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Cited by 241Pharmaceutical Practices and Patient OutcomesDementia and Cognitive Impairment ResearchIntensive Care Unit Cognitive Disorders

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A Systematic Review of Amnestic and Non-Amnestic Mild Cognitive Impairment Induced by Anticholinergic, Antihistamine, GABAergic and Opioid Drugs

Tannenbaum, Cara, Paquette, Amélie, Hilmer, Sarah, Holroyd-Leduc, Jayna, Carnahan, Ryan·2012·Drugs & Aging
DOI 10.1007/bf03262280
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Abstract

Background Mild cognitive deficits are experienced by 18% of community-dwelling older adults, many of whom do not progress to dementia. The effect of commonly used medication on subtle impairments in cognitive function may be under-recognized. Objective The aim of the review was to examine the evidence attributing amnestic or non-amnestic cognitive impairment to the use of medication with anticholinergic, antihistamine, GABAergic or opioid effects. Methods MEDLINE and EMBASE were searched for randomized, double-blind, placebo-controlled trials of adults without underlying central nervous system disorders who underwent detailed neuropsychological testing prior to and after oral administration of drugs affecting cholinergic, histaminergic, GABAergic or opioid receptor pathways. Seventy-eight studies were identified, reporting 162 trials testing medication from the four targeted drug classes. Two investigators independently appraised study quality and extracted relevant data on the occurrence of amnestic, non-amnestic or combined cognitive deficits induced by each drug class. Only trials using validated neuropsychological tests were included. Quality of the evidence for each drug class was assessed based on consistency of results across trials and the presence of a dose-response gradient. Results In studies of short-, intermediate- and long-acting benzodiazepine drugs (n = 68 trials), these drugs consistently induced both amnestic and non-amnestic cognitive impairments, with evi…

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  • Anticholinergic urological drugs, particularly oxybutynin, have been consistently associated with short term cognitive decline in randomised controlled trials.

    “Anticholinergic urological drugs, particularly oxybutynin, have been consistently associated with short term cognitive decline in randomised controlled trials,8 41 so a long term risk of dementia is plausible.”

    From Anticholinergic drugs and risk of dementia: case-control study (2018) · cites this paper as [8]

  • It is well known that anticholinergics affect cognition, and guidelines suggest they are to be avoided among frail older people.

    “It is well known that anticholinergics affect cognition,8 and guidelines suggest they are to be avoided among frail older people.9”

    From Anticholinergic drugs and risk of dementia: case-control study (2018) · cites this paper as [8]

  • Many studies have linked anticholinergic drug use with concurrent or short term cognitive effects, but few have examined associations of long term anticholinergic exposure; the latter tend to report positive associations.

    “Many studies have linked anticholinergic drug use with concurrent or short term cognitive effects, but few have examined associations of long term anticholinergic exposure;8 the latter tend to report positive associations.12 14 15”

    From Anticholinergic drugs and risk of dementia: case-control study (2018) · cites this paper as [8]

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Metadata

Authors
Tannenbaum, C., Paquette, A., Hilmer, S., Holroyd-Leduc, J., & Carnahan, R.
Affiliations
  • Université de Montréal (CA)
  • Institut Universitaire de Gériatrie de Montréal (CA)
  • The University of Sydney (AU)
  • University of Calgary (CA)
  • University of Iowa (US)
Corresponding author
Tannenbaum, Cara
ORCID
Venue
Drugs & Aging
Publisher
Springer Science and Business Media LLC
Published
2012-08
Volume
29
Issue
8
Pages
639-658
ISSN
  • 1170-229X (ISSN-L)
  • 1179-1969
DOI
10.1007/bf03262280
OpenAlex
W2043475910
Cited by
241
References
7
Citations by year
2026: 7 · 2025: 10 · 2024: 19 · 2023: 14 · 2022: 16 · 2021: 19 · 2020: 20 · 2019: 19 · 2018: 20 · 2017: 17 · 2016: 22 · 2015: 25 · 2014: 19 · 2013: 11 · 2012: 2
FWCI
1.81
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Drugs & Aging (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Astellas Pharma
  • U.S. Public Health Service (5 U18 HSO16094)
  • Canadian Institutes of Health Research (108262)
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Keywords
amnestic mild cognitive impairment, non-amnestic mild cognitive impairment, drug-induced cognitive impairment, benzodiazepines, antihistamines, tricyclic antidepressants, antimuscarinic agents, opioids, GABAergic drugs, older adults, dose-response relationship, attention deficits, memory impairment, lorazepam, oxybutynin, oxycodone, antipsychotic drugs
MeSH terms
Amnesia, Analgesics, Opioid, Histamine Antagonists, Humans, Cholinergic Antagonists, GABA Agents, Cognitive Dysfunction

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