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Anticholinergic medications and Cognition

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https://www.readbyqxmd.com/read/29756003/onset-and-remission-of-psychosis-in-parkinson-s-disease-pharmacologic-and-motoric-markers
#1
Jared Thomas Hinkle, Kate Perepezko, Catherine C Bakker, Martinus P G Broen, Kathleen Chin, Ted M Dawson, Vanessa Johnson, Zoltan Mari, Cherie L Marvel, Kelly A Mills, Alexander Pantelyat, Olga Pletnikova, Liana S Rosenthal, Melissa D Shepard, Daniel A Stevens, Juan C Troncoso, Jiangxia Wang, Gregory M Pontone
Background: Psychosis is among the most disabling complications of Parkinson's disease (PD). The chronicity of PD psychosis remains understudied and the relative importance of dopaminergic therapy versus the disease process itself in engendering psychosis remains unclear. Objectives: To examine pharmacologic and motoric correlates of PD psychosis onset and remission in a longitudinally monitored PD cohort. Methods: We analyzed data from 165 participants enrolled in a longitudinal PD study through the Morris K...
January 2018: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/29736815/anticholinergic-drug-burden-tools-scales-and-adverse-outcomes-in-different-clinical-settings-a-systematic-review-of-reviews
#2
REVIEW
Tomas J Welsh, Veronika van der Wardt, Grace Ojo, Adam L Gordon, John R F Gladman
BACKGROUND: Cumulative anticholinergic exposure (anticholinergic burden) has been linked to a number of adverse outcomes. To conduct research in this area, an agreed approach to describing anticholinergic burden is needed. OBJECTIVE: This review set out to identify anticholinergic burden scales, to describe their rationale, the settings in which they have been used and the outcomes associated with them. METHODS: A search was performed using the Healthcare Databases Advanced Search of MEDLINE, EMBASE, Cochrane, CINAHL and PsycINFO from inception to October 2016 to identify systematic reviews describing anticholinergic burden scales or tools...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29729025/anticholinergic-medications-in-patients-admitted-with-cognitive-impairment-or-falls-amici-the-impact-of-hospital-admission-on-anticholinergic-cognitive-medication-burden-results-of-a-multicentre-observational-study
#3
I Weichert, R Romero-Ortuno, J Tolonen, T Soe, C Lebus, S Choudhury, C V Nadarajah, P Nanayakkara, M Orrù, S Di Somma
WHAT IS KNOWN AND OBJECTIVE: Drugs with anticholinergic properties increase the risk of falls, delirium, chronic cognitive impairment, and mortality and counteract procholinergic medications used in the treatment of dementia. Medication review and optimisation to reduce anticholinergic burden in patients at risk is recommended by specialist bodies. Little is known how effective this review is in patients who present acutely and how often drugs with anticholinergic properties are used temporarily during an admission...
May 4, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29683887/association-of-anticholinergic-risk-score-with-functional-status-in-patients-preparing-for-pelvic-reconstructive-surgery
#4
Taylor J Brueseke, Maria de la Luz Nieto, Samantha Pulliam, Jennifer M Wu
OBJECTIVES: Anticholinergic medication use has been associated with cognitive impairment and other functional limitations, particularly in older patients. The anticholinergic risk score (ARS) can be used to measure a patient's cumulative exposure to medications with anticholinergic properties. Our primary objective was to evaluate the correlation between ARS and functional status, as measured by instrumental activities of daily living (IADL), in patients preparing to undergo urogynecologic surgery...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29671539/evaluation-of-suspected-dementia
#5
Nathan Falk, Ariel Cole, T Jason Meredith
Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected to double by 2060. Risk factors for dementia include age; family history of dementia; personal history of cardiovascular disease, cerebrovascular disease, diabetes mellitus, or midlife obesity; use of anticholinergic medications; apolipoprotein E4 genotype; and lower education level...
March 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29642720/use-of-potentially-inappropriate-medications-in-people-with-dementia-in-vietnam-and-its-associated-factors
#6
Tuan Anh Nguyen, Thang Pham, Huyen Thi Thanh Vu, Thanh Xuan Nguyen, Trinh Thi Vu, Binh Thi Thanh Nguyen, Ngoc Quynh Nguyen, Binh Thanh Nguyen, Binh Thanh Nguyen, Tam Ngoc Nguyen, Sinh Viet Phan, Anh Trung Nguyen, Tuan Le Pham, Ha Thu Dang, Lisa Kalisch-Ellett, Marianne Gillam, Nicole Pratt, Sun Qiang, Haipeng Wang, Tipaporn Kanjanarach, Mohamed Azmi Ahmad Hassali, Zaheer-Ud-Din Babar, Asrenee Ab Razak, Dujrudee Chinwong, Elizabeth E Roughead
This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics...
January 1, 2018: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/29625707/-atropinic-burden-and-anticholinergic-drugs-interest-and-application-in-clinical-practice-in-the-elderly
#7
Sibylle de Germay, Maryse Lapeyre-Mestre, Jean-Louis Montastruc, François Montastruc
Anticholinergic drugs (also called antimuscarinics or atropinics) increase the risk of falls, cognitive impairment and/or mortality in older patients. These drugs belong to the lists of potentially inappropriate medications in the elderly. The aim of this review was to present and discuss the different tools available to measure the atropinic risk in drug exposure of older patients. Several scales, developed from biological and/or clinical criteria, allow to classify anticholinergic drugs according to their atropinic potency and to assign to them an atropinic burden...
March 7, 2018: Thérapie
https://www.readbyqxmd.com/read/29608782/one-year-effect-of-the-medicare-annual-wellness-visit-on-detection-of-cognitive-impairment-a-cohort-study
#8
Nicole R Fowler, Noll L Campbell, Gerhardt M Pohl, Leanne M Munsie, Noam Y Kirson, Urvi Desai, Erich J Trieschman, Mark K Meiselbach, J Scott Andrews, Malaz A Boustani
OBJECTIVES: To examine the effect of the Medicare Annual Wellness Visit (AWV) on the detection of cognitive impairment and on follow-up cognitive care for older adults. DESIGN: Retrospective matched-cohort study. SETTING: United States. PARTICIPANTS: A 5% random sample of fee-for-service Medicare beneficiaries continuously enrolled for 12 months before and after an index ambulatory visit occurring from 2011 to 2013 with no claims evidence of cognitive impairment before index...
April 2, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29600808/anticholinergics-influence-transition-from-normal-cognition-to-mild-cognitive-impairment-in-older-adults-in-primary-care
#9
Noll L Campbell, Kathleen A Lane, Sujuan Gao, Malaz A Boustani, Fred Unverzagt
STUDY OBJECTIVE: To determine the influence of anticholinergic medications on transitions in cognitive diagnosis of older adults in primary care. DESIGN: This observational cohort study was conducted over a mean follow-up of 3.2 years. Anticholinergic exposure was defined by pharmacy dispensing and claims records. Cognitive diagnosis was performed by an expert panel at baseline and annually up to four years. DATA SOURCE: Medication exposure and other clinical data were extracted from the Indiana Network for Patient Care (INPC), while the cognitive diagnosis was derived from a cognitive screening and diagnosis study...
March 30, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29559218/understanding-older-adults-medication-decision-making-and-behavior-a-study-on-over-the-counter-otc-anticholinergic-medications
#10
Richard J Holden, Preethi Srinivas, Noll L Campbell, Daniel O Clark, Kunal S Bodke, Youngbok Hong, Malaz A Boustani, Denisha Ferguson, Christopher M Callahan
BACKGROUND: Older adults purchase and use over-the-counter (OTC) medications with potentially significant adverse effects. Some OTC medications, such as those with anticholinergic effects, are relatively contraindicated for use by older adults due to evidence of impaired cognition and other adverse effects. OBJECTIVE: To inform the design of future OTC medication safety interventions for older adults, this study investigated consumers' decision making and behavior related to OTC medication purchasing and use, with a focus on OTC anticholinergic medications...
March 6, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29481373/anticholinergic-medications-and-cognitive-function-in-late-midlife
#11
Martin M Limback-Stokin, Janina Krell-Roesch, Kimberly Roesler, Allison Hansen, Cynthia M Stonnington, M'hamed Temkit, Richard J Caselli, Yonas E Geda
No abstract text is available yet for this article.
February 23, 2018: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29406911/anti-cholinergic-medications-for-bladder-dysfunction-worsen-cognition-in-persons-with-multiple-sclerosis
#12
Sarah A Morrow, Heather Rosehart, Alp Sener, Blayne Welk
Bladder dysfunction is common in persons with MS (PwMS), often due to detrusor muscle overactivity. Anticholinergic medications are considered the first line treatment for bladder dysfunction and are known to worsen cognition in healthy older adults and in persons with dementia. Yet, it is not known if these medications have the same effect on PwMS. Thus, the Objective of this prospective matched-cohort study was to determine if anticholinergic medications affect objective measures of cognition in PwMS. We recruited PwMS starting either oxybutynin or tolterodine (cases)...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29404965/medication-profiles-of-patients-with-cognitive-impairment-and-high-anticholinergic-burden
#13
Ariel R Green, Liza M Reifler, Cynthia M Boyd, Linda A Weffald, Elizabeth A Bayliss
BACKGROUND: Drugs with anticholinergic properties are considered potentially inappropriate in patients with cognitive impairment because harms-including delirium, falls, and fractures-may outweigh benefits. OBJECTIVE: To highlight opportunities to improve clinical decision making and care for patients with cognitive impairment and multiple chronic conditions, we identified distinct subgroups of patients with mild cognitive impairment (MCI) and dementia who had high cumulative anticholinergic burden and specific patterns of anticholinergic use...
March 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29372598/risk-of-hospitalization-associated-with-anticholinergic-medication-for-patients-with-dementia
#14
Shuichi Watanabe, Takahide Fukatsu, Kosuke Kanemoto
BACKGROUND: With the ageing of the general population, demand has grown for measures to prevent hospitalization for dementia, which can exacerbate problems associated with activities of daily living in elderly individuals. Anticholinergic medication has been shown to cause falls, delirium, and cognitive impairment in aged patients. However, the risk of hospitalization associated with the administration of anticholinergics is unclear. METHODS: We analyzed the records of 61 outpatients (26 men, 35 women; mean age: 78 ± 7 years; mean follow-up period: 420 days) diagnosed with dementia (Alzheimer's disease: n = 45; dementia with Lewy bodies: n = 3; undifferentiated n = 13) and prescribed anti-dementia drugs between May 2013 and December 2014...
January 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29337859/effects-of-pharmacists-interventions-on-inappropriate-drug-use-and-drug-related-readmissions-in-people-with-dementia-a-secondary-analysis-of-a-randomized-controlled-trial
#15
Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jörn Schneede, Hugo Lövheim
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions...
January 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#16
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29322470/associations-between-the-drug-burden-index-potentially-inappropriate-medications-and-quality-of-life-in-residential-aged-care
#17
Stephanie L Harrison, Lisa Kouladjian O'Donnell, Clare E Bradley, Rachel Milte, Suzanne M Dyer, Emmanuel S Gnanamanickam, Enwu Liu, Sarah N Hilmer, Maria Crotty
BACKGROUND: Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life. OBJECTIVE: The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia...
January 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29287694/use-of-anticholinergic-drugs-and-its-relationship-with-psychological-well-being-and-mortality-in-long-term-care-facilities-in-helsinki
#18
Ulla Liisa Aalto, Hanna-Maria Roitto, Harriet Finne-Soveri, Hannu Kautiainen, Kaisu Pitkälä
OBJECTIVES: To assess the burden of drugs with anticholinergic properties (DAPs) and associated factors in long-term care facilities and to explore how psychological well-being and mortality are associated with the use of DAPs. DESIGN: Cross-sectional study and 1-year follow-up of all-cause mortality. SETTING AND PARTICIPANTS: All 4449 older people (>65 years of age) living in nursing homes and assisted living facilities in Helsinki in 2011 were recruited...
December 26, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#19
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29188908/anticholinergic-burden-and-cognition-in-older-patients-with-schizophrenia
#20
Christopher Tsoutsoulas, Benoit H Mulsant, Sanjeev Kumar, Zaid Ghazala, Aristotle N Voineskos, Mahesh Menon, Bruce G Pollock, Tarek K Rajji
OBJECTIVE: Older individuals with schizophrenia are at risk of being treated with anticholinergic medications due to the prevalence of medical comorbidities and polypharmacy. High anticholinergic burden impairs cognition and is a risk factor for Alzheimer's dementia. Thus, we assessed the impact of anticholinergic burden on Alzheimer's dementia-related and schizophrenia-related cognitive functions in older patients with schizophrenia. METHODS: Anticholinergic burden was measured using the Anticholinergic Cognitive Burden scale (ACB) in 60 community-dwelling patients aged ≥ 50 years who met DSM-IV criteria for schizophrenia between May 2007 and November 2011...
November 2017: Journal of Clinical Psychiatry
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