Departments of Psychiatry.
Department of Pharmacy Practice, D'Youville University School of Pharmacy, Buffalo, NY.
Alzheimer Dis Assoc Disord. 2023;37(1):20-27. doi: 10.1097/WAD.0000000000000538. Epub 2023 Jan 18.
We investigated whether anticholinergic drug use was related to developing mild cognitive impairment (MCI) or dementia in older adults at the population level.
We used an Anticholinergic Rating (ACR) scale, Clinical Dementia Rating, APOE genotype, and number of prescription medications. We examined time to incident MCI and incident dementia in a population-based cohort (n=1959). We assessed whether developing MCI or dementia was associated with (1) any anticholinergic drug use, (2) total ACR score, or (3) number of anticholinergic drugs taken.
Taking any anticholinergic drug was significantly associated with higher risk of developing MCI; however, higher ACR score or higher number of anticholinergic drugs, compared with lower, were not associated with greater risk of developing MCI. We found no significant relationship between anticholinergic use and developing dementia. The relationship between anticholinergic use and cognitive outcome was not affected by APOE genotype.
Among cognitively normal older adults in a population-based sample, anticholinergic drug use is independently associated with subsequently developing MCI, but not dementia. Thus, anticholinergic drug use may influence risk of MCI that is nonprogressive to dementia and potentially be a modifiable risk factor for MCI.
我们旨在研究在人群水平上，抗胆碱能药物的使用是否与老年人轻度认知障碍（MCI）或痴呆的发展有关。
我们使用抗胆碱能药物评估量表（ACR）、临床痴呆评定量表、载脂蛋白 E 基因型和处方药物数量来进行研究。我们在一项基于人群的队列研究（n=1959）中，检测了 MCI 和痴呆的发病时间。我们评估了 MCI 或痴呆的发病是否与（1）使用任何抗胆碱能药物，（2）总 ACR 评分，或（3）服用的抗胆碱能药物数量有关。
服用任何抗胆碱能药物与发生 MCI 的风险显著增加相关；然而，与低评分相比，更高的 ACR 评分或更多的抗胆碱能药物与发生 MCI 的风险增加无关。我们没有发现抗胆碱能药物的使用与痴呆的发生之间存在显著的关系。ACOE 基因型并未影响抗胆碱能药物的使用与认知结果之间的关系。
在基于人群的认知正常老年人样本中，抗胆碱能药物的使用与随后发生的 MCI 独立相关，但与痴呆无关。因此，抗胆碱能药物的使用可能会影响到非进展性痴呆的 MCI 风险，并且可能成为 MCI 的一个可改变的风险因素。
