ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2014
Long-term cognitive and functional effects of potentially inappropriate medications in older women.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 9 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 9 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Subjective cognitive decline and objective cognitive performance in older adults: A systematic review of longitudinal and cross-sectional studies.Journal of neuropsychology · 2025Pooled it
- Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models.Drugs & aging · 2021Pooled it
- Anticholinergic burden (prognostic factor) for prediction of dementia or cognitive decline in older adults with no known cognitive syndrome.The Cochrane database of systematic reviews · 2021Pooled it
- Quality of anticholinergic burden scales and their impact on clinical outcomes: a systematic review.European journal of clinical pharmacology · 2021Pooled it
- Anticholinergic drugs and incident dementia, mild cognitive impairment and cognitive decline: a meta-analysis.Age and ageing · 2020Pooled it
- Association between anticholinergic (atropinic) drug exposure and cognitive function in longitudinal studies among individuals over 50 years old: a systematic review.European journal of clinical pharmacology · 2019Pooled it
- Anticholinergic Drug Burden Tools/Scales and Adverse Outcomes in Different Clinical Settings: A Systematic Review of Reviews.Drugs & aging · 2018Pooled it
- The Association Between Anticholinergic Medication Burden and Health Related Outcomes in the 'Oldest Old': A Systematic Review of the Literature.Drugs & aging · 2015Pooled it
- Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review.BMC geriatrics · 2015Pooled it
- Effect of polypharmacy and potentially inappropriate medications on physical functional decline among older adults with advanced cancer receiving systemic treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Trial
- Baseline characteristics and comparability of older multimorbid patients with polypharmacy and general practitioners participating in a randomized controlled primary care trial.BMC family practice · 2021Trial
- Higher Fit-fOR-The-Aged (FORTA) Scores Comprising Medication Errors are Associated with Impaired Cognitive and Physical Function Tests in the VALFORTA Trial.Drugs & aging · 2019Trial
- DEFEAT-polypharmacy: deprescribing anticholinergic and sedative medicines feasibility trial in residential aged care facilities.International journal of clinical pharmacy · 2019Trial
- Anticholinergic exposure and cognitive decline in older adults: effect of anticholinergic exposure definitions in a 3-year analysis of the multidomain Alzheimer preventive trial (MAPT) study.British journal of clinical pharmacology · 2019Trial
- Cumulative Anticholinergic Exposure and Change in Gait Speed and Grip Strength in Older Adults.JAMA network open · 2025Article
- Frailty Focused Enhancements to Seniors' Hospital Care (FrESH): a Mixed Methods Study Reporting the Efficacy of Specialized Education for Front-line Staff.Canadian geriatrics journal : CGJ · 2025Article
- Article
- Polypharmacy, drug-drug interactions, anticholinergic burden and cognitive outcomes: a snapshot from a community-dwelling sample of older men and women in northern Italy.European journal of ageing · 2024Article
- Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.British journal of clinical pharmacology · 2023Article
- The association between socioeconomic status and use of potentially inappropriate medications in older adults.Journal of the American Geriatrics Society · 2023Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe use of potentially inappropriate medications in older adults can lead to known adverse drug events, but long-term effects are less clear. We therefore conducted a prospective cohort study of older women to determine whether PIM use is associated with risk of functional impairment or low cognitive performance.
methodsWe followed up 1,429 community-dwelling women (≥ 75 years) for a period of 5 years at four clinical sites in the United States. The primary predictor at baseline was PIM use based on 2003 Beers Criteria. We also assessed anticholinergic load using the Anticholinergic Cognitive Burden scale. Outcomes included scores on a battery of six cognitive tests at follow-up and having one or more incident impairments in instrumental activities of daily living. Regression models were adjusted for baseline age, race, education, smoking, physical activity, a modified Charlson Comorbidity Index, and cognitive score.
resultsThe mean ± SD age of women at baseline was 83.2 ± 3.3. In multivariate models, baseline PIM use and higher ACB scores were significantly associated with poorer performance in category fluency (PIM: p = .01; ACB: p = .02) and immediate (PIM: p = .04; ACB: p = .03) and delayed recall (PIM: p = .04). Both PIM use (odds ratio [OR]: 1.36 [1.05-1.75]) and higher ACB scores (OR: 1.11 [1.04-1.19]) were also strongly associated with incident functional impairment.
conclusionsThe results provide suggestive evidence that PIM use and increased anticholinergic load may be associated with risk of functional impairment and low cognitive performance. More cautious selection of medications in older adults may reduce these potential risks.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.