ArticleJournal of general internal medicine2021
A Cohort Study of Anticholinergic Medication Burden and Incident Dementia and Stroke in Older Adults.
Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis 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
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models.Drugs & aging · 2021Pooled it
- Japanese Anticholinergic Risk Scale and Domain-Specific Functional Outcomes in Older Poststroke Patients.Geriatrics & gerontology international · 2026Article
- Anticholinergic drug burden and incident cardiovascular events: a population-based study.BMC medicine · 2026Article
- The assessment of the relationship between anticholinergic burden and short-term blood pressure variability.BMC pharmacology & toxicology · 2025Article
- Anticholinergic burden and polypharmacy in patients referred from primary care to tertiary dementia centers in Brazil.Dementia & neuropsychologia · 2025Article
- Inequalities in the Quality and Safety of Post-Diagnostic Primary Care for People With Dementia: A Scoping Review.International journal of geriatric psychiatry · 2024Article
- Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson's Disease without Dementia.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2024Article
- Selecting a Brief Cognitive Screening Test Based on Patient Profile: It Is Never Too Early to Start.Journal of clinical medicine · 2024Article
- Antihypertensive medications and dementia in older adults with hypertension.medRxiv : the preprint server for health sciences · 2024Article
- Drug prescriptions in elderly hospitalized patients with cognitive impairment in the Italian Dementia Friendly Hospital project.Frontiers in pharmacology · 2024Article
- Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study.BMJ (Clinical research ed.) · 2023Article
- Higher Temperatures in Socially Vulnerable US Communities Increasingly Limit Safe Use of Electric Fans for Cooling.GeoHealth · 2023Article
- Classifying Polypharmacy According to Pharmacotherapeutic and Clinical Risks in Older Adults: A Latent Class Analysis in Quebec, Canada.Drugs & aging · 2023Article
- Geographically associated endophytic fungi contribute to the tropane alkaloids accumulation ofFrontiers in plant science · 2023Article
- Potential Targets for Deprescribing in Medically Complex Older Adults with Suspected Cognitive Impairment.Geriatrics (Basel, Switzerland) · 2022Article
- Anticholinergic medication burden and cognitive function in participants of the ASPREE study.Pharmacotherapy · 2022Article
- Anticholinergic Burden of Geriatric Ward Inpatients.Medicina (Kaunas, Lithuania) · 2021Article
- Anticholinergic burden and polypharmacy in hospitalized urology patients: Prevalence and clinical implications.Indian journal of urology : IJU : journal of the Urological Society of IndiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundAnticholinergic medications may increase risk of dementia and stroke, but prospective studies in healthy older people are lacking.
objectiveCompare risk of incident dementia and stroke by anticholinergic burden among initially healthy older people.
designProspective cohort study.
settingPrimary care (Australia and USA).
participants19,114 community-dwelling participants recruited for the ASPREE trial, aged 70+ years (65+ if US minorities) without major cardiovascular disease, dementia diagnosis, or Modified Mini-Mental State Examination score below 78/100. MEASUREMENTS: Baseline anticholinergic exposure was calculated using the Anticholinergic Cognitive Burden (ACB) score. Dementia was adjudicated using Diagnostic and Statistical Manual of Mental Disorders volume IV criteria, and stroke using the World Health Organization definition.
resultsAt baseline, 15,000 participants (79%) had an ACB score of zero, 2930 (15%) a score of 1-2, and 1184 (6%) a score of ≥ 3 (indicating higher burden). After a median follow-up of 4.7 years and adjusting for baseline covariates, a baseline ACB score of ≥ 3 was associated with increased risk of ischemic stroke (adjusted HR 1.58, 95% CI 1.06, 2.35), or dementia (adjusted HR 1.36, 95% CI 1.01, 1.82), especially of mixed etiology (adjusted HR 1.53, 95% CI 1.06, 2.21). Results were similar for those exposed to moderate/highly anticholinergic medications. LIMITATIONS: Residual confounding and reverse causality are possible. Assessment of dose or duration was not possible.
conclusionsHigh anticholinergic burden in initially healthy older people was associated with increased risk of incident dementia and ischemic stroke. A vascular effect may underlie this association. These findings highlight the importance of minimizing anticholinergic exposure in healthy older people.
Indexed as
Identifiers
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.