Older people are susceptible to the adverse effects of anticholinergic medications, including cognitive impairment.
1A systematic review of observational studies reported mixed associations between high anticholinergic burden, a cumulative measure of anticholinergic medications, and cognitive performance in older people.
- Ruxton K.
- Woodman R.J.
- Mangoni A.A.
Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis.
Br J Clin Pharmacol. 2015; 80: 209-220
2Observational studies may have biased estimates of the impact of exposures, as the exposed and unexposed may systematically differ in covariates associated with the outcomes.
- Kersten H.
- Molden E.
- Tolo I.K.
- et al.
Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: A randomized controlled trial.
J Gerontol A Biol Sci Med Sci. 2013; 68: 271-278
- Cole S.R.
- Hernan M.A.
Constructing inverse probability weights for marginal structural models.
Am J Epidemiol. 2008; 168: 656-664
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- Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis.Br J Clin Pharmacol. 2015; 80: 209-220
- Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: A randomized controlled trial.J Gerontol A Biol Sci Med Sci. 2013; 68: 271-278
- Constructing inverse probability weights for marginal structural models.Am J Epidemiol. 2008; 168: 656-664
- Moving towards best practice when using Inverse Probability of Treatment Weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies.Stat Med. 2015; 34: 3661-3679
- Comprehensive clinical assessment of home-based older persons within New Zealand: An epidemiological profile of a national cross-section.Aust N Z J Public Health. 2016; 40: 349-355
- Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: A systematic review.BMC Geriatr. 2015; 15: 31
- Anticholinergic component of the Drug Burden Index and the Anticholinergic Drug Scale as measures of anticholinergic exposure in older people in New Zealand: A Population-level Study.Drugs Aging. 2013; 30: 927-934
- A tutorial on propensity score estimation for multiple treatments using generalized boosted models.Stat Med. 2013; 32: 3388-3414
- Anticholinergic medication use and cognitive impairment in the older population: The Medical Research Council Cognitive Function and Ageing Study.J Am Geriatr Soc. 2011; 59: 1477-1483
- Drugs with anticholinergic properties and cognitive performance in the elderly: Results from the PAQUID Study.Br J Clin Pharmacol. 2005; 59: 143-151
Published online: May 10, 2020
H.A. was supported by the National Institute on Aging (R01AG047891-01A1, P50AG047270, and P30AG021342-16S1); in addition, H.A. and L.H. received support from the National Institute on Aging Yale Claude D. Pepper Older Americans Independence Center (P30AG021342).
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.