Detailed cognitive function and use of drugs with anticholinergic properties in older people: a community-based cross-sectional study.
BACKGROUND
Many potentially inappropriate drugs prescribed to older people have anticholinergic properties and may therefore be harmful. Drugs with anticholinergic properties (DAPs) are associated with cognitive decline.


OBJECTIVE
Our aim was to study the profile of various cognitive functions related to current use of DAPs.


METHODS
A cross-sectional study was conducted in Helsinki, Finland, and included 400 home-dwelling individuals aged 75-90 years without major clinical dementia but with a history of stable atherosclerotic disease who were participants of the DEBATE (Drugs and Evidence-Based Medicine in the Elderly) study. The cognition of the users (n = 295) and non-users (n = 105) of DAPs was measured with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test battery.


RESULTS
Use of DAPs was statistically significantly associated with a low score in verbal fluency, in naming, and on the Mini-Mental State Examination (MMSE). In the logistic regression analysis, the difference remained for low verbal fluency (odds ratio [OR] 1.84, 95 % CI 1.02-3.32; p = 0.044) and naming (OR 1.81, 95 % CI 1.09-3.00; p = 0.021) but not for MMSE score after adjusting for age, sex and education.


CONCLUSIONS
Performances for verbal fluency and naming were poorer in DAP users than in non-users, suggesting a possible impairment of executive functioning and semantic memory. The dimensions of the CERAD test assessing episodic memory-the subtests that are the most sensitive in terms of detecting early Alzheimer's disease-did not show differences between users and non-users of DAPs.
Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland. juho.uusvaara@kauniala.fi
Juho
J
Uusvaara
Kaisu H
KH
Pitkala
Hannu
H
Kautiainen
Reijo S
RS
Tilvis
Timo E
TE
Strandberg
D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D053327:Apolipoprotein E4 / Q000235:genetics; D002318:Cardiovascular Diseases / Q000188:drug therapy; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D011581:Psychological Tests
D053327:Apolipoprotein E4; D018680:Cholinergic Antagonists