Anticholinergic drugs and dementia risk: Using stem cell–based studies to complement pharmacoepidemiology
Alzheimer s & Dementia Translational Research & Clinical Interventions,
Год журнала:
2025,
Номер
11(1)
Опубликована: Янв. 1, 2025
Язык: Английский
Multiple Chronic Conditions and Polypharmacy in Cognitively Unimpaired Older Adults are Associated with Subsequent Cognitive Decline: Results from the National Alzheimer's Coordinating Center Data
Archives of Gerontology and Geriatrics,
Год журнала:
2025,
Номер
134, С. 105846 - 105846
Опубликована: Апрель 6, 2025
Язык: Английский
Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy
British Journal of Clinical Pharmacology,
Год журнала:
2023,
Номер
89(7), С. 2224 - 2235
Опубликована: Фев. 23, 2023
The
aim
of
this
study
is
to
estimate
the
association
between
anticholinergic
burden,
general
cognitive
ability
and
various
measures
brain
structural
MRI
in
relatively
healthy
middle-aged
older
individuals.
Язык: Английский
Cumulative anticholinergic exposure and white matter hyperintensity burden in community‐dwelling older adults
Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 19, 2024
Abstract
Background
Anticholinergic
exposure
is
associated
with
dementia
risk;
however,
the
mechanisms
for
this
association
remain
unclear.
The
objective
of
study
was
to
examine
between
anticholinergic
and
white
matter
hyperintensity
(WMH)
burden.
Methods
This
a
retrospective
analysis
data
from
Adult
Changes
in
Thought
(ACT)
study,
prospective
cohort
among
adults
aged
≥65
years
on
risk
factors.
We
used
collected
through
March
2020
analysis.
sample
included
ACT
participants
who
were
referred
had
clinical
magnetic
resonance
imaging
(MRI)
scan
≥10
continuous
healthcare
enrollment
prior
scan.
Our
primary
total
standardized
daily
dose
(TSDD)
anticholinergics.
Outcomes
three
semi‐quantitative
ratings
WMH
volume.
separate
linear
regression
models
each
outcome
estimate
compare
covariate‐adjusted
mean
values
group.
Results
Of
1043
individuals
analyses,
28%
no
use,
33%
1–90
TSDD,
15%
91–365
7%
366–1095
17%
≥1096
TSDD.
age
81
years,
most
female
(58%)
White
race
(88%).
Compared
those
TSDD
group
higher
(worse)
adjusted
[95%
confidence
intervals]
Fazekas
(4.0
[3.8,
4.2]
vs.
3.4
[3.2,
3.5];
p
:
<0.001),
Modified
Scheltens
(14.3
[13.4,
15.2]
12.2
[11.5,
12.9];
Age‐Related
Matter
(5.6
[5.3,
6.0]
4.8
[4.5,
5.1];
=
0.001).
A
dose–response
relationship
not
found.
Conclusions
highest
greater
Future
studies
should
focus
longitudinal
changes
burden
better
understand
biological
underlying
link
anticholinergics
risk.
Язык: Английский
Is there an anticholinergic effect of drugs beyond polypharmacy? A simulation study on death, dementia, and delirium in UK Biobank
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2024,
Номер
unknown
Опубликована: Авг. 6, 2024
The
use
of
anticholinergic
drugs
has
been
associated
with
adverse
health
outcomes.
However,
their
effects
cannot
be
completely
separated
from
the
general
polypharmacy
using
standard
methods.
objective
this
study
was
to
explore
extent
which
detrimental
attributed
burden
measured
by
scales
(ABS)
were
distinct
those
polypharmacy.
We
compared
observed
ABS
against
simulated
generated
pseudoscales
intended
measure
UK
Biobank
primary
care
data.
randomly
sampled
525
and
non-anticholinergic
prescribed
in
year
2015
~200,000
participants
an
average
age
65
years.
then
created
1,000
pseudoscales,
score
designed
represent
strength
background
effect
polypharmacy,
differentiating
constructed
capture
either
or
putative
exhibiting
similar
distributional
properties
23
real-world
(statistical
equivalence).
performed
individual
logistic
regressions
for
each
scale
estimate
associations
between
respectively,
risk
death,
dementia,
delirium.
Across
outcomes,
odds
ratios
anticholinergic-polypharmacy
on
0.03-0.05
greater
than
general-polypharmacy
pseudoscales.
number
composing
correlated
size
both
(r=~0.5,
p<0.001)
(r=~0.7,
p<0.001).
In
total,
50-90%
showed
stronger
majority
exhibited
studied
outcomes
would
expected
alone
(range
differences
ratios:
-0.05
0.20).
Most
existing
more
variance
association
delirium
alone,
but
varying
degrees
strength.
Язык: Английский
The anticholinergic burden in patients with chronic kidney disease: Patterns, risk factors, and the link with cognitive impairment
Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 28, 2024
Abstract
Background
People
with
chronic
kidney
disease
(CKD)
have
an
elevated
risk
of
cognitive
impairment
(CI).
Medications
anticholinergic
activity
are
recognized
for
their
adverse
reactions
on
central
nervous
system.
The
putative
association
between
the
burden
and
CI
has
not
previously
been
evaluated
in
patients
CKD.
study
aimed
to
(i)
describe
prescriptions
medications
activity,
(ii)
analyze
factors
associated
these
prescriptions,
(iii)
evaluate
burden's
performance.
Methods
CKD‐REIN,
a
prospective
cohort
study,
enrolled
nephrology
outpatients
confirmed
diagnosis
CKD
(eGFR
<60
mL/min/1.73m
2
).
Drug
were
recorded
prospectively
during
5‐year
follow‐up.
Mini
Mental
State
Examination
(MMSE)
was
assessed
at
baseline
defined
as
MMSE
score
<24/30.
For
each
patient,
determined
by
summing
Anticholinergic
Cognitive
Burden
(ACB)
scores
all
prescription
drugs
baseline.
Multinomial
logistic
regression
used
ACB
score.
Logistic
Results
At
baseline,
3007
(median
age
[IQR],
69[60–76];
65%
men)
had
data
included.
1549
(52%)
taking
least
one
drug
properties.
Most
(1092;
70%)
low
burden,
294
(19%)
moderate
163
(11%)
high
burden.
A
history
neurological/psychiatric
disorders
higher
number
daily
greater
probability
having
(odds
ratio
(OR)
[95%
confidence
interval
(95%
CI)]
=
1.88[1.29;2.74]
1.53[1.45;1.61],
respectively).
Patients
significantly
presenting
impairment,
compared
without
(OR[95%
CI]
1.76[1.12;2.75])
after
adjustment
sociodemographic
factors,
comorbidities,
laboratory
data,
taken
daily.
Conclusions
results
our
emphasize
need
caution
properties
Язык: Английский
A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank
José María Vera Mur,
M. Klee,
Heathcote R Wright
и другие.
American Journal of Epidemiology,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 11, 2024
Abstract
Observational
studies
have
reported
that
hearing
aid
(HA)
use
is
associated
with
a
reduced
risk
of
dementia
diagnosis,
suggesting
possible
protective
effect.
However,
extant
observational
do
not
explicitly
model
causal
effects,
while
randomised
controlled
trials
on
the
effect
HA
exhibit
short
follow-up.
Here
we
used
self-report,
tests,
and
healthcare
records
in
UK
Biobank
to
design
hypothetical
intervention
for
diagnosis
people
incident
loss
(HL).
users
exhibited
higher
than
non-users
(RR=1.43,
95%CI=1.08-1.88).
Associations
between
were
robust
across
sensitivity
analyses
(RRs:
1.34-1.59)
but
adjustment
primary
utilisation
(0.77,
0.44-1.33)
or
secondary
care
(0.68,
0.39-1.18)
substantially
decreased
observed
The
decrease
estimates
upon
(1.30,
0.95-1.78)
0.94-1.78)
was
smaller
when
participants
relatively
early
diagnoses
HL
included
sample
compared
they
not.
While
findings
are
conclusive,
suggest
residual
confounding
by
dating
without
data
Biobank.
Язык: Английский