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The cognitive impact of anticholinergics: a clinical review.

Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, Schubert CC, Munger S, Fick D, Miller D, Gulati R - Clin Interv Aging (2009)

Bottom Line: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition.

View Article: PubMed Central - PubMed

Affiliation: Wishard Health Services, Indianapolis, IN, USA.

ABSTRACT

Context: The cognitive side effects of medications with anticholinergic activity have been documented among older adults in a variety of clinical settings. However, there has been no systematic confirmation that acute or chronic prescribing of such medications lead to transient or permanent adverse cognitive outcomes.

Objective: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.

Data sources: We searched the MEDLINE, OVID, and CINAHL databases from January, 1966 to January, 2008 for eligible studies.

Study selection: Studies were included if the anticholinergic activity was systematically measured and correlated with standard measurements of cognitive performance. Studies were excluded if they reported case studies, case series, editorials, and review articles.

Data extraction: We extracted the method used to determine anticholinergic activity of medications and its association with cognitive outcomes.

Results: Twenty-seven studies met our inclusion criteria. Serum anticholinergic assay was the main method used to determine anticholinergic activity. All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.

Conclusions: Medications with anticholinergic activity negatively affect the cognitive performance of older adults. Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition.

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Related in: MedlinePlus

Selection process for study inclusion.
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Related In: Results  -  Collection


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f1-cia-4-225: Selection process for study inclusion.

Mentions: Our search strategies revealed 258 potential articles from MEDLINE. However, after scanning the titles and the abstracts, we excluded 217 studies because they did not meet our inclusion criteria. An additional 20 of the remaining 41 articles were excluded because they were reviews, case reports, or case series. From the reference lists of the identified articles we were able to find six additional pertinent publications (see Figure 1).


The cognitive impact of anticholinergics: a clinical review.

Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, Schubert CC, Munger S, Fick D, Miller D, Gulati R - Clin Interv Aging (2009)

Selection process for study inclusion.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697587&req=5

f1-cia-4-225: Selection process for study inclusion.
Mentions: Our search strategies revealed 258 potential articles from MEDLINE. However, after scanning the titles and the abstracts, we excluded 217 studies because they did not meet our inclusion criteria. An additional 20 of the remaining 41 articles were excluded because they were reviews, case reports, or case series. From the reference lists of the identified articles we were able to find six additional pertinent publications (see Figure 1).

Bottom Line: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition.

View Article: PubMed Central - PubMed

Affiliation: Wishard Health Services, Indianapolis, IN, USA.

ABSTRACT

Context: The cognitive side effects of medications with anticholinergic activity have been documented among older adults in a variety of clinical settings. However, there has been no systematic confirmation that acute or chronic prescribing of such medications lead to transient or permanent adverse cognitive outcomes.

Objective: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.

Data sources: We searched the MEDLINE, OVID, and CINAHL databases from January, 1966 to January, 2008 for eligible studies.

Study selection: Studies were included if the anticholinergic activity was systematically measured and correlated with standard measurements of cognitive performance. Studies were excluded if they reported case studies, case series, editorials, and review articles.

Data extraction: We extracted the method used to determine anticholinergic activity of medications and its association with cognitive outcomes.

Results: Twenty-seven studies met our inclusion criteria. Serum anticholinergic assay was the main method used to determine anticholinergic activity. All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.

Conclusions: Medications with anticholinergic activity negatively affect the cognitive performance of older adults. Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition.

Show MeSH
Related in: MedlinePlus