Use of anticholinergics and the risk of cognitive impairment in an African American population

Anticholinergic properties of certain medications often go unrecognized, and are frequently used by the elderly population. Few studies have yet defined the long-term impact of these medications on the incidence of cognitive impairment. We report a 6-year longitudinal, observational study, evaluatin...

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Vydáno v:Neurology Ročník 75; číslo 2; s. 152
Hlavní autoři: Campbell, N L, Boustani, M A, Lane, K A, Gao, S, Hendrie, H, Khan, B A, Murrell, J R, Unverzagt, F W, Hake, A, Smith-Gamble, V, Hall, K
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 13.07.2010
Témata:
African Americans - genetics
Aged
Aged, 80 and over
Apolipoproteins E - genetics
Chi-Square Distribution
Cholinergic Antagonists - therapeutic use
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Cognition Disorders - genetics
Female
Humans
Incidence
Longitudinal Studies
Male
Neuropsychological Tests
Odds Ratio
Risk
Risk Factors
ISSN:1526-632X, 1526-632X
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Shrnutí:Anticholinergic properties of certain medications often go unrecognized, and are frequently used by the elderly population. Few studies have yet defined the long-term impact of these medications on the incidence of cognitive impairment. We report a 6-year longitudinal, observational study, evaluating 1,652 community-dwelling African American subjects over the age of 70 years who were enrolled in the Indianapolis-Ibadan Dementia Project between 2001 and 2007 and who had normal cognitive function at baseline. The exposure group included those who reported the baseline use of possible or definite anticholinergics as determined by the Anticholinergic Cognitive Burden scale. Our main outcome measure was the incidence of cognitive impairment, defined as either dementia or cognitive impairment not dementia, or poor performance on a dementia screening instrument during the follow-up period. At baseline, 53% of the population used a possible anticholinergic, and 11% used a definite anticholinergic. After adjusting for age, gender, educational level, and baseline cognitive performance, the number of definite anticholinergics was associated with an increased risk of cognitive impairment (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.07-1.99; p = 0.02), whereas the number of possible anticholinergics at baseline did not increase the risk (OR 0.96, 95% CI 0.85-1.09; p = 0.55). The risk of cognitive impairment among definite anticholinergic users was increased if they were not carriers of the APOE epsilon4 allele (OR 1.77, 95% CI 1.03-3.05; p = 0.04). Limiting the clinical use of definite anticholinergics may reduce the incidence of cognitive impairment among African Americans.
Bibliografie:ObjectType-Article-1
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0b013e3181e7f2ab