Evidence map›Paper›PMID 35764818›Full record

ArticleEuropean journal of clinical pharmacology2022

Anticholinergic burden and cognitive performance: cross-sectional results from the ELSA-Brasil study.

Adriana Nancy Medeiros Dos Santos, Guilherme Amorim Avilla Gimenez Junior, Isabela M Benseñor, Alessandra C Goulart, Andre R Brunoni, Maria Carmen Viana, Paulo A Lotufo, Claudia Kimie Suemoto

Abstract read
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In one paragraph

Article in European journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study.PCN reports : psychiatry and clinical neurosciences · 2025
    Article
  2. Article
  3. Health-related quality of life and use of medication with anticholinergic activity in patients with multiple myeloma.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Article
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

8 authors at 2 institutions in 1 country.

Adriana Nancy Medeiros Dos SantosDepartment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil. adriana.nancy.medeiros@usp.br.ORCID http://orcid.org/0000-0002-0705-9895
Guilherme Amorim Avilla Gimenez JuniorDepartment of Experimental Pathophysiology, University of Sao Paulo Medical School, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-9312-5774
Isabela M BenseñorDepartment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-6723-5678
Alessandra C GoulartDepartment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil.ORCID http://orcid.org/0000-0003-1076-5210
Andre R BrunoniDepartment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-6310-3571
Maria Carmen VianaDepartment of Social Medicine, Center of Psychiatric Epidemiology (CEPEP), Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.ORCID http://orcid.org/0000-0002-0464-4845
Paulo A LotufoDepartment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-4856-8450
Claudia Kimie SuemotoCenter for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0002-5942-4778
Universidade de São Paulo · BRUniversidade Federal do Espírito Santo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesUsing multiple drugs with anticholinergic properties is common and might lead to cumulative anticholinergic toxicity and increased risk of cognitive impairment. Therefore, we sought to investigate the association between the Anticholinergic Cognitive Burden (ACB) Scale and cognitive performance among middle-aged and older adults.

methodsIn this cross-sectional study with 13,065 participants from the baseline visit of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), mean age was 51.7 ± 9.0 years old, 55% women, and 53% white. The ACB was calculated based on the medications in use. We investigated the association of ACB with global cognition and memory, verbal fluency (VF), and trail-making test version B (TMT-B) z-scores, using multiple linear regression models adjusted for sociodemographic and clinical variables.

resultsOverall, 16% of participants had an ACB score greater than 0. ACB was associated with poor cognitive performance in all tests in crude analysis. After adjustment for sociodemographic characteristics, the association remained significant for the global cognitive score, as well as the memory and the TMT-B z-scores. However, after further adjustments for clinical variables, only trend associations of ACB with poor memory (β =  - 0.02, 95% Cl =  - 0.05, 0.00, p = 0.056) and the TMT-B z-scores (β =  - 0.02, 95% Cl =  - 0.04, 0.00, p = 0.054) were found. In stratified analyses by age groups, ACB was associated with poor cognitive performance on the TMT-B (β =  - 0.03, 95% Cl =  - 0.05, - 0.01, p = 0.005) in individuals aged less than 65 years old.

conclusionAlthough the ACB was associated with poor executive function only among middle-aged adults in adjusted analysis, residual confounding may partly explain our results.

Indexed as

Cholinergic AntagonistsCognitionAdultAgedBrazilCross-Sectional StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedCholinergic AntagonistsAnticholinergic burdenCognitionDementiaDrug utilization

Identifiers

PMID35764818
OpenAlexW4283713253

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.