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Anticholinergic drugs increase the risk of cognitive decline and dementia in older people

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Question

Question:

What is the relationship between anticholinergic use, cognitive decline and onset of dementia in an older, community-dwelling population?

Population:

6912 adults (4128 women, mean age 73.8 years; 2784 men, mean age 73.6 years) aged ≥65 years, living in the community and recruited from electoral rolls.

Setting:

Three cities in France, recruitment period: 1999–2001.

Prognostic factors:

Cognitive performance was measured using a battery of tests: Isaacs Set Test assessed verbal fluency, Benton Visual Retention Test (BVRT) assessed visual memory, Trail-Making Test A (TMT A) measured psychomotor speed, TMT B measured executive function, Mini-Mental State Examination (MMSE) provided a global measure of cognitive function and clinical diagnoses of dementia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition). The use of anticholinergic drugs was assessed by in-person interview; prescriptions and medications were checked where possible. Discontinuing anticholinergic treatment was defined as reporting anticholinergic drug use only at baseline but not at either the 2- or 4-year follow-up. Social and demographic variables were recorded using standardised interview questions. Fasting-blood samples were taken to determine cholesterol levels. Cognitive tests were administered at baseline and at 2- and 4-year follow-up. TMT A and B were administered only at the 4-year follow-up. Univariate and multivariate logistic regression analyses were performed to determine the association between anticholinergic drug use and cognitive decline.

Outcomes:

Cognitive decline (defined as being …

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