Centre for Addiction and Mental Health (SC, NA, RR, JNN, WW, SK, BHM, BGP, TKR), Toronto, Canada; Department of Psychiatry (JNB, WW, CEF, AJF, NH, SK, KL, LM, BHM, BGP, TKR), University of Toronto, Toronto, Canada.
Centre for Addiction and Mental Health (SC, NA, RR, JNN, WW, SK, BHM, BGP, TKR), Toronto, Canada.
Am J Geriatr Psychiatry. 2021 Dec;29(12):1239-1252. doi: 10.1016/j.jagp.2021.03.002. Epub 2021 Mar 18.
Anticholinergic burden has been associated with deleterious effects on cognition particularly in those with an underlying brain disorder. We developed a new assay based on cultured cells to measure serum anticholinergic activity (cSAA). We report on its relationships with established anticholinergic burden rating scales and cognitive assessments in older patients with mild cognitive impairment (MCI) or major depressive disorder (MDD) in remission or both.
The study was cross sectional in nature.
This was a five-centre study conducted in Toronto, Canada.
Serum samples were collected and cSAA levels were measured in 311 participants aged 60 years or older (154 with MCI, 57 with MDD, and 100 with MCI + MDD).
The cSAA assay uses radio-ligand binding to cultured cells stably expressing the muscarinic M1 receptors, with an added procedure to remove potential confounds associated with serum proteins. Lists of medications were used to calculate Anticholinergic Burden and Anticholinergic Drug Scale total scores. Participants also completed a comprehensive cognitive battery.
Higher cSAA levels were associated with higher anticholinergic burden and anticholinergic drug scale scores, and also with lower performance on executive function tests, after adjusting for age, gender, education, and diagnosis.
These results support the use of the cSAA assay as a laboratory measure of anticholinergic burden.
抗胆碱能负担与认知功能损害有关，尤其在存在潜在脑疾病的患者中更为明显。我们开发了一种基于细胞培养的新测定法来测量血清抗胆碱能活性（cSAA）。我们报告了其与老年轻度认知障碍（MCI）或缓解期的重性抑郁障碍（MDD）或两者兼有患者的既定抗胆碱能负担评分量表和认知评估之间的关系。
本研究为横断面研究。
这是在加拿大多伦多进行的一项五中心研究。
收集了 311 名年龄在 60 岁或以上的参与者的血清样本并测量了 cSAA 水平（154 名 MCI，57 名 MDD，100 名 MCI+MDD）。
cSAA 测定法使用放射性配体与稳定表达毒蕈碱 M1 受体的培养细胞结合，并采用额外的程序来去除与血清蛋白相关的潜在混杂因素。药物清单用于计算抗胆碱能负担和抗胆碱能药物量表的总评分。参与者还完成了全面的认知测试。
在调整年龄、性别、教育程度和诊断后，较高的 cSAA 水平与较高的抗胆碱能负担和抗胆碱能药物量表评分相关，与执行功能测试的表现降低相关。
这些结果支持使用 cSAA 测定法作为抗胆碱能负担的实验室测量。
