PMID- 19093918
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20220309
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 56
IP  - 12
DP  - 2008 Dec
TI  - Cumulative anticholinergic exposure is associated with poor memory and executive 
      function in older men.
PG  - 2203-10
LID - 10.1111/j.1532-5415.2008.02009.x [doi]
AB  - OBJECTIVES: To examine the longitudinal relationship between cumulative exposure 
      to anticholinergic medications and memory and executive function in older men. 
      DESIGN: Prospective cohort study. SETTING: A Department of Veterans Affairs 
      primary care clinic. PARTICIPANTS: Five hundred forty-four community-dwelling men 
      aged 65 and older with diagnosed hypertension. MEASUREMENTS: The outcomes were 
      measured using the Hopkins Verbal Recall Test (HVRT) for short-term memory and 
      the instrumental activity of daily living (IADL) scale for executive function at 
      baseline and during follow-up. Anticholinergic medication use was ascertained 
      using participants' primary care visit records and quantified as total 
      anticholinergic burden using a clinician-rated anticholinergic score. RESULTS: 
      Cumulative exposure to anticholinergic medications over the preceding 12 months 
      was associated with poorer performance on the HVRT and IADLs. On average, a 
      1-unit increase in the total anticholinergic burden per 3 months was associated 
      with a 0.32-point (95% confidence interval (CI)= 0.05-0.58) and 0.10-point (95% 
      CI=0.04-0.17) decrease in the HVRT and IADLs, respectively, independent of other 
      potential risk factors for cognitive impairment, including age, education, 
      cognitive and physical function, comorbidities, and severity of hypertension. The 
      association was attenuated but remained statistically significant with memory 
      (0.29, 95% CI=0.01-0.56) and executive function (0.08, 95% CI=0.02-0.15) after 
      further adjustment for concomitant non-anticholinergic medications. CONCLUSION: 
      Cumulative anticholinergic exposure across multiple medications over 1 year may 
      negatively affect verbal memory and executive function in older men. Prescription 
      of drugs with anticholinergic effects in older persons deserves continued 
      attention to avoid deleterious adverse effects.
FAU - Han, Ling
AU  - Han L
AD  - Department of Internal Medicine, Program on Aging, Yale University School of 
      Medicine, New Haven, Connecticut 06511, USA. ling.han@yale.edu
FAU - Agostini, Joseph V
AU  - Agostini JV
FAU - Allore, Heather G
AU  - Allore HG
LA  - eng
GR  - P30 AG021342/AG/NIA NIH HHS/United States
GR  - P30AG21342/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
RN  - 0 (Cholinergic Antagonists)
SB  - IM
MH  - *Activities of Daily Living
MH  - Aged
MH  - Cholinergic Antagonists/*adverse effects
MH  - Humans
MH  - Male
MH  - Memory Disorders/*chemically induced
MH  - Prospective Studies
PMC - PMC3952110
MID - NIHMS560938
EDAT- 2008/12/20 09:00
MHDA- 2009/01/23 09:00
PMCR- 2014/03/13
CRDT- 2008/12/20 09:00
PHST- 2008/12/20 09:00 [entrez]
PHST- 2008/12/20 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
PHST- 2014/03/13 00:00 [pmc-release]
AID - JGS2009 [pii]
AID - 10.1111/j.1532-5415.2008.02009.x [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2008 Dec;56(12):2203-10. doi: 10.1111/j.1532-5415.2008.02009.x.