Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study.
OBJECTIVE
To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people.


METHODS
Longitudinal cohort study.


METHODS
63 randomly selected general practices in the Montpellier region of southern France.


METHODS
372 people aged > 60 years without dementia at recruitment.


METHODS
Anticholinergic burden from drug use, cognitive examination, and neurological assessment.


RESULTS
9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years.


CONCLUSIONS
Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors.
Ancelin
Marie L
ML
Inserm, E361, Pathologies of the Nervous System, 34093 Montpellier, France.
Artero
Sylvaine
S
Portet
Florence
F
Dupuy
Anne-Marie
AM
Touchon
Jacques
J
Ritchie
Karen
K
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000187:drug effects; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D003704:Dementia / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D004812:Epidemiologic Methods; D005602:France / Q000453:epidemiology; D006801:Humans; D007806:Language Disorders / Q000139:chemically induced / Q000453:epidemiology; D008569:Memory Disorders / Q000139:chemically induced / Q000453:epidemiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000187:drug effects; D013028:Space Perception / Q000187:drug effects; D013850:Thinking / Q000187:drug effects
D018680:Cholinergic Antagonists