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Anticholinergic medications and Cognition

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https://www.readbyqxmd.com/read/28810270/the-personal-antipsychotic-choice-index
#1
Floor van Dijk, Iris de Wit, Matthijs Blankers, Iris Sommer, Lieuwe de Haan
Introduction We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication. Method Patients selected effectiveness and adverse effects criteria from the Subject's Response to Antipsychotics-34 questionnaire. Numerical data from meta-analyses, clinical trial data, receptor affinities and expert opinions were used to rank antipsychotics on each criterion. When using the the tool, patients indicate on a 5-point Likert scale how they value each (adverse) effect...
August 15, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28805566/botulinum-toxin-therapy-for-nonmotor-aspects-of-parkinson-s-disease
#2
Jarosław Sławek, Mariusz Madaliński
The medical treatment of Parkinson's disease (PD) is symptomatic both in terms of motor and nonmotor aspects. The nonmotor symptoms therapy should be taken into account as many of them negatively influence the quality of life and are treatable. Botulinum neurotoxin (BoNT) offers effective treatment for drooling and bladder dysfunctions and alternative treatment for constipation and pain related to parkinsonism. BoNT for drooling is probably the best-documented therapy for nonmotor symptoms by clinical trials...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28752589/frailty-and-potentially-inappropriate-medication-use-at-nursing-home-transition
#3
Laura C Maclagan, Colleen J Maxwell, Sima Gandhi, Jun Guan, Chaim M Bell, David B Hogan, Nick Daneman, Sudeep S Gill, Andrew M Morris, Lianne Jeffs, Michael A Campitelli, Dallas P Seitz, Susan E Bronskill
BACKGROUND/OBJECTIVES: To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN: Retrospective cohort study using health administrative databases. SETTING: Ontario, Canada. PARTICIPANTS: 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014...
July 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28688993/fat-demented-and-stupid-an-unrecognized-legacy-of-pediatric-urology
#4
REVIEW
Christopher S Cooper
The human body is an unfathomably intricate structure consisting of many connected and intertwined systems. This makes it impossible for therapeutic interventions to selectively target only one physiologic system without some impact or side effects on all the other systems. The resiliency of the human body modifies and disguises side effects, some of which may be undetectable for years and not apparent without scientific investigation. Pediatric urologists employ relatively few medications for the common conditions they treat and in general these consist of antibiotics, anticholinergics, and anesthetics...
June 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28627117/the-cognitive-features-of-idiopathic-and-dyt1-dystonia
#5
REVIEW
Marjan Jahanshahi, Mariam Torkamani
Dystonia is a common movement disorder. In this paper, we review the literature on cognitive function in idiopathic and DYT1 dystonia. In idiopathic or DYT1 dystonia, cognition is largely intact with only isolated executive dysfunction. Dystonia patients also have increased temporal and spatial discrimination thresholds, considered endophenotypes of the disorder because deficits are also shown by unaffected relatives and nonmanifesting carriers of the DYT1 mutation. Anticholinergic medication in high doses can be associated with memory impairment in dystonia...
June 19, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28603629/anticholinergic-drug-exposure-is-associated-with-delirium-and-postdischarge-institutionalization-in-acutely-ill-hospitalized-older-patients
#6
Angelique Egberts, Saskia T van der Craats, Melissa D van Wijk, Shams Alkilabe, Patricia M L A van den Bemt, Francesco U S Mattace-Raso
Several studies investigated the possible association between anticholinergic drugs and diverse clinical outcomes in older persons, but the results are inconsistent. The aim of this study was to investigate whether anticholinergic drug exposure is associated with delirium on admission, length of hospital stay, postdischarge institutionalization and in-hospital mortality in acutely ill hospitalized older patients. In this observational chart review study, we included acutely ill patients aged 65 and older who were admitted to the geriatric ward of the Erasmus University Medical Center, Rotterdam, The Netherlands, between 2012 and 2015 (n = 905)...
June 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28578178/frequency-and-correlates-of-anticholinergic-use-among-patients-with-schizophrenia-in-denmark-a-nation-wide-pharmacoepidemiological-study
#7
S G Pristed, C U Correll, J Nielsen
Anticholinergic medications are used to treat extrapyramidal adverse effects induced by antipsychotics. Anticholinergics are associated with adverse effects: constipation, dry mouth and worsening of cognitive function. Anticholinergics have potential for abuse and are not recommended for long term-treatment. We aimed to investigate the use of anticholinergics in patients with schizophrenia. The national health registers in Denmark were used to examine: The prevalence of anticholinergics in 1996-2012 using a cross-sectional design; geographic variations in the prescription of anticholinergics in 2012; correlates of treatment with anticholinergics...
September 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28535785/optimizing-medication-appropriateness-in-older-adults-a-randomized-clinical-interventional-trial-to-decrease-anticholinergic-burden
#8
Daniela C Moga, Erin L Abner, Dorinda N Rigsby, Lynne Eckmann, Mark Huffmyer, Richard R Murphy, Beth B Coy, Gregory A Jicha
BACKGROUND: The complexity of medication therapy in older adults with multiple comorbidities often leads to inappropriate prescribing. Drugs with anticholinergic properties are of particular interest because many are not recognized for this property; their use may lead to increased anticholinergic burden resulting in significant health risks, as well as negatively impacting cognition. Medication therapy management (MTM) interventions showed promise in addressing inappropriate medication use, but the effectiveness of targeted multidisciplinary team interventions addressing anticholinergic medications in older populations is yet to be determined...
May 23, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28507653/use-of-potentially-inappropriate-medications-among-ambulatory-home-dwelling-elderly-patients-with-dementia-a-review-of-the-literature
#9
Tejal Patel, Karen Slonim, Linda Lee
BACKGROUND: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use...
May 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28503836/role-of-anticholinergic-burden-in-primary-care-patients-with-first-cognitive-complaints
#10
G Grande, I Tramacere, D L Vetrano, F Clerici, S Pomati, C Mariani, G Filippini
BACKGROUND AND PURPOSE: Drugs with anticholinergic properties might have a negative impact on cognition, but findings are still conflicting. The association was evaluated between anticholinergic drugs and cognitive performance in primary care patients with first cognitive complaints. METHODS: From April 2013 to March 2014, 353 general practitioners administered the Mini-Mental State Examination (MMSE) to patients presenting with first cognitive complaints. Drug history was collected and the anticholinergic cognitive burden (ACB) was scored and categorized as ACB 0, ACB 1 and ACB 2+...
July 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28483009/clinical-and-functional-characteristics-of-nursing-facility-residents-with-opioid-induced-constipation
#11
Carrie Allen, Barbara J Zarowitz, Terrence O'Shea, Catherine Datto, Temitope Olufade
OBJECTIVE: Our goal was to determine the prevalence, clinical characteristics, and treatment differences of opioid-induced constipation (OIC) in older adults with noncancer pain compared with opioid-treated patients without OIC. DESIGN: Retrospective database analysis. SETTING: United States nursing facilities: Patients, Participants, facility residents. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Minimum data set and prescription claims, pain, impaired cognition, falls, delirium, and drug treatment...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28441276/augs-consensus-statement-association-of-anticholinergic-medication-use-and-cognition-in-women-with-overactive-bladder
#12
(no author information available yet)
Overactive bladder affects a significant portion of the overall population and has substantial impact on daily activities and quality-of-life. When considering treatment, behavioral therapies should be instituted first, followed by medical therapies. Anticholinergic medications and beta-3 agonists are often used as initial pharmacologic therapy, but caution should be taken in prescribing anticholinergic medications in frail or cognitively impaired patients. Recently, concerns have developed regarding anticholinergic medications and the associated risk of cognitive impairment, dementia, and Alzheimer disease in the general population...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28436193/association-between-using-medications-with-anticholinergic-properties-and-short-term-cognitive-decline-among-older-men-a-retrospective-cohort-study-in-taiwan
#13
Yi-Hui Wu, Chih-Jen Wang, Cheng-Hao Hung, Liang-Yu Chen, Ming-Hsien Lin, Pei-Ning Wang, Liang-Kung Chen
AIM: The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan. METHODS: This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28413414/comedication-and-treatment-length-in-users-of-acetylcholinesterase-inhibitors
#14
Anne Sverdrup Efjestad, Hege Ihle-Hansen, Vidar Hjellvik, Hege Salvesen Blix
BACKGROUND/AIMS: Reduced clinical effect on cognitive decline in dementia by acetylcholinesterase inhibitors (AChEIs) may be due to concurrent use of drugs with anticholinergic properties. The aim was to analyze the incidence of AChEI use and comedication with drugs with anticholinergic properties and other potential unfavorable effects. METHODS: A prospective study applying drug use data from the Norwegian Prescription Database. Anticholinergic Drug Scale (ADS) scores were used as a measure of overall anticholinergic burden...
January 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/28407520/anticholinergic-drug-use-is-associated-with-episodic-memory-decline-in-older-adults-without-dementia
#15
Goran Papenberg, Lars Bäckman, Laura Fratiglioni, Erika J Laukka, Johan Fastbom, Kristina Johnell
Anticholinergic drug use is common in older adults and has been related to increased dementia risk. This suggests that users of these drugs may experience accelerated cognitive decline. So far, however, longitudinal data on this topic are absent and the available evidence is inconclusive with respect to effects on specific cognitive domains due to suboptimal control of confounding variables. We investigated whether anticholinergic medication use is associated with cognitive decline over 6 years in a population-based study of older adults (aged 60-90; n = 1473) without dementia...
July 2017: Neurobiology of Aging
https://www.readbyqxmd.com/read/28390849/cognitive-burden-of-anticholinergic-medications-in-psychotic-disorders
#16
Seenae Eum, S Kristian Hill, Leah H Rubin, Ryan M Carnahan, James L Reilly, Elena I Ivleva, Sarah K Keedy, Carol A Tamminga, Godfrey D Pearlson, Brett A Clementz, Elliot S Gershon, Matcheri S Keshavan, Richard S E Keefe, John A Sweeney, Jeffrey R Bishop
BACKGROUND: Patients with psychotic disorders are often treated with numerous medications, many of which have anticholinergic activity. We assessed cognition in relation to the cumulative anticholinergic burden of multiple drugs included in treatment regimens of participants from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. METHOD: Clinically stable participants with schizophrenia (n=206), schizoaffective disorder (n=131), and psychotic bipolar disorder (n=146) were examined...
April 5, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28346565/anticholinergic-burden-and-functional-status-in-older-people-with-cognitive-impairment-results-from-the-regal-project
#17
V Boccardi, M Baroni, L Paolacci, S Ercolani, A Longo, M Giordano, C Ruggiero, P Mecocci
OBJECTIVE: The use of drugs with intrinsic anticholinergic properties is widespread among old age persons. A growing body of evidences suggest that a high anticholinergic burden is associated with physical and cognitive impairment. However, the association between anticholinergic drug use and functional status is still poorly investigated, particularly among subjects with initial cognitive impairment. DESIGN: Cross-sectional study examining the association between drug-related anticholinergic burden and functional status in cognitively healthy (CH) (n=691), mild cognitive impairment (MCI) (n=541) or mild Alzheimer's diseases (AD) (n=1127) subjects...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28274871/an-improved-high-efficiency-assay-for-assessing-serum-anticholinergic-activity-using-cultured-cells-stably-expressing-m1-receptors
#18
José N Nobrega, Roger J Raymond, Bruce G Pollock
Assessments of total anticholinergic activity (SAA) in serum are of considerable interest for its potential involvement in cognitive impairment associated with polydrug states in the elderly and other populations. Such estimations have been based on the displacement of radioligand binding in rat brain tissues. The validity of such measurements has been questioned, as a potentially distorting effect of large serum proteins was identified. We sought to develop a modified assay that would be more efficient and free of this potential confound...
March 6, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28213762/association-between-cognitive-impairment-and-urinary-dysfunction-in-parkinson-s-disease
#19
Zuzanna Tkaczynska, Andrea Pilotto, Sara Becker, Susanne Gräber-Sultan, Daniela Berg, Inga Liepelt-Scarfone
Urinary dysfunction (UD) is a common non-motor feature of Parkinson's disease (PD), and might be secondary to neurodegeneration involving cortical and subcortical brain areas. The possible link between UD and cognitive deficits has never been examined in frontal cortex impairment, and is still not completely understood in PD. In the present study, 94 PD patients underwent a comprehensive motor, cognitive and non-motor assessment. It was shown that 55.3% of patients reported UD, of which 17% needed specific urological treatment...
February 17, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28185237/use-of-bladder-antimuscarinics-in-older-adults-with-impaired-cognition
#20
Ariel R Green, Jodi Segal, Jing Tian, Esther Oh, David L Roth, Liam Hilson, Jennifer L Dodson, Cynthia M Boyd
OBJECTIVE: To examine the use of antimuscarinics for treating urinary incontinence (UI) in older adults with varying levels of cognition. DESIGN: Cross-sectional. SETTING: National Alzheimer's Coordinating Center from 2005 through 2015. PARTICIPANTS: Community-dwelling men and women aged 65 and older (N = 24,106). MEASUREMENTS: Clinicians and staff evaluated each participant's dementia status during annual in-person assessments...
February 2017: Journal of the American Geriatrics Society
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