ArticleAging clinical and experimental research2021
Mild polypharmacy and MCI progression in older adults: the mediation effect of drug-drug interactions.
Article in Aging clinical and experimental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 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
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Medicine Optimisation and Deprescribing Intervention Outcomes for Older People with Dementia or Mild Cognitive Impairment: A Systematic Review.Drugs & aging · 2025Pooled it
- Prevalence of Drug-Drug Interactions in Older Community-Dwelling Individuals: A Systematic Review and Meta-analysis.Drugs & aging · 2023 · on this mapPooled it
- Anticholinergic burden for prediction of cognitive decline or neuropsychiatric symptoms in older adults with mild cognitive impairment or dementia.The Cochrane database of systematic reviews · 2022Pooled it
- Nonagenarians with major neurocognitive disorder hospitalized in a high-complexity hospital.Dementia & neuropsychologia · 2026Article
- EVALUATION OF SCREENING TOOL OF OLDER PEOPLE'S PRESCRIPTIONS (STOPP) CRITERIA IN AN URBAN COHORT OF OLDER PEOPLE WITH HIV.Pharmacoepidemiology · 2025Article
- Pre-clinical Models for Geriatric Pharmacotherapy.Drugs & aging · 2024Review
- Polypharmacy and medication regimen complexity in transfusion-dependent thalassaemia patients: a cross- sectional study.International journal of clinical pharmacy · 2024Observational
- 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
- Patients with dementia: prevalence and type of drug-drug interactions.Frontiers in pharmacology · 2024Article
- Baseline Profiles of Drug Prescriptions Prior to Diagnosis of Mild Cognitive Impairment (MCI) Obtained by Latent Class Analysis (LCA), and Assessment of Their Association with Conversion to Dementia.Healthcare (Basel, Switzerland) · 2023Article
- Anticholinergic exposure and its association with dementia/Alzheimer's disease and mortality in older adults.BMC geriatrics · 2023Article
- Health-Related Predictors of Changes in Cognitive Status in Community-Dwelling Older Individuals.Frontiers in aging neuroscience · 2022Article
- Qiangji Decoction Alleviates Neurodegenerative Changes and Hippocampal Neuron Apoptosis Induced by D-GalactoseFrontiers in pharmacology · 2021Article
- Polypharmacy is associated with lower progression from MCI to Alzheimer's disease, with sex-specific patterns across drug classes.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundPolypharmacy has been associated with worse cognitive performance, but its impact on mild cognitive impairment (MCI) progression to dementia has not been explored.
aimsThe aims of the study were to investigate the association between multidrug regimens and MCI progression, and the possible mediation of drug-drug interactions and drugs' anticholinergic effect in such association.
methodsThis work included 342 older adults with MCI, who were involved in an Italian multicenter population-based cohort study. Information on drugs taken was derived from general practitioners' records and data on drug-drug interactions and anticholinergic burden [evaluated through the Anticholinergic Cognitive Burden and the Anticholinergic Risk Scale (ARS)] were extracted. Multinomial logistic regressions assessed the associations between mild polypharmacy (≥ 3 drugs/day), drug-drug interactions, and anticholinergic burden with MCI changes after 1-year follow-up. Mediation analysis evaluated potential mediators of that relationship.
resultsApproximately, 50% of participants took ≥ 3 drugs/day. During the follow-up, 4.1% of MCI patients progressed to dementia. The odds of developing dementia was sixfold higher in those who took ≥ 3drugs/day (OR = 6.04, 95% CI 1.19-30.74), eightfold higher in those with ≥ 1 drug-drug interaction/s (OR = 8.45, 95% CI 1.70-41.91), and fivefold higher in those with ARS ≥ 1 (OR = 5.10, 95% CI 1.04-24.93). Drug-drug interactions mediated 70.4% of the association between medication number and MCI progression to dementia (p = 0.07). DISCUSSION: Our study suggests that even mild polypharmacy may increase the risk of MCI progression to dementia, probably due to the presence of drug-drug interactions, which often occur in multidrug regimens.
conclusionsOlder people require careful management of pharmacological treatments, with special attention to drug-drug interactions and drug-related anticholinergic effects.
Indexed as
Identifiers
31758500What 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.