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Anticholinergic medications and Cognition

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https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#1
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27909739/quantification-of-anticholinergic-and-sedative-drug-load-with-the-drug-burden-index-a-review-of-outcomes-and-methodological-quality-of-studies
#2
REVIEW
Hans Wouters, Helene van der Meer, Katja Taxis
PURPOSE: The Drug Burden Index (DBI) is a non-invasive method to quantify patients' anticholinergic and sedative drug burden from their prescriptions. This systematic review aimed to summarise the evidence on the associations between the DBI and clinical outcomes and methodological quality of studies. METHODS: A search in PubMed and Embase (search terms: 'drug', 'burden', and 'index') was performed and experts were contacted. We excluded publications that did not report empirical results or clinical outcomes...
December 1, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27891403/efficacy-of-transcutaneous-electrical-nerve-stimulation-in-the-treatment-of-overactive-bladder
#3
Nidhi Sharma, Kaja Rekha, Krishnamurthy Jayashree Srinivasan
INTRODUCTION: Overactive Bladder (OAB) accounts for 40-70% cases of incontinence. The etiology is unknown though detrusor instability is found in urodynamic evaluation of almost all cases. Detrusor instability or hyperreflexia can be inhibited by direct inhibition of impulses in the pre-ganglionic afferent neuron or by inhibition of bladder pre-ganglionic neurons of the efferent limb of micturition reflex. Transcutaneous Electrical Nerve Stimulation (TENS) is based on the gate control theory of abolishing the local micturition reflex arc...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27866902/the-atypical-antipsychotic-olanzapine-disturbs-depotentiation-by-modulating-machrs-and-impairs-reversal-learning
#4
Woo Seok Song, Jin Hee Cha, Sang Ho Yoon, Young Seon Cho, Kyeong-Yeol Park, Myoung-Hwan Kim
Antipsychotic medication is an essential component for treating schizophrenia, which is a serious mental disorder that affects approximately 1% of the global population. Olanzapine (Olz), one of the most frequently prescribed atypical antipsychotics, is generally considered a first-line drug for treating schizophrenia. In contrast to psychotic symptoms, the effects of Olz on cognitive symptoms of schizophrenia are still unclear. In addition, the mechanisms by which Olz affects the neural circuits associated with cognitive function are unknown...
November 17, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/27827295/trends-in-medication-use-over-11-years-in-patients-presenting-to-a-rural-and-remote-memory-clinic
#5
Ryan Verity, Andrew Kirk, Debra Morgan, Chandima Karunanayake
BACKGROUND: Anticholinergic and sedating medications are generally contraindicated in those with cognitive decline. We examined trends in medication use by patients at initial presentation to a rural and remote memory clinic (RRMC) between March 2004 and June 2015 to determine whether patterns of medication use have changed. METHODS: The first 444 patients seen at the RRMC between 2004 and 2015 were included in this analysis. Medication lists were collected at the patient's initial visit, and it was noted whether patients were taking anticholinergic or potentially sedating drugs...
November 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27763767/drug-burden-index-and-change-in-cognition-over-time-in-community-dwelling-older-men-the-champ-study
#6
Kris M Jamsen, Danijela Gnjidic, Sarah N Hilmer, Jenni Ilomäki, David G Le Couteur, Fiona M Blyth, David J Handelsman, Vasi Naganathan, Louise M Waite, Robert G Cumming, J Simon Bell
OBJECTIVE: Anticholinergic and sedative medications are associated with acute cognitive impairment but the long-term impact on change in cognition is unclear. This study investigated the effect of anticholinergic and sedative medications, quantified using the Drug Burden Index (DBI), on change in cognition over time in community-dwelling older men. METHODS: This was a prospective cohort study of men aged ≥70 years in Sydney, Australia. DBI was assessed at baseline, two and five years...
October 20, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27751466/re-association-between-anticholinergic-medication-use-and-cognition-brain-metabolism-and-brain-atrophy-in-cognitively-normal-older-adults
#7
Alan J Wein
No abstract text is available yet for this article.
November 2016: Journal of Urology
https://www.readbyqxmd.com/read/27727284/orthostatic-hypotension-and-the-long-term-risk-of-dementia-a-population-based-study
#8
Frank J Wolters, Francesco U S Mattace-Raso, Peter J Koudstaal, Albert Hofman, M Arfan Ikram
BACKGROUND: Orthostatic hypotension (OH) is a common cause of transient cerebral hypoperfusion in the population. Cerebral hypoperfusion is widely implicated in cognitive impairment, but whether OH contributes to cognitive decline and dementia is uncertain. We aimed to determine the association between OH and the risk of developing dementia in the general population. METHODS AND FINDINGS: Between 4 October 1989 and 17 June 1993, we assessed OH in non-demented, stroke-free participants of the population-based Rotterdam Study...
October 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27711982/association-of-anticholinergic-burden-with-cognitive-impairment-and-health-care-utilization-among-a-diverse-ambulatory-older-adult-population
#9
Noll L Campbell, Anthony J Perkins, Pamela Bradt, Sinem Perk, Ronald C Wielage, Malaz A Boustani, Daniel B Ng
STUDY OBJECTIVE: To determine the association between Anticholinergic Cognitive Burden (ACB) score and both cognitive impairment and health care utilization among a diverse ambulatory older adult population. DESIGN: Retrospective cohort study. DATA SOURCE: Medication exposure and other clinical data were extracted from the Regenstrief Medical Record System (RMRS), and cognitive diagnosis derived from a dementia screening and diagnosis study...
October 6, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27663539/postoperative-delirium-following-orthognathic-surgery-in-a-young-patient
#10
Fernanda Herrera da Costa, Paulo Adilson Herrera, Cecília Luiz Pereira-Stabile, Glaykon Alex Vitti Stabile
Delirium is an organic mental syndrome with acute onset characterized by diffuse brain dysfunction and neural activity disorganization. It is usually related to cognition and perception changes, decreased level of consciousness, and disorganization of thoughts that are unrelated to previous dementia. Occurrence is more frequent in patients with previous degenerative disease and elderly patients, especially those older than 85 years. Although the pathophysiology is not totally known, studies have shown that, among the main factors that lead to delirium, the drugs used for general anesthesia induction are the most relevant (hypnotics, anticholinergic drugs, and H2 receptor blockers), especially those used in long surgical procedures...
August 27, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27638818/anticholinergic-drug-use-and-risk-to-cognitive-performance-in-older-adults-with-questionable-cognitive-impairment-a-cross-sectional-analysis
#11
Sunil Swami, Ronald A Cohen, John A Kairalla, Todd M Manini
BACKGROUND: Age-associated decline in central cholinergic activity makes older adults susceptible to the harmful effects of anticholinergic (AC) medications; however, there is an inadequate understanding of the association and possible effects of AC drugs on cognition. This cross-sectional study examines the associations of AC medications on cognition among older adults with questionable cognitive impairment (QCI). METHODS: For this cross-sectional study, we used a multicenter database of community-dwelling older adults (N = 7351) aged 60+ years with QCI, from September 2005 to March 2014, as the baseline data...
November 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27590402/anticholinergic-medication-burden-and-5-year-risk-of-hospitalization-and-death-in-nursing-home-elderly-residents-with-coronary-artery-disease
#12
Davide L Vetrano, Domenico La Carpia, Giulia Grande, Paola Casucci, Tiziana Bacelli, Roberto Bernabei, Graziano Onder
OBJECTIVES: To assess the association of the anticholinergic medication burden with hospitalization and mortality in nursing home elderly patients and to investigate the role of coronary artery disease (CAD). DESIGN: Longitudinal (5-year) retrospective observational study. SETTING: Nursing homes in Italy. PARTICIPANTS: A total of 3761 nursing home older residents. MEASUREMENTS: A comprehensive clinical and functional assessment was carried out through the interRAI long-term care facility instrument...
August 30, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27579830/estimated-budget-impact-of-increased-use-of-mirabegron-a-novel-treatment-for-overactive-bladder
#13
Sinem Perk, Ronald C Wielage, Noll L Campbell, Timothy M Klein, Anthony Perkins, Linda M Posta, Thomas Yuran, Robert W Klein, Daniel B Ng
BACKGROUND: Oral pharmacological treatment for overactive bladder (OAB) consists of antimuscarinics and the beta-3 adrenergic agonist mirabegron. Antimuscarinic adverse events (AEs) such as dry mouth, constipation, and blurry vision can result in frequent treatment discontinuation rates, leaving part of the OAB population untreated. Antimuscarinics also contribute to a patient's anticholinergic cognitive burden (ACB), so the Beers Criteria recommends cautious use of antimuscarinics in elderly patients who take multiple anticholinergic medications or have cognitive impairment...
September 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27576609/anticholinergic-burden-in-schizophrenia-and-ability-to-benefit-from-psychosocial-treatment-programmes-a-3-year-prospective-cohort-study
#14
K O'Reilly, P O'Connell, G Donohoe, C Coyle, D O'Sullivan, Z Azvee, C Maddock, K Sharma, H Sadi, M McMahon, H G Kennedy
BACKGROUND: Many medications administered to patients with schizophrenia possess anticholinergic properties. When aggregated, pharmacological treatments may result in a considerable anticholinergic burden. The extent to which anticholinergic burden has a deleterious effect on cognition and impairs ability to participate in and benefit from psychosocial treatments is unknown. METHOD: Seventy patients were followed for approximately 3 years. The MATRICS consensus cognitive battery (MCCB) was administered at baseline...
August 31, 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27574750/estimated-budget-impact-of-increased-use-of-mirabegron-a-novel-treatment-for-overactive-bladder
#15
Sinem Perk, Ronald C Wielage, Noll L Campbell, Timothy M Klein, Anthony Perkins, Linda M Posta, Thomas Yuran, Robert W Klein, Daniel B Ng
BACKGROUND: Oral pharmacological treatment for overactive bladder (OAB) consists of antimuscarinics and the beta-3 adrenergic agonist mirabegron. Antimuscarinic adverse events (AEs) such as dry mouth, constipation, and blurry vision can result in frequent treatment discontinuation rates, leaving part of the OAB population untreated. Antimuscarinics also contribute to a patient's anticholinergic cognitive burden (ACB), so the Beers Criteria recommends cautious use of antimuscarinics in elderly patients who take multiple anticholinergic medications or have cognitive impairment...
September 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27531858/central-cholinergic-pathway-involvement-in-the-regulation-of-pupil-diameter-blink-rate-and-cognitive-function
#16
Preshanta Naicker, Shailendra Anoopkumar-Dukie, Gary D Grant, David L Neumann, Justin J Kavanagh
Anticholinergic medications can exert their effects by acting on muscarinic receptors, which mediates the function of acetylcholine in the central nervous system. Acetylcholine plays a number of roles, particularly in regards to the control of muscle activity and normal cognitive functioning. Eighteen subjects were recruited into the human, double-blind, placebo-controlled, four-way crossover study. Pupil diameter and blink rate were assessed at rest while eye tracking technology recorded eye characteristics...
August 12, 2016: Neuroscience
https://www.readbyqxmd.com/read/27443047/over-prescribed-medications-under-appreciated-risks-a-review-of-the-cognitive-effects-of-anticholinergic-medications-in-older-adults
#17
REVIEW
Daniel M I Britt, Gregory S Day
Anticholinergic medications are associated with adverse cognitive effects in cognitively normal and impaired individuals, with a greater magnitude of effect observed in individuals with preexisting cognitive impairment due to Alzheimer disease.
May 2016: Missouri Medicine
https://www.readbyqxmd.com/read/27401519/the-impact-of-plasma-cholinergic-enzyme-activity-and%C3%A2-other-risk-factors-for-the-development-of%C3%A2-delirium%C3%A2-in%C3%A2-patients-receiving-palliative-care
#18
Konstanze Plaschke, Katharina A Petersen, Susanne Frankenhauser, Markus A Weigand, Jürgen Kopitz, Hubert J Bardenheuer
CONTEXT: Delirium is an important complication in palliative care patients. One of the potential risk factors for cognitive disorders is deterioration in cholinergic neurotransmission. Anticholinergic medications are known to be important owing to the association of their metabolites with significant morbidity, which is often the result of cumulative effects of medications (anticholinergic burden). Additionally, cholinergic enzymes are possible candidates reflecting the cholinergic situation in patients...
July 9, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27364828/dtb-select-7-july-2016
#19
(no author information available yet)
MHRA: avoid live vaccines in immunosuppressed patients ● Topical NSAIDs for musculoskeletal pain in adults ● Adherence to pregnancy prevention measures during isotretinoin treatment ● Impact of the NHS Health Check programme ● Ibuprofen: first choice for migraine in young people? ● Neuropsychiatric safety of ▼ varenicline and bupropion ● Effects of anticholinergic medication in cognitively normal older adults ● New NICE guidance for controlled drugs.
July 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27340375/an-update-on-geriatric-medication-safety-and-challenges-specific-to-the-care-of-older-adults
#20
Michael Koronkowski, Christine Eisenhower, Zachary Marcum
The prescribing of drug therapies in older adults presents a number of safety challenges. The increased complexity of chronic care for older adults has led to polypharmacy and potentially inappropriate medication use, which can contribute to drug-induced diseases, adverse drug reactions, drug interactions, cognitive impairment, falls, hospitalization, and mortality. In this review, the authors discuss recent medication safety literature pertaining to the classes of medications commonly prescribed to older adults: anticholinergics, psychiatric medications, and antibiotics...
March 2016: Annals of Long-term Care: the Official Journal of the American Medical Directors Association
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