Journal article
Anticholinergic medication burden and cognitive function in participants of the ASPREE study
Pharmacotherapy, Vol.42(2), pp.134-144
02/2022
DOI: 10.1002/phar.2652
PMCID: PMC8863638
PMID: 34866212
Abstract
What is the association between anticholinergic burden and specific domains of cognitive function in older adults who are initially without major cognitive impairment?
Post-hoc analysis of longitudinal observational data from the ASPirin in Reducing Events in the Elderly (ASPREE) study.
19,114 participants from Australia and the United States aged 70 years and older (65 years and older for US minorities) were recruited and followed for a median of 4.7 years. At enrollment, participants were free of known cardiovascular disease, major physical disability, or dementia.
Cognitive assessments administered at baseline and biennially at follow-up visits included the Modified Mini-Mental State examination (3MS), Hopkins Verbal Learning Test-Revised (HVLT-R) delayed recall, Controlled Oral Word Association Test (COWAT), and Symbol Digit Modalities Test (SDMT). Anticholinergic burden was calculated at baseline using the Anticholinergic Cognitive Burden (ACB) scale and grouped as scores of 0 (no burden), 1-2 (low to moderate), or 3+ (high).
Linear mixed effects models were used to assess the relationship between ACB score and cognition over time. After adjusting for sex, age, education, minority status, smoking status, hypertension, diabetes, depression, chronic kidney disease, country, and frailty, participants with a high ACB score had worse performance over time for 3MS (Adjusted [Adj] B=-0.092, P=0.034), HVLT-R delayed recall (Adj B=-0.104, P<0.001), COWAT (Adj B=-0.151, P<0.001), and SDMT (Adj B=-0.129, P=0.026), than participants with an ACB score of 0. A low to moderate ACB score was also associated with worse performance over time for HVLT-R delayed recall (Adj B=-0.037, P=0.007) and COWAT (Adj B=-0.065, P=0.003), compared to those with no ACB.
Anticholinergic burden predicts worse cognitive function over time in initially dementia-free older adults, particularly for executive function (COWAT) and episodic memory (HVLT-R).
Details
- Title: Subtitle
- Anticholinergic medication burden and cognitive function in participants of the ASPREE study
- Creators
- Jonathan C Broder - Monash UniversityJoanne Ryan - Monash UniversityRaj C Shah - Rush UniversityJessica E Lockery - Monash UniversitySuzanne G Orchard - Monash UniversityJulia F-M Gilmartin-Thomas - Australian Institute for Musculoskeletal ScienceMichelle A Fravel - University of IowaAlice J Owen - Monash UniversityRobyn L Woods - Monash UniversityRory Wolfe - Monash UniversityElsdon Storey - Monash UniversityAnne M Murray - Berman Center for Outcomes and Clinical ResearchMichael E Ernst - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Pharmacotherapy, Vol.42(2), pp.134-144
- DOI
- 10.1002/phar.2652
- PMID
- 34866212
- PMCID
- PMC8863638
- NLM abbreviation
- Pharmacotherapy
- ISSN
- 0277-0008
- eISSN
- 1875-9114
- Grant note
- U01 AG029824 / NIA NIH HHS U19 AG062682 / NIA NIH HHS P30 AG024824 / NIA NIH HHS
- Language
- English
- Date published
- 02/2022
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297452202771
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