Carnahan Ryan M, Chandramouleeshwaran Susmita, Ahsan Naba, Raymond Roger, Nobrega Jose N, Wang Wei, Fischer Corinne E, Flint Alastair J, Herrmann Nathan, Kumar Sanjeev, Lanctôt Krista L, Mah Linda, Mulsant Benoit H, Pollock Bruce G, Rajji Tarek K
Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, Iowa, USA.
Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.
Pharmacotherapy. 2025 Jun;45(6):332-340. doi: 10.1002/phar.70022. Epub 2025 May 6.
The Anticholinergic Drug Scale (ADS) is a commonly used measure of anticholinergic exposure. This study describes an expanded and revised version of the ADS (rADS) and its relationship with cultured cell-based serum anticholinergic activity (cSAA) and cognitive measures.
Adults aged 60 years and older with mild cognitive impairment (MCI), remitted major depressive disorder (rMDD), or both, participate in the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study.
Cross-sectional investigation of data from the PACt-MD study.
The rADS includes ratings for 1047 distinct products, about twice as many as the originally published scale; previously published ratings were revised for 40 drugs. Total rADS scores were calculated as sums of ratings of all drugs taken by participants; cSAA was measured in the participants' sera; cognitive performance included measures of executive function, language, processing speed, verbal memory, visuospatial memory, working memory, and an overall composite score.
The relationship between rADS total scores and cSAA was examined using a Spearman rank correlation coefficient. Relationships between rADS total scores and cognitive performance measures were explored in multivariable linear regression models.
The sample included 310 participants (mean [standard deviation] age: 72 (6) years; 61.6% were women, and 81.6% had MCI [with or without rMDD]). Total rADS scores were positively correlated with cSAA (Spearman's correlation coefficient: 0.178, p = 0.0016). Total rADS scores were not significantly associated with cognitive performance.
The revised scale is recommended as a replacement for the original ADS since it includes ratings for more drugs and was significantly, albeit weakly, associated with cSAA, similar to previous findings using the original ADS.
抗胆碱能药物量表（ADS）是一种常用的衡量抗胆碱能药物暴露情况的工具。本研究描述了ADS的扩展修订版（rADS）及其与基于培养细胞的血清抗胆碱能活性（cSAA）和认知指标的关系。
年龄在60岁及以上、患有轻度认知障碍（MCI）、缓解期重度抑郁症（rMDD）或两者兼有的成年人，参与了认知修复加经颅直流电刺激预防阿尔茨海默病痴呆症（PACt-MD）研究。
对PACt-MD研究的数据进行横断面调查。
rADS包括对1047种不同产品的评分，约为最初发表量表的两倍；对40种药物的先前发表评分进行了修订。rADS总分计算为参与者服用的所有药物评分之和；cSAA在参与者血清中进行测量；认知表现包括执行功能、语言、处理速度、言语记忆、视觉空间记忆、工作记忆和综合总分的测量。
使用Spearman等级相关系数检验rADS总分与cSAA之间的关系。在多变量线性回归模型中探讨rADS总分与认知表现指标之间的关系。
样本包括310名参与者（平均[标准差]年龄：72（6）岁；61.6%为女性，81.6%患有MCI[无论是否伴有rMDD]）。rADS总分与cSAA呈正相关（Spearman相关系数：0.178，p = 0.0016）。rADS总分与认知表现无显著关联。
建议使用修订后的量表替代原始ADS，因为它包括更多药物的评分，并且与cSAA有显著关联，尽管较弱，这与之前使用原始ADS的研究结果相似。
