ArticleJournal of the American Geriatrics Society2023
Longitudinal associations of anticholinergic medications on cognition and possible mitigating role of physical activity.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- The association between smoking status and aging cognitive trajectory accounting for bias in attrition.American journal of epidemiology · 2026Article
- CALS and ACB Scales are Associated with Physical and Cognitive Impairment and Predict Mortality in Nursing Home Residents.Drugs - real world outcomes · 2025Article
- Age and Sex Differences in Adverse Events Associated With Antipsychotics: An Analysis of the FDA Adverse Events Database.International journal of geriatric psychiatry · 2025Article
- Cumulative Anticholinergic Exposure and Change in Gait Speed and Grip Strength in Older Adults.JAMA network open · 2025Article
- Cumulative anticholinergic exposure and white matter hyperintensity burden in community-dwelling older adults.Journal of the American Geriatrics Society · 2025Article
- Medication Exposure and Risk of Dementia and Alzheimer's Disease.International journal of molecular sciences · 2024Review
- 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
- Effect of Increasing or Decreasing Use of Polypharmacy on Recovery of Activities of Daily Living in Patients With Stroke in the Recovery-Phase Rehabilitation Ward: A Retrospective Cohort Study Using Propensity Score Matching.Stroke research and treatment · 2024Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMany older adults take at least one prescription medication with anticholinergic (ACH) activity, which can impact the central nervous system and can lead to cognitive decline and impairment especially in an aging population susceptible to cognitive changes. We examined this relationship between ACH burden and cognitive function in middle-aged and older adults. We further determined if increased activity levels mitigated the relationships between ACH burden and cognition.
methodsData from The Reasons for Geographic and Racial Differences in Stroke project were used. We included 20,575 adults aged ≥45 years with longitudinal cognitive testing. The anticholinergic cognitive burden (ACB) scale was used to assess for ACH use and overall burden. Cognitive data included an overall composite score, a memory, and verbal fluency composites. Mixed effects models were conducted to determine if cognitive function worsened over time for participants with higher ACB (>3) scores. The full model adjusted for age, sex, race, education, diabetes, hypertension, cardiovascular disease, congestive heart failure, and dyslipidemia, self-reported physical activity (PA) and depressive symptoms.
resultsA significant relationship between ACH burden and composite cognitive scores was found (p = <0.001), with those with higher ACB showing more rapid cognitive decline over time. There was an effect of age for participants with higher ACB (>3) scores and ACB as a continuous variable. Baseline PA level was associated with less cognitive decline over time and this effect was greater in older cohorts.
conclusionsWe observed an effect of ACHs on cognition in adults ≥45 years old that worsened with age. ACH users showed more cognitive effects, whereas PA emerged as a possible mitigating factor.
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