The Experts below are selected from a list of 3117 Experts worldwide ranked by ideXlab platform
Ian Maidment - One of the best experts on this subject based on the ideXlab platform.
-
anticholinergic and benzodiazepine medication use and risk of incident dementia a uk cohort study
BMC Geriatrics, 2019Co-Authors: Carlota M Grossi, Chris Fox, Kathryn Richardson, Ian Maidment, Antony Arthur, Yoon K Loke, Nicholas Steel, Phyo K Myint, Noll L Campbell, Malaz BoustaniAbstract:Studies suggest that anticholinergic medication or benzodiazepine use could increase dementia risk. We tested this hypothesis using data from a UK cohort study. We used data from the baseline (Y0), 2-year (Y2) and 10-year (Y10) waves of the Medical Research Council Cognitive Function and Ageing Study. Participants without dementia at Y2 were included (n = 8216). Use of benzodiazepines (including nonbenzodiazepine Z-drugs), Anticholinergics with score 3 (ACB3) and Anticholinergics with score 1 or 2 (ACB12) according to the Anticholinergic Cognitive Burden scale were coded as ever use (use at Y0 or Y2), recurrent use (Y0 and Y2), new use (Y2, but not Y0) or discontinued use (Y0, but not Y2). The outcome was incident dementia by Y10. Incidence rate ratios (IRR) were estimated using Poisson regression adjusted for potential confounders. Pre-planned subgroup analyses were conducted by age, sex and Y2 Mini-Mental State Examination (MMSE) score. Dementia incidence was 9.3% (N = 220 cases) between Y2 and Y10. The adjusted IRRs (95%CI) of developing dementia were 1.06 (0.72, 1.60), 1.28 (0.82, 2.00) and 0.89 (0.68, 1.17) for benzodiazepines, ACB3 and ACB12 ever-users compared with non-users. For recurrent users the respective IRRs were 1.30 (0.79, 2.14), 1.68 (1.00, 2.82) and 0.95 (0.71, 1.28). ACB3 ever-use was associated with dementia among those with Y2 MMSE> 25 (IRR = 2.28 [1.32–3.92]), but not if Y2 MMSE≤25 (IRR = 0.94 [0.51–1.73]). Neither benzodiazepines nor ACB12 medications were associated with dementia. Recurrent use of ACB3 Anticholinergics was associated with dementia, particularly in those with good baseline cognitive function. The long-term prescribing of Anticholinergics should be avoided in older people.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI) 50.03‐0.64, P 5.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI 5 0.14‐0.11, P 5.79). Twoyear mortality was greater for those taking definite (OR 51.68; 95% CI 51.30‐2.16; Po.001) and possible (OR 51.56; 95% CI 51.36‐1.79;Po.001) Anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. J Am Geriatr Soc 2011.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:Objectives To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. Design A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. Setting Community-dwelling and institutionalized participants. Participants Thirteen thousand four participants aged 65 and older. Measurements Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. Results At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P Conclusion The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.
-
impact of Anticholinergics on the aging brain a review and practical application
Aging Health, 2008Co-Authors: Malaz Boustani, Noll L Campbell, Ian Maidment, Stephanie Munger, Chris FoxAbstract:Objective: in an effort to enhance medication prescribing for older adults and reduce the burden of cognitive impairment, this paper reviews the literature regarding the negative impact of Anticholinergics on cognitive function and provides clinicians with a practical guidance for anticholinergic use in older adults. Methods: a Medline search identified studies evaluating the use of Anticholinergics and the relationship between Anticholinergics and cognitive impairment. Results: prescribing Anticholinergics for older adults leads to acute cognitive impairment and, possibly, chronic cognitive deficits. Assessing anticholinergic burden with a simple scale may represent a useful noninvasive tool to optimize geriatric pharmacotherapy. Conclusion: more studies are needed to validate the Anticholinergic Cognitive Burden scale and establish therapeutic guidelines in the presence of cognitive anticholinergic adverse effects.
Cornelius Katona - One of the best experts on this subject based on the ideXlab platform.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI) 50.03‐0.64, P 5.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI 5 0.14‐0.11, P 5.79). Twoyear mortality was greater for those taking definite (OR 51.68; 95% CI 51.30‐2.16; Po.001) and possible (OR 51.56; 95% CI 51.36‐1.79;Po.001) Anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. J Am Geriatr Soc 2011.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:Objectives To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. Design A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. Setting Community-dwelling and institutionalized participants. Participants Thirteen thousand four participants aged 65 and older. Measurements Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. Results At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P Conclusion The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.
Kaarin J Anstey - One of the best experts on this subject based on the ideXlab platform.
-
the effect of cumulative anticholinergic use on the cognitive function of older adults results from the personality and total health path through life study
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2020Co-Authors: Malinee Neelamegam, Janice C Zgibor, Henian Chen, Kathleen Orourke, Chighaf Bakour, Lakshminarayan Rajaram, Kaarin J AnsteyAbstract:Background: Multiple comorbidities are common in older adults, resulting in polypharmacy that often includes medications with anticholinergic properties. These medications have multiple side effects, which are more pronounced in the older population. This study examined the association between the use of Anticholinergics and changes in cognitive function of older adults. Methods: The study population consisted of 2222 individuals aged 65-69 years at baseline from the PATH Through Life Study in Australia. Medication data were obtained from the Pharmaceutical Benefits Scheme (PBS). Cognitive measures were obtained from neuropsychological battery assessment. Exposure to cumulative anticholinergic use was quantified to Total Standardized Daily Dose (TSDD). The association between change in cognitive measures between baseline and 4-year follow-up, and cumulative use of anticholinergic was assessed through generalized linear models. Results: During the study period, 18.6% (n=413) of participants filled at least one prescription for Anticholinergics. Compared to those not on Anticholinergics, participants on Anticholinergics were more likely to be female (62.7% compared to 45.1%) and spent lesser time engaging in vigorous physical activity (0.4 hours/week compared to 0.9 hours/week). Cumulative use of anticholinergic resulting in a total standardized daily dose exceeding 1095 was significantly associated with poorer performance in Trail Making Test Part B (Model 1: β=5.77, Model 2: β=5.33, Model 3: β=8.32, p<0.01), indicating impairment in processing speed. Conclusion: In our study, except for speed of processing, other cognitive domains measured were not affected by cumulative anticholinergic use over a 4-year period.
David G Smithard - One of the best experts on this subject based on the ideXlab platform.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI) 50.03‐0.64, P 5.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI 5 0.14‐0.11, P 5.79). Twoyear mortality was greater for those taking definite (OR 51.68; 95% CI 51.30‐2.16; Po.001) and possible (OR 51.56; 95% CI 51.36‐1.79;Po.001) Anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. J Am Geriatr Soc 2011.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:Objectives To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. Design A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. Setting Community-dwelling and institutionalized participants. Participants Thirteen thousand four participants aged 65 and older. Measurements Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. Results At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P Conclusion The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.
Chris Fox - One of the best experts on this subject based on the ideXlab platform.
-
increasing prevalence of anticholinergic medication use in older people in england over 20 years cognitive function and ageing study i and ii
Research Square, 2020Co-Authors: Carlota M Grossi, Chris Fox, Kathryn Richardson, George M Savva, Fiona E Matthews, Antony Arthur, Yoon K Loke, Nicholas Steel, Carol Brayne, Louise RobinsonAbstract:Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality, and their use should be limited in older people. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990–1993 (N = 7635) and 2008–2011 (N = 7762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score = 3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2–6.3%) of the older population in 1990–93 to 9.9% (9.3–10.7%) in 2008–11, adjusted odds ratio of 1.90 (95% CI 1.67–2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent Anticholinergics in CFAS II (16.5% [95% CI 12.0–22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.
-
anticholinergic and benzodiazepine medication use and risk of incident dementia a uk cohort study
BMC Geriatrics, 2019Co-Authors: Carlota M Grossi, Chris Fox, Kathryn Richardson, Ian Maidment, Antony Arthur, Yoon K Loke, Nicholas Steel, Phyo K Myint, Noll L Campbell, Malaz BoustaniAbstract:Studies suggest that anticholinergic medication or benzodiazepine use could increase dementia risk. We tested this hypothesis using data from a UK cohort study. We used data from the baseline (Y0), 2-year (Y2) and 10-year (Y10) waves of the Medical Research Council Cognitive Function and Ageing Study. Participants without dementia at Y2 were included (n = 8216). Use of benzodiazepines (including nonbenzodiazepine Z-drugs), Anticholinergics with score 3 (ACB3) and Anticholinergics with score 1 or 2 (ACB12) according to the Anticholinergic Cognitive Burden scale were coded as ever use (use at Y0 or Y2), recurrent use (Y0 and Y2), new use (Y2, but not Y0) or discontinued use (Y0, but not Y2). The outcome was incident dementia by Y10. Incidence rate ratios (IRR) were estimated using Poisson regression adjusted for potential confounders. Pre-planned subgroup analyses were conducted by age, sex and Y2 Mini-Mental State Examination (MMSE) score. Dementia incidence was 9.3% (N = 220 cases) between Y2 and Y10. The adjusted IRRs (95%CI) of developing dementia were 1.06 (0.72, 1.60), 1.28 (0.82, 2.00) and 0.89 (0.68, 1.17) for benzodiazepines, ACB3 and ACB12 ever-users compared with non-users. For recurrent users the respective IRRs were 1.30 (0.79, 2.14), 1.68 (1.00, 2.82) and 0.95 (0.71, 1.28). ACB3 ever-use was associated with dementia among those with Y2 MMSE> 25 (IRR = 2.28 [1.32–3.92]), but not if Y2 MMSE≤25 (IRR = 0.94 [0.51–1.73]). Neither benzodiazepines nor ACB12 medications were associated with dementia. Recurrent use of ACB3 Anticholinergics was associated with dementia, particularly in those with good baseline cognitive function. The long-term prescribing of Anticholinergics should be avoided in older people.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:PARTICIPANTS: Thirteen thousand four participants aged 65 and older. MEASUREMENTS: Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI) 50.03‐0.64, P 5.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI 5 0.14‐0.11, P 5.79). Twoyear mortality was greater for those taking definite (OR 51.68; 95% CI 51.30‐2.16; Po.001) and possible (OR 51.56; 95% CI 51.36‐1.79;Po.001) Anticholinergics. CONCLUSION: The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality. J Am Geriatr Soc 2011.
-
anticholinergic medication use and cognitive impairment in the older population the medical research council cognitive function and ageing study
Journal of the American Geriatrics Society, 2011Co-Authors: Chris Fox, Kathryn Richardson, Ian Maidment, George M Savva, Fiona E Matthews, David G Smithard, Simon Coulton, Cornelius KatonaAbstract:Objectives To determine whether the use of medications with possible and definite anticholinergic activity increases the risk of cognitive impairment and mortality in older people and whether risk is cumulative. Design A 2-year longitudinal study of participants enrolled in the Medical Research Council Cognitive Function and Ageing Study between 1991 and 1993. Setting Community-dwelling and institutionalized participants. Participants Thirteen thousand four participants aged 65 and older. Measurements Baseline use of possible or definite Anticholinergics determined according to the Anticholinergic Cognitive Burden Scale and cognition determined using the Mini-Mental State Examination (MMSE). The main outcome measure was decline in the MMSE score at 2 years. Results At baseline, 47% of the population used a medication with possible anticholinergic properties, and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of nonanticholinergic medications, number of comorbid health conditions, and cognitive performance at baseline, use of medication with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score (95% confidence interval (CI)=0.03-0.64, P=.03) than not taking Anticholinergics, whereas the use of possible Anticholinergics at baseline was not associated with further decline (0.02, 95% CI=-0.14-0.11, P=.79). Two-year mortality was greater for those taking definite (OR=1.68; 95% CI=1.30-2.16; P Conclusion The use of medications with anticholinergic activity increases the cumulative risk of cognitive impairment and mortality.
-
impact of Anticholinergics on the aging brain a review and practical application
Aging Health, 2008Co-Authors: Malaz Boustani, Noll L Campbell, Ian Maidment, Stephanie Munger, Chris FoxAbstract:Objective: in an effort to enhance medication prescribing for older adults and reduce the burden of cognitive impairment, this paper reviews the literature regarding the negative impact of Anticholinergics on cognitive function and provides clinicians with a practical guidance for anticholinergic use in older adults. Methods: a Medline search identified studies evaluating the use of Anticholinergics and the relationship between Anticholinergics and cognitive impairment. Results: prescribing Anticholinergics for older adults leads to acute cognitive impairment and, possibly, chronic cognitive deficits. Assessing anticholinergic burden with a simple scale may represent a useful noninvasive tool to optimize geriatric pharmacotherapy. Conclusion: more studies are needed to validate the Anticholinergic Cognitive Burden scale and establish therapeutic guidelines in the presence of cognitive anticholinergic adverse effects.