The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Long-term anticholinergic use and the aging brain
Open accessAbstract
Background: Older Americans are facing an epidemic of chronic diseases and are thus exposed to anticholinergics (ACs) that might negatively affect their risk of developing mild cognitive impairment (MCI) or dementia. Objective: To investigate the association between impairment in cognitive function and previous AC exposure. Design: A retrospective cohort study. Setting: Primary care clinics in Indianapolis, Indiana. Participants: A total of 3690 older adults who have undergone cognitive assessment and had a 1‐year medication‐dispensing record. Outcome: Cognitive function was measured in two sequential steps: a two‐step screening process followed by a formal diagnostic process for participants with positive screening results. Exposure: Three patterns of AC exposure were defined by the duration of AC exposure, the number of AC medications dispensed at the same time, and the severity of AC effects as determined by the Anticholinergic Cognitive Burden list. Results: Compared with older adults with no AC exposure and after adjusting for age, race, gender, and underlying comorbidity, the odds ratio for having a diagnosis of MCI was 2.73 (95% confidence interval, 1.27–5.87) among older adults who were exposed to at least three possible ACs for at least 90 days; the odds ratio for having dementia was 0.43 (95% confidence interval, 0.10–1.81). Conclusion: Exposure to medications with severe AC cognitive burden may be a risk factor for developing MCI.
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Observational studies of anticholinergic drugs and dementia risk have generally been relatively small, only assessed short-term exposure, or were subject to recall bias.
“Observational studies of anticholinergic drugs and dementia risk7,8,9,10 have generally been relatively small, only assessed short-term exposure, or were subject to recall bias.”
From Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study (2019) · cites this paper as [7]
The Introduction and Discussion describe limited long-term evidence and short observation windows, including this study’s one-year design and a prior study’s 3- to 12-month follow-up. The Discussion also identifies a small exposed subgroup. Our copy does not identify recall bias as a limitation of these studies, so it supports only part of the attributed characterization. (LLM, conf=0.83)
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Cited by
Sorted by citations
The Diagnosis and Management of Mild Cognitive Impairment: A Clinical Review
Langa, K. M., & Levine, D. A. (2014) · JAMA · doi:10.1001/jama.2014.13806 · Cited by 1,337
Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study
Coupland, C. A. C., Hill, T., Dening, T., Morriss, R., Moore, M., & Hippisley-Cox, J. (2019) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2019.0677 · Cited by 637
Anticholinergic drugs and risk of dementia: case-control study
Richardson, K., Fox, C., Maidment, I., Steel, N., Loke, Y. K., Arthur, A., Myint, P. K., Grossi, C. M., Mattishent, K., Bennett, K., et al. (2018) · BMJ · doi:10.1136/bmj.k1315 · Cited by 520
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Metadata
- Authors
- Cai, X., Campbell, N., Khan, B., Callahan, C., & Boustani, M.
- Affiliations
- University of Iowa (US)
- Regenstrief Institute (US)
- Indiana University Indianapolis (US)
- Corresponding author
- Boustani, Malaz
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2012-11-26
- Volume
- 9
- Issue
- 4
- Pages
- 377-385
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC3674201
- OpenAlex
- W2034252538
- Cited by
- 202
- References
- 3
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 12 · 2023: 15 · 2022: 13 · 2021: 20 · 2020: 20 · 2019: 17 · 2018: 16 · 2017: 16 · 2016: 14 · 2015: 16 · 2014: 12 · 2013: 3
- FWCI
- 8.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Institute on Aging
- Hartford Foundation for Public Giving
- 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
- anticholinergic agents, anticholinergic cognitive burden
- MeSH terms
- Aged, Aged, 80 and over, Aging, Brain, Chronic Disease, Dementia, Drug Utilization, Female, Humans, Male, Middle Aged, Psychological Tests, Retrospective Studies, Risk Factors, Cohort Studies, Comorbidity, Odds Ratio, Cholinergic Antagonists, Polypharmacy, Racial Groups, Cognitive Dysfunction
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