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Anticholinergic medications and Cognition

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https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#1
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29119486/potentially-harmful-medication-use-and-decline-in-health-related-quality-of-life-among-community-dwelling-older-adults
#2
Kenya Ie, Eric Chou, Richard D Boyce, Steven M Albert
BACKGROUND: Several scales to quantify the impact of potentially harmful medications (PHMs) have been shown to predict mortality and functional decline; however, the effect of PHMs on quality of life (QoL) has not been well-studied. OBJECTIVE: The aims of this study were to investigate an association between PHM use and change in health-related QoL among community-dwelling older adults, and to compare the predictive capacity of PHM scales. METHODS: We conducted a retrospective cohort study using prescription claims data and survey responses...
December 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/29067353/midlife-anticholinergic-drug-use-risk-of-alzheimer-s-disease-and-brain-atrophy-in-community-dwelling-older-adults
#3
Yi-Fang Chuang, Palchamy Elango, Christopher E Gonzalez, Madhav Thambisetty
INTRODUCTION: We examined how long-term anticholinergic (AC) drug use beginning at midlife affects risk of Alzheimer's disease (AD) and rates of brain atrophy in cognitively normal older adults. METHODS: We followed 723 individuals (mean baseline age 52.3 years; mean follow-up interval 20.1 years) in the Baltimore Longitudinal Study of Aging. The AC drug exposure was defined using the Anticholinergic Cognitive Burden Scale: Nonusers (n = 404), as well as participants exposed to medications with AC activity but without known clinically relevant negative cognitive effects (i...
September 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29016375/the-impact-of-medication-anticholinergic-burden-on-cognitive-performance-in-people-with-schizophrenia
#4
Mei San Ang, Nur Amirah Abdul Rashid, Max Lam, Attilio Rapisarda, Michael Kraus, Richard S E Keefe, Jimmy Lee
BACKGROUND: Cognitive deficits are prevalent in people with schizophrenia and associated with functional impairments. In addition to antipsychotics, pharmacotherapy in schizophrenia often includes other psychotropics, and some of these agents possess anticholinergic properties, which may impair cognition. The objective of this study was to explore the association between medication anticholinergic burden and cognition in schizophrenia. METHODS: Seven hundred five individuals with schizophrenia completed a neuropsychological battery comprising Judgment of Line Orientation Test, Wechsler Abbreviated Scale of Intelligence Matrix Reasoning, Continuous Performance Test-Identical Pairs Version, and the Brief Assessment of Cognition in Schizophrenia...
October 9, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28942203/potentially-inappropriate-medication-association-between-the-use-of-antidepressant-drugs-and-the-subsequent-risk-for-dementia
#5
Kathrin Heser, Tobias Luck, Susanne Röhr, Birgitt Wiese, Hanna Kaduszkiewicz, Anke Oey, Horst Bickel, Edelgard Mösch, Siegfried Weyerer, Jochen Werle, Christian Brettschneider, Hans-Helmut König, Angela Fuchs, Michael Pentzek, Hendrik van den Bussche, Martin Scherer, Wolfgang Maier, Steffi G Riedel-Heller, Michael Wagner
BACKGROUND: Potentially inappropriate medication (PIM) is associated with an increased risk for detrimental health outcomes in elderly patients. Some antidepressant drugs are considered as PIM, but previous research on the association between antidepressants and subsequent dementia has been inconclusive. Therefore, we investigated whether the intake of antidepressants, particularly of those considered as PIM according to the Priscus list, would predict incident dementia. METHODS: We used data of a prospective cohort study of non-demented primary care patients (n = 3239, mean age = 79...
September 14, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28889761/safety-issues-associated-with-using-medication-to-treat-overactive-bladder
#6
REVIEW
George Araklitis, Linda Cardozo
The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB. Areas covered: Patients with increased anticholinergic load are at risk of cognitive decline, dementia or even death. The elderly are particularly at risk due to polypharmacy. Botulinum toxin carries the risk of high urinary residuals, urinary tract infection and need to self catheterise. The use of vaginal oestrogens may improve OAB symptoms, but there is concern in those with a history of breast cancer...
November 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28869467/potentially-inappropriate-medication-anticholinergic-burden-and-mortality-in-people-attending-memory-clinics
#7
Amanda J Cross, Johnson George, Michael C Woodward, David Ames, Henry Brodaty, Rory Wolfe, Michael H Connors, Rohan A Elliott
BACKGROUND: There is limited evidence regarding the association between potentially inappropriate medications (PIM) and mortality in older people with cognitive impairment. OBJECTIVE: To examine whether use of medications considered to be potentially inappropriate in older people with cognitive impairment (PIMcog) and anticholinergic cognitive burden (ACB) were associated with mortality in people who attended memory clinics. METHODS: Cross-sectional and longitudinal analyses of data from the Prospective Research In MEmory clinics (PRIME) study...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28868891/anticholinergic-burden-in-older-inpatients-on-psychotropic-medication-do-we-care
#8
Mei Shiang Lee, Steve Kisely, Boris Zolotarev, Andrew Warren, Jack Henderson, Manoj George
OBJECTIVES: This quality activity explored the prescribing patterns in an Older Persons Mental Health Inpatient Unit in order to establish whether the Anticholinergic Cognitive Burden Scale (ACB Scale) score on admission was reviewed to minimise anticholinergic cognitive burden (ACB) while maintaining therapeutic effects. METHODS: A retrospective electronic chart review of 50 discharged patients for any documented ACB review by the treating team, as well as the ACB Scale scores on admission and discharge...
September 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28810270/the-personal-antipsychotic-choice-index
#9
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
#10
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
#11
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...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28688993/fat-demented-and-stupid-an-unrecognized-legacy-of-pediatric-urology
#12
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...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28627117/the-cognitive-features-of-idiopathic-and-dyt1-dystonia
#13
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...
October 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
(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
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