title: Histamine2 receptor antagonist use and decline in cognitive function among community dwelling elderly.
abstract: OBJECTIVE
  Previous studies have reported mixed results regarding the use of histamine(2) receptor antagonist use and cognitive function. This study evaluated the relationship between the use of histamine(2) receptor antagonists and cognitive decline among community dwelling elderly.
  
  
  METHODS
  This cohort study included 2082 subjects from the Duke Established Populations for Epidemiologic Studies of the Elderly who were not cognitively impaired at baseline (1989/90). Histamine(2) receptor antagonist use was determined during in-home interviews. Cognitive function was assessed at 3 and 7 years after baseline by two measures: (1) incident cognitive impairment defined by the short portable mental status questionnaire (SPMSQ); and (2) cognitive decline (increase in two or more SPMSQ errors). Analyzes used multivariable discrete-time hazard models with weighted data adjusted for sampling design and controlled for demographic, health behavior characteristics and health status.
  
  
  RESULTS
  At baseline, nearly 5% of participants used a histamine(2) receptor antagonist. During follow-up, incident cognitive impairment occurred in 24.0%, whereas 34.5% increased by two or more errors on the SPMSQ. In multivariable models, current histamine(2) receptor antagonist users compared to never users had a higher risk for cognitive impairment (Adj. RR 1.51; 95%CI 0.93-2.47) and for decline in performance (increase of two or more errors) on the SPMSQ (Adj. RR 1.24; 95%CI 0.74-2.08). A nonsignificant increased risk of cognitive impairment and decline with either higher dose or short-term use was found whereas a nonsignificant protective effect on cognitive decline with current long-term use was seen.
  
  
  CONCLUSIONS
  These results suggest no beneficial effects, and perhaps a detrimental effect, of histamine(2) receptor antagonist use on cognitive function in community dwelling elderly.
authors.affiliation: Institute for the Study of Geriatric Pharmacotherapy, College of Pharmacy, 7-115 Weaver-Densford Hall, University of Minnesota, 308 Harvard Street., Minneapolis, MN 55455, USA. hanlo004@tc.umn.edu
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Artz
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Gerda G
authors.initials: GG
authors.lastname: Fillenbaum
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schmader
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000139:chemically induced*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D017891:Pharmacoepidemiology
chemical_list: D006635:Histamine H2 Antagonists