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. 2017 Aug 1;9(1):58.
doi: 10.1186/s13195-017-0284-4.

Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders

Virginie Dauphinot  1   2 , Christelle Mouchoux  3   4   5 , Sébastien Veillard  6 , Floriane Delphin-Combe  6 , Pierre Krolak-Salmon  6   3   5
Affiliations

Anticholinergic drugs and functional, cognitive impairment and behavioral disturbances in patients from a memory clinic with subjective cognitive decline or neurocognitive disorders

Virginie Dauphinot et al. Alzheimers Res Ther. .

Abstract

Background: Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients.

Methods: A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD). The AC burden was measured using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden (ACB), Chew's score, Han's score, and the number of drugs with AC activity. Functional, cognitive performance and behavior disturbances were assessed using the Instrumental Activities of Daily Living (IADL) scale (IADL), the Mini Mental State Examination (MMSE), and the Neuropsychiatric Inventory (NPI).

Results: Among 473 included patients, 46.3% were at major NCD. Patients took on average 5.3 ± 2.6 drugs. MMSE was lower when Han's score (p = 0.04) and number of AC drugs were higher (p < 0.001). IADL was lower when AC burden was higher, whatever the AC measurement. NPI was higher when ACB, Han's score, and number of AC drugs were higher. After adjustment, all AC scores remained associated with IADL, while Han's score and number of drugs with AC remained associated with the MMSE.

Conclusions: In patients with SCD or NCD, AC burden is associated with lower functional score, whereas the cross-sectional association between AC burden and cognitive performance or behavioral disturbance varies according to AC scores. Particular attention should be paid when prescribing drugs with AC properties, especially among patients with memory complaints.

Keywords: Adverse effects; Cognitive disorders and dementia; Functional disorders; Neuropharmacology.

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Conflict of interest statement

Ethics approval and consent to participate

Information regarding the collection of individual data, with the aim to perform research on routine care, was provided to the patients. No consent to participate was required since the study was conducted in routine care without intervention, but patients may refuse that their data be used for research purposes. The research on these data has been approved by a local ethics committee, CPP Lyon Sud-Est III (Comité de Protection des Personnes/Persons Protection Comity). Authorization for handling personal data has been granted by the French Data Protection Authority (CNIL: Commission Nationale de l’Informatique et Libertés): 06/08/2010, number of registration: 10-18. All procedures are in compliance with the Helsinky declaration.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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