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Anticholinergic Meds May Raise Risk for Cognitive Decline

Effects significantly worse among individuals with risk factors for Alzheimer disease

FRIDAY, Sept. 4, 2020 (HealthDay News) — Anticholinergic medications (aCH) are associated with an increased risk for incident mild cognitive impairment (MCI) and cognitive decline in older adults, according to a study published online Sept. 2 in Neurology.

Alexandra J. Weigand, from San Diego State University, and colleagues assessed the cognitive consequences of aCH in cognitively normal older adults. The analysis included 688 cognitively normal adults (mean age, 73.5 years) with follow-up over a 10-year period.

The researchers found that aCH+ participants had an increased risk for progression to MCI (hazard ratio [HR], 1.42) and there was a significant interaction between aCH and Alzheimer disease risk, with (aCH+)(ε4+) individuals showing more than a twofold increased risk for incident MCI (HR, 2.47) compared with (aCH−)(ε4−) individuals. The risk was even higher among (aCH+)(p-tau/Aβ+) individuals (HR, 4.25) versus (aCH−)(p-tau/Aβ−) individuals. aCH predicts a steeper slope of decline in memory and language, with effects worsened in individuals with Alzheimer disease risk factors.

“Findings underscore the adverse impact of aCH medications on cognition and the need for deprescribing trials, particularly among individuals with elevated risk for Alzheimer disease,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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