaluate whether reducing anticholinergic burden might improve cognitive function among older adults. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 57-64. SN - 1447-0594 UR - https://www.unboundmedicine.com/medline/citation/28436193/Association_between_using_medications_with_anticholinergic_properties_and_short_term_cognitive_decline_among_older_men:_A_retrospective_cohort_study_in_Taiwan_ L2 - https://doi.org/10.1111/ggi.13032 DB - PRIME DP - Unbound Medicine ER -