Evidence map›Paper›PMID 39911736›Full record

ArticleAlzheimer's & dementia (New York, N. Y.)

Anticholinergic drugs and dementia risk: Using stem cell-based studies to complement pharmacoepidemiology.

Tiara A Schwarze-Taufiq, Inez K A Pranoto, Katherine Hui, Chizuru Kinoshita, Onchee Yu, Paul K Crane, Shelly L Gray, Jessica E Young

Abstract read
In one paragraph

Article in Alzheimer's & dementia (New York, N. Y.). 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
–field-weighted citation impact
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.

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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.

Tiara A Schwarze-TaufiqDepartment of Laboratory Medicine and Pathology University of Washington Seattle Washington USA.
Inez K A PranotoDepartment of Laboratory Medicine and Pathology University of Washington Seattle Washington USA.
Katherine HuiDepartment of Laboratory Medicine and Pathology University of Washington Seattle Washington USA.
Chizuru KinoshitaDepartment of Laboratory Medicine and Pathology University of Washington Seattle Washington USA.
Onchee YuKaiser Permanente Washington Health Research Institute Seattle Washington USA.
Paul K CraneDepartment of Medicine University of Washington Seattle Washington USA.
Shelly L GraySchool of Pharmacy University of Washington Seattle Washington USA.
Jessica E YoungDepartment of Laboratory Medicine and Pathology University of Washington Seattle Washington USA.ORCID https://orcid.org/0000-0003-2106-0339

Funding

Translational pharmacoepidemiology: neuroprotection and neurotoxicity of antihypertensives and strong anticholinergicsU19AG066567 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI Christine L MacDonald · 2021 to 2026
$80.4M
NIA NIH HHS U19 AG066567
6 · The paper itself

Abstract

backgroundAnticholinergic (AC) use remains common in older adults despite evidence of safety risks, including increased risk in dementia. Pharmacoepidemiology studies from various populations report associations between specific anticholinergic classes - antidepressants and bladder antimuscarinics - and increased dementia incidence. However, it is difficult to determine whether these associations are directly caused by the neurotoxic effects of anticholinergic drugs or by the underlying health conditions which the medications are taken for, known as confounding by indication. Here, we leverage human induced pluripotent stem cells-derived-neurons (hiPSC-Ns) to complement the pharmacoepidemiology studies by directly examining the effects of various anticholinergic classes on dementia-related cellular phenotypes.

methodsWe treated human induced pluripotent stem cell (hiPSC)-derived neurons with eight drugs representing different AC medication classes, including antidepressants, bladder antimuscarinics, antihistamines, and antispasmodics. We analyzed these neurons for cytotoxicity, amyloid beta (Aβ) peptide levels in the conditioned medium, and the level of intracellular phosphorylated tau from these cultures.

resultsWe observed that antidepressants and bladder antimuscarinics were consistently cytotoxic, whereas antihistamines and antispasmodics did not show overt cytotoxicity at the times and concentrations that we tested. Some of the cytotoxic medications altered the amounts of Aβ1-42 peptides, but there were no significant differences in the intracellular ratio of phosphorylated tau/total tau between AC drug treatments.

conclusionsThese results corroborate population-based studies and suggest a molecular basis for the differences in dementia risk observed according to AC class. This warrants future work examining the effect of AC medications on hiPSC-derived cells from multiple subjects and examining other molecular outcomes including synaptic function and neuroinflammation in hiPSC-based models. Highlights: Certain classes of anticholinergic (AC) medications are linked to dementia.Human-induced pluripotent stem cell (hiPSC) models are used to directly test the cytotoxicity of AC medications.AC classes that are associated with dementia are more neurotoxic.

Indexed as

Alzheimer's diseaseanticholinergicscytotoxicityhuman induced pluripotent stem cellspharmacoepidemiology

Identifiers

PMID39911736
PMCPMC11795422

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