Papenberg Goran, Bäckman Lars, Fratiglioni Laura, Laukka Erika J, Fastbom Johan, Johnell Kristina
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.
Neurobiol Aging. 2017 Jul;55:27-32. doi: 10.1016/j.neurobiolaging.2017.03.009. Epub 2017 Mar 16.
Anticholinergic drug use is common in older adults and has been related to increased dementia risk. This suggests that users of these drugs may experience accelerated cognitive decline. So far, however, longitudinal data on this topic are absent and the available evidence is inconclusive with respect to effects on specific cognitive domains due to suboptimal control of confounding variables. We investigated whether anticholinergic medication use is associated with cognitive decline over 6 years in a population-based study of older adults (aged 60-90; n = 1473) without dementia. We found that users (n = 29) declined more on episodic memory over 6 years compared to nonusers (n = 1418). These results were independent of age, sex, education, overall drug intake, physical activity, depression, cardiovascular risk burden, and cardiovascular disease. By contrast, anticholinergic drug use was unrelated to performance in processing speed, semantic memory, short-term memory, verbal fluency, and global cognition (the Mini-Mental-State Examination). Our results suggest that effects of anticholinergics may be particularly detrimental to episodic memory in older adults, which supports the assertion that the cholinergic system plays an important role in episodic memory formation.
抗胆碱能药物在老年人中使用普遍，且与痴呆风险增加有关。这表明这些药物使用者可能会经历认知能力加速衰退。然而，到目前为止，关于这一主题的纵向数据尚缺，并且由于混杂变量控制欠佳，现有证据在抗胆碱能药物对特定认知领域的影响方面尚无定论。在一项针对无痴呆的老年人群（年龄60 - 90岁；n = 1473）的基于人群的研究中，我们调查了使用抗胆碱能药物是否与6年内的认知衰退有关。我们发现，与未使用者（n = 1418）相比，使用者（n = 29）在6年内的情景记忆衰退更多。这些结果不受年龄、性别、教育程度、总体药物摄入量、身体活动、抑郁、心血管风险负担和心血管疾病的影响。相比之下，抗胆碱能药物的使用与加工速度、语义记忆、短期记忆、语言流畅性和整体认知（简易精神状态检查表）表现无关。我们的结果表明，抗胆碱能药物的影响可能对老年人的情景记忆特别有害，这支持了胆碱能系统在情景记忆形成中起重要作用的观点。
