Observational studyPharmacotherapy2018
Anticholinergics Influence Transition from Normal Cognition to Mild Cognitive Impairment in Older Adults in Primary Care.
Observational study in Pharmacotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 6 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- The Prognostic Utility of Anticholinergic Burden Scales: An Integrative Review and Gap Analysis.Drugs & aging · 2023Pooled 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
- The effects of anticholinergic medications on cognition in children: a systematic review and meta-analysis.Scientific reports · 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
- Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.Journal of the American Geriatrics Society · 2021Trial
- Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4 randomized, placebo-controlled study (PILLAR).BMC geriatrics · 2020Trial
- Verbal learning deficits associated with increased anticholinergic burden are attenuated with targeted cognitive training in treatment refractory schizophrenia patients.Schizophrenia research · 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
- Article
- Deprescribing Anticholinergics to Preserve Brain Health: Reducing the Risk of Dementia through Deprescribing (R2D2): Study Protocol for a Randomized Clinical Trial.Research square · 2024Article
- Medication burden and anticholinergic use are associated with overt HE in individuals with cirrhosis.Hepatology communications · 2024Article
- Increased anticholinergic medication use in middle-aged and older autistic adults and its associations with self-reported memory difficulties and cognitive decline.Autism research : official journal of the International Society for Autism Research · 2024Article
- Home medication inventory method to assess over-the-counter (OTC) medication possession and use: A pilot study on the feasibility of in-person and remote modalities with older adults.Research in social & administrative pharmacy : RSAP · 2024Article
- Development and Pilot Testing of an Algorithm-Based Approach to Anticholinergic Deprescribing in Older Patients.Drugs & aging · 2024Article
- The potential ofFrontiers in pharmacology · 2024Review
- Pharmacist-driven interventions to de-escalate urinary antimuscarinics in the Programs of All-Inclusive Care for the Elderly.Journal of the American Geriatrics Society · 2022Observational
- Deprescribing anticholinergics in primary care older adults: Experience from two models and impact on a continuous measure of exposure.Journal of the American College of Clinical Pharmacy : JACCP · 2022Article
- Combination and Novel Pharmacologic Agents for OAB.Current urology reports · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
STUDY
objectiveTo determine the influence of anticholinergic medications on transitions in cognitive diagnosis of older adults in primary care.
designThis observational cohort study was conducted over a mean follow-up of 3.2 years. Anticholinergic exposure was defined by pharmacy dispensing and claims records. Cognitive diagnosis was performed by an expert panel at baseline and annually up to 4 years. DATA SOURCE: Medication exposure and other clinical data were extracted from the Indiana Network for Patient Care (INPC). The cognitive diagnosis was derived from a cognitive screening and diagnosis study.
participantsA total of 350 adults 65 years and older without dementia and receiving primary care in a safety net health care system. MEASUREMENT AND MAIN
resultsCognitive diagnosis followed a two-phase screening and consensus-based neuropsychiatric examination to determine a baseline diagnosis as normal cognition, mild cognitive impairment (MCI), or dementia, with a follow-up neuropsychiatric examination and consensus-based diagnosis repeated annually. The Anticholinergic Cognitive Burden scale was used to identify anticholinergics dispensed up to 10 years before enrollment and annually throughout the study. A total standard daily dose of anticholinergics was calculated by using pharmacy dispensing data from the INPC. Among 350 participants, a total of 978 diagnostic assessments were completed over a mean follow-up of 3.2 years. Compared with stable cognition, increasing use of strong anticholinergics calculated by total standard daily dose increased the odds of transition from normal cognition to MCI (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01-1.31, p = 0.0342). Compared with stable MCI, strong anticholinergics did not influence the reversion of MCI to normal cognition (OR 0.95, 95% CI 0.86-1.05, p = 0.3266).
conclusionDe-prescribing interventions in older adults with normal cognition should test anticholinergics as potentially modifiable risk factors for cognitive impairment.
Indexed as
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What OpenQuestion holds
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.