title: The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study.
abstract: OBJECTIVE
  to examine the effect of medications with anticholinergic effects on cognitive impairment and deterioration in Alzheimer's dementia (AD).
  
  
  METHODS
  cognitive function was measured at baseline and at 6- and 18-month follow-up using the Mini-Mental State Exam (MMSE), the Severe Impairment Battery (SIB) and the Alzheimer's Disease Assessment Battery, Cognitive subsection (ADAS-COG) in a cohort study of 224 participants with AD. Baseline anticholinergic Burden score (ABS) was measured using the Anticholinergic Burden scale and included all prescribed and over the counter medication.
  
  
  RESULTS
  the sample was 224 patients with Alzheimer's dementia and 71.4% were women. Their mean age was 81.0 years [SD 7.4 (range 55-98)]. The mean number of medications taken was 3.6 (SD 2.4) and the mean anticholinergic load was 1.1 (SD 1.4, range 0-7). The total number of drugs taken and anticholinergic load correlated (rho = 0.44; P < 0.01). There were no differences in MMSE and other cognitive functioning at either 6 or 18 months after adjusting for baseline cognitive function, age, gender and use of cholinesterase inhibitors between those with, and those without high anticholinergenic load.
  
  
  CONCLUSIONS
  medications with anticholinergic effect in patients with AD were not found to effect deterioration in cognition over the subsequent 18 months. Our study did not support a continuing effect of these medications on people with AD who are established on them.
authors.affiliation: Dementia Research Innovation Group, Norwich School of Medicine, Norwich Research Park, University of East Anglia, UK. chris.fox@uea.ac.uk
authors.forename: Chris
authors.initials: C
authors.lastname: Fox
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
authors.forename: Ian D
authors.initials: ID
authors.lastname: Maidment
authors.forename: Simon
authors.initials: S
authors.lastname: Coulton
authors.forename: David G
authors.initials: DG
authors.lastname: Smithard
authors.forename: Malaz
authors.initials: M
authors.lastname: Boustani
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000517:prevention & control*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000517:prevention & control*; D015331:Cohort Studies; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D018680:Cholinergic Antagonists