SynthesisAge and ageing2020
Anticholinergic drugs and incident dementia, mild cognitive impairment and cognitive decline: a meta-analysis.
Synthesis in Age and ageing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 4 of them syntheses that pooled it.
What it found
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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
63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Systemic medications and dementia risk: a systematic umbrella review.Molecular psychiatry · 2025Pooled it
- Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review.BMC pharmacology & toxicology · 2022Pooled 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
- The effects of anticholinergic medications on cognition in children: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Cardiac Vagal Efficiency Is Enhanced by Percutaneous Auricular Neurostimulation in Adolescents With Nausea: Moderation by Antidepressant Drug Exposure.Neurogastroenterology and motility · 2025Trial
- Your brain doesn't look a day past 70! Cross-sectional associations with brain-predicted age in the cognitively-intact oldest-old.GeroScience · 2026Article
- Long-Term Antidepressant Use and Dementia Risk: A Propensity Score-Matched Study of Swiss Older Adults, with an Anticholinergic-Specific Analysis.Drugs - real world outcomes · 2026Article
- Review
- Long-Term Cardiovascular Risks of Anticholinergic Versus Non-Anticholinergic Antidepressants: A Target Trial Emulation With Negative Control Correction.Pharmacoepidemiology and drug safety · 2026Article
- How to advance the pharmacological management of cognitive impairment in Parkinson's disease.Journal of Parkinson's disease · 2026Review
- Navigating the challenges of overactive bladder management in women.World journal of urology · 2026Review
- Diagnosis and management of urinary incontinence in females.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Review
- Effects of Nonpharmacological and Nonsurgical Intervention for Lower Urinary Tract Symptoms in Parkinson's Disease: A Systematic Review and Meta-analysis.European urology open science · 2026Review
- Potentially inappropriate medications related to two-year progression of mild cognitive impairment and dementia.European journal of clinical pharmacology · 2026Article
- Association Rule Analysis of Cognitive Frailty Subtypes in Community-Dwelling Older Adults.Clinical interventions in aging · 2026Article
- Exposome influences: a multi-omics perspective on the combined toxic effects of pharmaceuticals and personal care products in Alzheimer's disease.Frontiers in toxicology · 2026Review
- Osteoporosis and risk of dementia among older adults: a population‑based cohort study.Bone research · 2025Observational
- Joint Effects of Anticholinergic Burden and Neurofilament Light on Dementia Risk: The Shanghai Aging Study.CNS neuroscience & therapeutics · 2025Article
- Short-term cognitive effects of anticholinergics in patients with neurogenic lower urinary tract dysfunction: A systematic review and meta-analysis.Biomedical reports · 2025Article
- Anticholinergic burden and incident dementia: a Swedish nationwide case-control study.Alzheimer's research & therapy · 2025Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundthe long-term effect of the use of drugs with anticholinergic activity on cognitive function remains unclear.
methodswe conducted a systematic review and meta-analysis of the relationship between anticholinergic drugs and risk of dementia, mild cognitive impairment (MCI) and cognitive decline in the older population. We identified studies published between January 2002 and April 2018 with ≥12 weeks follow-up between strongly anticholinergic drug exposure and the study outcome measurement. We pooled adjusted odds ratios (OR) for studies reporting any, and at least short-term (90+ days) or long-term (365+ days) anticholinergic use for dementia and MCI outcomes, and standardised mean differences (SMD) in global cognition test scores for cognitive decline outcomes. Statistical heterogeneity was measured using the I2 statistic and risk of bias using ROBINS-I.
resultstwenty-six studies (including 621,548 participants) met our inclusion criteria. 'Any' anticholinergic use was associated with incident dementia (OR 1.20, 95% confidence interval [CI] 1.09-1.32, I2 = 86%). Short-term and long-term use were also associated with incident dementia (OR 1.23, 95% CI 1.17-1.29, I2 = 2%; and OR 1.50, 95% CI 1.22-1.85, I2 = 90%). 'Any' anticholinergic use was associated with cognitive decline (SMD 0.15; 95% CI 0.09-0.21, I2 = 3%) but showed no statistically significant difference for MCI (OR 1.24, 95% CI 0.97-1.59, I2 = 0%).
conclusionsanticholinergic drug use is associated with increased dementia incidence and cognitive decline in observational studies. However, a causal link cannot yet be inferred, as studies were observational with considerable risk of bias. Stronger evidence from high-quality studies is needed to guide the management of long-term use.
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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.