ArticleBritish journal of clinical pharmacology2023
Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.
Article in British journal of clinical pharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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
9 citing papers in PubMed, 10 citations in OpenAlex.
- Cognitive function in the context of pharmacogenetic CYP2D6 variability and anticholinergic burden in older adults - results from the ActiFE study.European journal of clinical pharmacology · 2026Article
- Associations of anticholinergic burden of medication with cognitive decline and longitudinal brain atrophy in the Alzheimer's disease spectrum.Frontiers in aging neuroscience · 2026Article
- A simulation study comparing anticholinergic drug use with polypharmacy for risk of death, dementia, and delirium in UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank.American journal of epidemiology · 2025Article
- Multiple chronic conditions and polypharmacy in cognitively unimpaired older adults are associated with subsequent cognitive decline: results from the national alzheimer's coordinating center data.Archives of gerontology and geriatrics · 2025Article
- Cumulative anticholinergic exposure and white matter hyperintensity burden in community-dwelling older adults.Journal of the American Geriatrics Society · 2025Article
- The anticholinergic burden in patients with chronic kidney disease: Patterns, risk factors, and the link with cognitive impairment.Journal of the American Geriatrics Society · 2025Article
- Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.British journal of clinical pharmacology · 2023Article
- Anticholinergic drugs and dementia risk: Using stem cell-based studies to complement pharmacoepidemiology.Alzheimer's & dementia (New York, N. Y.)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
aimsThe aim of this study is to estimate the association between anticholinergic burden, general cognitive ability and various measures of brain structural MRI in relatively healthy middle-aged and older individuals.
methodsIn the UK Biobank participants with linked health-care records (n = 163,043, aged 40-71 at baseline), of whom about 17 000 had MRI data available, we calculated the total anticholinergic drug burden according to 15 different anticholinergic scales and due to different classes of drugs. We then used linear regression to explore the associations between anticholinergic burden and various measures of cognition and structural MRI, including general cognitive ability, 9 separate cognitive domains, brain atrophy, volumes of 68 cortical and 14 subcortical areas and fractional anisotropy and median diffusivity of 25 white-matter tracts.
resultsAnticholinergic burden was modestly associated with poorer cognition across most anticholinergic scales and cognitive tests (7/9 FDR-adjusted significant associations, standardised betas (β) range: -0.039, -0.003). When using the anticholinergic scale exhibiting the strongest association with cognitive functions, anticholinergic burden due to only some classes of drugs exhibited negative associations with cognitive function, with β-lactam antibiotics (β = -0.035, P
conclusionsAnticholinergic burden is weakly associated with poorer cognition, but there is little evidence for associations with brain structure. Future studies might focus more broadly on polypharmacy or more narrowly on distinct drug classes, instead of using purported anticholinergic action to study the effects of drugs on cognitive ability.
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.