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Letter to the Editor| Volume 21, ISSUE 9, P1357-1358.e3, September 2020

Impact of Anticholinergic Burden on Cognitive Performance: A Cohort Study of Community-Dwelling Older Adults

      Older people are susceptible to the adverse effects of anticholinergic medications, including cognitive impairment.
      • 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.
      A systematic review of observational studies reported mixed associations between high anticholinergic burden, a cumulative measure of anticholinergic medications, and cognitive performance in older people.
      • 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.
      Observational studies may have biased estimates of the impact of exposures, as the exposed and unexposed may systematically differ in covariates associated with the outcomes.
      • Cole S.R.
      • Hernan M.A.
      Constructing inverse probability weights for marginal structural models.
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      References

        • 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
        • 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
        • Austin P.C.
        • Stuart E.A.
        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
        • Schluter P.J.
        • Ahuriri-Driscoll A.
        • Anderson T.J.
        • et al.
        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
        • Salahudeen M.S.
        • Duffull S.B.
        • Nishtala P.S.
        Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: A systematic review.
        BMC Geriatr. 2015; 15: 31
        • Narayan S.W.
        • Hilmer S.N.
        • Horsburgh S.
        • et al.
        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
        • McCaffrey D.F.
        • Griffin B.A.
        • Almirall D.
        • et al.
        A tutorial on propensity score estimation for multiple treatments using generalized boosted models.
        Stat Med. 2013; 32: 3388-3414
        • Fox C.
        • Richardson K.
        • Maidment I.D.
        • et al.
        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
        • Lechevallier-Michel N.
        • Molimard M.
        • Dartigues J.F.
        • et al.
        Drugs with anticholinergic properties and cognitive performance in the elderly: Results from the PAQUID Study.
        Br J Clin Pharmacol. 2005; 59: 143-151