Chronic Anticholinergic Use and the Aging Brain

dc.contributor.authorCai, Xueya
dc.contributor.authorCampbell, Noll
dc.contributor.authorKhan, Babar
dc.contributor.authorCallahan, Chris
dc.contributor.authorBoustani, Malaz
dc.contributor.departmentMedicine, School of Medicine
dc.date.accessioned2025-06-06T14:45:38Z
dc.date.available2025-06-06T14:45:38Z
dc.date.issued2013
dc.description.abstractBackground: Older Americans are facing an epidemic of chronic diseases and are thus exposed to anticholinergics (ACs) that might negatively affect their risk of developing mild cognitive impairment (MCI) or dementia. Objective: To investigate the association between impairment in cognitive function and previous AC exposure. Design: A retrospective cohort study. Setting: Primary care clinics in Indianapolis, Indiana. Participants: A total of 3690 older adults who have undergone cognitive assessment and had a 1-year medication-dispensing record. Outcome: Cognitive function was measured in two sequential steps: a two-step screening process followed by a formal diagnostic process for participants with positive screening results. Exposure: Three patterns of AC exposure were defined by the duration of AC exposure, the number of AC medications dispensed at the same time, and the severity of AC effects as determined by the Anticholinergic Cognitive Burden list. Results: Compared with older adults with no AC exposure and after adjusting for age, race, gender, and underlying comorbidity, the odds ratio for having a diagnosis of MCI was 2.73 (95% confidence interval, 1.27-5.87) among older adults who were exposed to at least three possible ACs for at least 90 days; the odds ratio for having dementia was 0.43 (95% confidence interval, 0.10-1.81). Conclusion: Exposure to medications with severe AC cognitive burden may be a risk factor for developing MCI.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationCai X, Campbell N, Khan B, Callahan C, Boustani M. Long-term anticholinergic use and the aging brain. Alzheimers Dement. 2013;9(4):377-385. doi:10.1016/j.jalz.2012.02.005
dc.identifier.urihttps://hdl.handle.net/1805/48551
dc.language.isoen_US
dc.publisherWiley
dc.relation.isversionof10.1016/j.jalz.2012.02.005
dc.relation.journalAlzheimer's & Dementia
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectAnticholinergics
dc.subjectCognitive impairment
dc.subjectDementia
dc.subjectMild cognitive impairment
dc.subjectElderly
dc.titleChronic Anticholinergic Use and the Aging Brain
dc.typeArticle
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