Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study
Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 y...
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| Published in | BMJ Vol. 332; no. 7539; pp. 455 - 458 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
British Medical Journal Publishing Group
25.02.2006
British Medical Association BMJ Publishing Group LTD BMJ Publishing Group BMJ Publishing Group Ltd |
| Edition | International edition |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 years without dementia at recruitment. Main outcome measures Anticholinergic burden from drug use, cognitive examination, and neurological assessment. Results 9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years. Conclusions Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. |
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| AbstractList | To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people.
Longitudinal cohort study.
63 randomly selected general practices in the Montpellier region of southern France.
372 people aged > 60 years without dementia at recruitment.
Anticholinergic burden from drug use, cognitive examination, and neurological assessment.
9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years.
Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 years without dementia at recruitment. Main outcome measures Anticholinergic burden from drug use, cognitive examination, and neurological assessment. Results 9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years. Conclusions Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors.[PUBLICATION ABSTRACT] Abstract Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 years without dementia at recruitment. Main outcome measures Anticholinergic burden from drug use, cognitive examination, and neurological assessment. Results 9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years. Conclusions Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 years without dementia at recruitment. Main outcome measures Anticholinergic burden from drug use, cognitive examination, and neurological assessment. Results 9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years. Conclusions Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60 years without dementia at recruitment. Main outcome measures Anticholinergic burden from drug use, cognitive examination, and neurological assessment. Results 9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years. Conclusions Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people.OBJECTIVETo assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people.Longitudinal cohort study.DESIGNLongitudinal cohort study.63 randomly selected general practices in the Montpellier region of southern France.SETTING63 randomly selected general practices in the Montpellier region of southern France.372 people aged > 60 years without dementia at recruitment.PARTICIPANTS372 people aged > 60 years without dementia at recruitment.Anticholinergic burden from drug use, cognitive examination, and neurological assessment.MAIN OUTCOME MEASURESAnticholinergic burden from drug use, cognitive examination, and neurological assessment.9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years.RESULTS9.2% of subjects continuously used anticholinergic drugs during the year before cognitive assessment. Compared with non-users, they had poorer performance on reaction time, attention, delayed non-verbal memory, narrative recall, visuospatial construction, and language tasks but not on tasks of reasoning, immediate and delayed recall of wordlists, and implicit memory. Eighty per cent of the continuous users were classified as having mild cognitive impairment compared with 35% of non-users, and anticholinergic drug use was a strong predictor of mild cognitive impairment (odds ratio 5.12, P = 0.001). No difference was found between users and non-users in risk of developing dementia at follow-up after eight years.Elderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors.CONCLUSIONSElderly people taking anticholinergic drugs had significant deficits in cognitive functioning and were highly likely to be classified as mildly cognitively impaired, although not at increased risk for dementia. Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors. |
| Author | Ritchie, Karen Dupuy, Anne-Marie Portet, Florence Touchon, Jacques Ancelin, Marie L Artero, Sylvaine |
| AuthorAffiliation | 1 Inserm, E361, Pathologies of the Nervous System, 34093 Montpellier, France |
| AuthorAffiliation_xml | – name: 1 Inserm, E361, Pathologies of the Nervous System, 34093 Montpellier, France |
| Author_xml | – sequence: 1 givenname: Marie L surname: Ancelin fullname: Ancelin, Marie L organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France – sequence: 2 givenname: Sylvaine surname: Artero fullname: Artero, Sylvaine organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France – sequence: 3 givenname: Florence surname: Portet fullname: Portet, Florence organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France – sequence: 4 givenname: Anne-Marie surname: Dupuy fullname: Dupuy, Anne-Marie organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France – sequence: 5 givenname: Jacques surname: Touchon fullname: Touchon, Jacques organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France – sequence: 6 givenname: Karen surname: Ritchie fullname: Ritchie, Karen email: ritchie@montp.inserm.fr organization: Inserm, E, Pathologies of the Nervous System, Montpellier, France |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17500993$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/16452102$$D View this record in MEDLINE/PubMed https://inserm.hal.science/inserm-00000025$$DView record in HAL |
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| Keywords | Human Medicine Drug Cognitive disorder Follow up study Cohort study Use mild cognitive impairment Anticholinesterase agent Elderly Parasympatholytic Public health |
| Language | English |
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| Notes | Correspondence to: K Ritchie, Inserm E361, Hôpital La Colombière, Pav 42, 39 Avenue Flahault, BP 34493, 34093 Montpellier Cedex 5, France ArticleID:bmj.38740.439664.DE href:bmj-332-455.pdf PMID:16452102 ark:/67375/NVC-0087VT18-5 local:bmj;332/7539/455 istex:69E8403D344F26E541C415E12D72A6DE9A2AD67E ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Correspondence to: K Ritchie, Inserm E361, Hôpital La Colombière, Pav 42, 39 Avenue Flahault, BP 34493, 34093 Montpellier Cedex 5, France ritchie@montp.inserm.fr Ethical approval: Authorisation for the study was obtained from the national data protection committee (CNIL) and the national ethics committee. Funding: Financial support for the Eugeria project was given by the French Social Security (CNAM-TS), the Fondation de France, the Direction Générale de la Santé, and the Region Languedoc Roussillon. Contributors: The first two authors, MLA and SA, contributed equally to this work. KR is guarantor. All authors participated in analysis and interpretation of data, drafting or revising the article, and all have given final approval to be published. We thank Francine Jourdan for her assistance in data management. Competing interests: None declared. |
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| Snippet | Abstract Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design... Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal... To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Longitudinal cohort study. 63... OBJECTIVE: To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal... To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people.OBJECTIVETo assess the potential of... OBJECTIVE: To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. DESIGN: Longitudinal... Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal... |
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| SubjectTerms | Aged Aged, 80 and over Analgesics Antiarrhythmics Anticholinergics Antihypertensives Attention Attention - drug effects Biological and medical sciences Cholinergic agents Cholinergic Antagonists Cholinergic Antagonists - adverse effects Cognition & reasoning Cognition Disorders Cognition Disorders - chemically induced Cognition Disorders - diagnosis Cognitive impairment Dementia Dementia - chemically induced Dementia - diagnosis Dementia - epidemiology Drug therapy Epidemiologic Methods France France - epidemiology General aspects Geriatrics Humans Inhibitor drugs Language Disorders Language Disorders - chemically induced Language Disorders - epidemiology Life Sciences Medical sciences Memory Memory Disorders Memory Disorders - chemically induced Memory Disorders - epidemiology Middle Aged Miscellaneous Neurology Neuropsychological Tests Older adults Prescription drugs Public health. Hygiene Public health. Hygiene-occupational medicine Reaction Time Reaction Time - drug effects Research Support, Non-U.S. Gov't Santé publique et épidémiologie Space Perception - drug effects Thinking - drug effects |
| Title | Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study |
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