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Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders.
Alzheimers Res Ther. 2017 Aug 01; 9(1):58.AR

Abstract

BACKGROUND

Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients.

METHODS

A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD). The AC burden was measured using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden (ACB), Chew's score, Han's score, and the number of drugs with AC activity. Functional, cognitive performance and behavior disturbances were assessed using the Instrumental Activities of Daily Living (IADL) scale (IADL), the Mini Mental State Examination (MMSE), and the Neuropsychiatric Inventory (NPI).

RESULTS

Among 473 included patients, 46.3% were at major NCD. Patients took on average 5.3 ± 2.6 drugs. MMSE was lower when Han's score (p = 0.04) and number of AC drugs were higher (p < 0.001). IADL was lower when AC burden was higher, whatever the AC measurement. NPI was higher when ACB, Han's score, and number of AC drugs were higher. After adjustment, all AC scores remained associated with IADL, while Han's score and number of drugs with AC remained associated with the MMSE.

CONCLUSIONS

In patients with SCD or NCD, AC burden is associated with lower functional score, whereas the cross-sectional association between AC burden and cognitive performance or behavioral disturbance varies according to AC scores. Particular attention should be paid when prescribing drugs with AC properties, especially among patients with memory complaints.

Authors+Show Affiliations

Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France. virginie.dauphinot@chu-lyon.fr. Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France. virginie.dauphinot@chu-lyon.fr.Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France. Hospices Civils de Lyon, Groupement Hospitalier, Service pharmaceutique, Lyon, France. Université Lyon 1, INSERM, U1028; UMR CNRS 5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France. Centre de Recherche Clinique (CRC) - VCF (Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France. Université Lyon 1, INSERM, U1028; UMR CNRS 5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28764796

Citation

Dauphinot, Virginie, et al. "Anticholinergic Drugs and Functional, Cognitive Impairment and Behavioral Disturbances in Patients From a Memory Clinic With Subjective Cognitive Decline or Neurocognitive Disorders." Alzheimer's Research & Therapy, vol. 9, no. 1, 2017, p. 58.
Dauphinot V, Mouchoux C, Veillard S, et al. Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders. Alzheimers Res Ther. 2017;9(1):58.
Dauphinot, V., Mouchoux, C., Veillard, S., Delphin-Combe, F., & Krolak-Salmon, P. (2017). Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders. Alzheimer's Research & Therapy, 9(1), 58. https://doi.org/10.1186/s13195-017-0284-4
Dauphinot V, et al. Anticholinergic Drugs and Functional, Cognitive Impairment and Behavioral Disturbances in Patients From a Memory Clinic With Subjective Cognitive Decline or Neurocognitive Disorders. Alzheimers Res Ther. 2017 Aug 1;9(1):58. PubMed PMID: 28764796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders. AU - Dauphinot,Virginie, AU - Mouchoux,Christelle, AU - Veillard,Sébastien, AU - Delphin-Combe,Floriane, AU - Krolak-Salmon,Pierre, Y1 - 2017/08/01/ PY - 2017/01/18/received PY - 2017/07/04/accepted PY - 2017/8/3/entrez PY - 2017/8/3/pubmed PY - 2018/5/16/medline KW - Adverse effects KW - Cognitive disorders and dementia KW - Functional disorders KW - Neuropharmacology SP - 58 EP - 58 JF - Alzheimer's research & therapy JO - Alzheimers Res Ther VL - 9 IS - 1 N2 - BACKGROUND: Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients. METHODS: A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD). The AC burden was measured using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden (ACB), Chew's score, Han's score, and the number of drugs with AC activity. Functional, cognitive performance and behavior disturbances were assessed using the Instrumental Activities of Daily Living (IADL) scale (IADL), the Mini Mental State Examination (MMSE), and the Neuropsychiatric Inventory (NPI). RESULTS: Among 473 included patients, 46.3% were at major NCD. Patients took on average 5.3 ± 2.6 drugs. MMSE was lower when Han's score (p = 0.04) and number of AC drugs were higher (p < 0.001). IADL was lower when AC burden was higher, whatever the AC measurement. NPI was higher when ACB, Han's score, and number of AC drugs were higher. After adjustment, all AC scores remained associated with IADL, while Han's score and number of drugs with AC remained associated with the MMSE. CONCLUSIONS: In patients with SCD or NCD, AC burden is associated with lower functional score, whereas the cross-sectional association between AC burden and cognitive performance or behavioral disturbance varies according to AC scores. Particular attention should be paid when prescribing drugs with AC properties, especially among patients with memory complaints. SN - 1758-9193 UR - https://www.unboundmedicine.com/medline/citation/28764796/Anticholinergic_drugs_and_functional_cognitive_impairment_and_behavioral_disturbances_in_patients_from_a_memory_clinic_with_subjective_cognitive_decline_or_neurocognitive_disorders_ L2 - https://alzres.biomedcentral.com/articles/10.1186/s13195-017-0284-4 DB - PRIME DP - Unbound Medicine ER -