Evidence map›Paper›PMID 33985348›Full record

ArticleThe American journal of psychiatry2021

Anticholinergic Medication Burden-Associated Cognitive Impairment in Schizophrenia.

Yash B Joshi, Michael L Thomas, David L Braff, Michael F Green, Ruben C Gur, Raquel E Gur, Keith H Nuechterlein, William S Stone, Tiffany A Greenwood, Laura C Lazzeroni and 12 more

Open access · greenAbstract read
In one paragraph

Article in The American journal of psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 3 pooled it
18.2field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 3 syntheses or guidelines pooled it, 166 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. Trial
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  6. Trial
  7. Trial
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  9. Review
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  13. Observational
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  18. Observational
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  20. Article

33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 1 institution in 1 country.

Yash B JoshiDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Michael L ThomasDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
David L BraffDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Michael F GreenDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Ruben C GurDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Raquel E GurDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Keith H NuechterleinDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
William S StoneDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Tiffany A GreenwoodDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Laura C LazzeroniDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Laura R MacDonaldDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Juan L MolinaDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
John A NungarayDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Allen D RadantDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Jeremy M SilvermanDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Joyce SprockDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Catherine A SugarDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Debby W TsuangDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Ming T TsuangDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Bruce I TuretskyDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Neal R SwerdlowDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Gregory A LightDesert Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego (Joshi, Braff, MacDonald, Molina, Light, Sprock); Department of Psychiatry, University of California, San Diego, La Jolla (Joshi, Braff, Swerdlow, Greenwood, MacDonald, Molina, Nungaray, Sprock, M.T. Tsuang, Light); Department of Psychology, Colorado State University, Fort Collins (Thomas); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Nuechterlein, Sugar); Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green); Department of Psychiatry, University of Pennsylvania, Philadelphia (R.C. Gur, R.E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences and Department of Biomedical Data Science, Stanford University, Stanford, Calif. (Lazzeroni); Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Health Care System, Palo Alto, Calif. (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D.W. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Radant, D.W. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research and Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar).
Mott MacDonald (United Kingdom) · GB

Funding

The Genetics of Endophenotypes and SchizophreniaR01MH065571 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BRAFF, DAVID L. · 2003 to 2013
$7.0M
SENSORY GATING &HABITUATION IN SCHIZOPHRENIAR01MH042228 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BRAFF, DAVID L. · 1987 to 2015
$6.5M
The Genetics of Endophenotypes and SchizophreniaR01MH065578 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI GUR, RAQUEL E · 2003 to 2013
$4.2M
The Genetics of Endophenotypes and SchizophreniaR01MH065554 · NIMH · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI SIEVER, LARRY J · 2003 to 2013
$4.1M
Evolution of Psychosis in Youth: Multimodal Risk and Resilience MarkersR01MH119219 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI GUR, RAQUEL E, GUR, RUBEN C. · 2019 to 2023
$3.8M
Genetics of Endophenotypes and SchizophreniaR01MH065558 · NIMH · UNIVERSITY OF WASHINGTON · PI TSUANG, DEBBY WEN · 2003 to 2013
$3.7M
The Genetics of Endophenotypes and SchizophreniaR01MH065707 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI GREEN, MICHAEL F. · 2003 to 2013
$3.6M
Psychiatry Research Residency Training TrackR25MH101072 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI NEAL R SWERDLOW · 2013 to 2026
$2.8M
Pharmacologic augmentation of targeted cognitive training in schizophreniaR33MH123603 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SWERDLOW, NEAL R · 2020 to 2022
$2.3M
Memantine augmentation of cognitive training in schizophreniaR33MH125114 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LIGHT, GREGORY A · 2021 to 2023
$2.2M
Pathway(s) From Genes to Functional Deficits of Schizophrenia PatientsR01MH079777 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LIGHT, GREGORY A · 2007 to 2010
$1.4M
Neuroimaging and Neurocognitive Computerized Adaptive Testing in SchizophreniaK23MH102420 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI THOMAS, MICHAEL L · 2014 to 2018
$815k
NIMH NIH HHS K23 MH102420NIMH NIH HHS R01 MH042228NIMH NIH HHS R01 MH065554NIMH NIH HHS R01 MH065558NIMH NIH HHS R01 MH065571NIMH NIH HHS R01 MH065578NIMH NIH HHS R01 MH065707NIMH NIH HHS R01 MH079777NIMH NIH HHS R01 MH119219NIMH NIH HHS R25 MH101072NIMH NIH HHS R33 MH123603NIMH NIH HHS R33 MH125114RRD VA IK1 RX003683RRD VA IK2 RX003395
6 · The paper itself

Abstract

objectiveMany psychotropic medications used to treat schizophrenia have significant anticholinergic properties, which are linked to cognitive impairment and dementia risk in healthy subjects. Clarifying the impact of cognitive impairment attributable to anticholinergic medication burden may help optimize cognitive outcomes in schizophrenia. The aim of this study was to comprehensively characterize how this burden affects functioning across multiple cognitive domains in schizophrenia outpatients.

methodsCross-sectional data were analyzed using inferential statistics and exploratory structural equation modeling to determine the relationship between anticholinergic medication burden and cognition. Patients with a diagnosis of schizophrenia or schizoaffective disorder (N=1,120) were recruited from the community at five U.S. universities as part of the Consortium on the Genetics of Schizophrenia-2. For each participant, prescribed medications were rated and summed according to a modified Anticholinergic Cognitive Burden (ACB) scale. Cognitive functioning was assessed by performance on domains of the Penn Computerized Neurocognitive Battery (PCNB).

resultsACB score was significantly associated with cognitive performance, with higher ACB groups scoring worse than lower ACB groups on all domains tested on the PCNB. Similar effects were seen on other cognitive tests. Effects remained significant after controlling for demographic characteristics and potential proxies of illness severity, including clinical symptoms and chlorpromazine-equivalent antipsychotic dosage.

conclusionsAnticholinergic medication burden in schizophrenia is substantial, common, conferred by multiple medication classes, and associated with cognitive impairments across all cognitive domains. Anticholinergic medication burden from all medication classes-including psychotropics used in usual care-should be considered in treatment decisions and accounted for in studies of cognitive functioning in schizophrenia.

Indexed as

AdolescentAdultAgedCholinergic AntagonistsCognitionCognitive DysfunctionCohort StudiesCross-Sectional StudiesHumansMiddle AgedNeuropsychological TestsSchizophreniaYoung AdultCholinergic AntagonistsAnticholinergicsCognition/Learning/MemoryPsychopharmacologySchizophrenia Spectrum and Other Psychotic Disorders

Identifiers

PMID33985348
PMCPMC8440496
OpenAlexW3161355986

What OpenQuestion holds

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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.