title: Cognitive decline in older persons initiating anticholinergic medications.
abstract: BACKGROUND
  This study examines the effect of initiating medications with anticholinergic activity on the cognitive functions of older persons.
  
  
  METHODS
  Participants were 896 older community-dwelling, Catholic clergy without baseline dementia. Medication data was collected annually. The Anticholinergic Cognitive Burden Scale was utilized to identify use of a medication with probable or definite anticholinergic activity. Participants had at least two annual cognitive evaluations.
  
  
  RESULTS
  Over a mean follow-up of 10 years, the annual rate of global cognitive function decline for never users, prevalent users, and incident users was -0.062 (SE = 0.005), -0.081(SE = 0.011), and -0.096 (SE = 0.007) z-score units/year, respectively. Compared to never users, incident users had a more rapid decline (difference = -0.034 z-score units/year, SE = 0.008, p<0.001) while prevalent users did not have a significantly more rapid decline (p = 0.1).
  
  
  CONCLUSIONS
  Older persons initiating a medication with anticholinergic activity have a steeper annual decline in cognitive functioning than those who are not taking these medications.
authors.affiliation: Rush Alzheimer's Disease Center (RADC), Rush University Medical Center, Chicago, Illinois, United States of America.
authors.forename: Raj C
authors.initials: RC
authors.lastname: Shah
authors.forename: Alicia L
authors.initials: AL
authors.lastname: Janos
authors.forename: Julia E
authors.initials: JE
authors.lastname: Kline
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.forename: Sue E
authors.initials: SE
authors.lastname: Leurgans
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.forename: Peter
authors.initials: P
authors.lastname: Wei
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Heilman
authors.forename: Jack W
authors.initials: JW
authors.lastname: Tsao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002410:Catholicism; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D002977:Clergy; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007807:Language Tests; D008297:Male; D011581:Psychological Tests; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D018680:Cholinergic Antagonists