Etusivulle

Central adverse events

Cognition +
  • Acetylcholine and cognition are related. Acetylcholine receptor block with scopolamine under experimental conditions show a cognitive decline in both young and elderly people20,21
  • Numerous studies have shown an association between the use of anticholinergic drugs and a decrease in cognitive functions. The risk of developing delirium also increases with the use of anticholinergics11,22,23
  • In particular, carriers of the apolipoprotein E4 allele are sensitive to the cognitive-decreasing effect of anticholinergics24
Other +
  • In elderly people, who are cognitively normal, the use of anticholinergics may worsen cognition, reduce brain glucose metabolism and increase brain atrophy compared to those who do not use anticholinergics26
Previous References

11. Rudolph JL, Salow MJ, Angelini MC, et al. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 2008;168:508-513.

20. Flicker Flicker C, Serby M, Ferris SH. Scopolamine effects on memory, language, visuospatial praxis and psychomotor speed. Psychopharmacology (Berl) 1990;100:243-50.

21. Molchan SE, Martinez RA, Hill JL, Weingartner HJ, Thompson K, Vitiello B, Sunderland T. Increased cognitive sensitivity to scopolamine with age and a perspective on the scopolamine model. Brain Res Brain Res Rev 1992;17:215-26.

22. Cancelli I, Beltrame M, Gigli GL, Valente M.Drugs with anticholinergic properties: cognitive and neuropsychiatric side-effects in elderly patients. Neurol Sci 2009;30:87-92. Review.

23. Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, Schubert CC, Munger S, Fick D, Miller D, Gulati R. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging 2009;4:225-33.

25. Teramura-Grönblad M, Muurinen S, Soini H, Suominen M, Pitkälä KH. Use of anticholinergic drugs and cholinesterase inhibitors and their association with psychological well-being among frail older adults in residential care facilities. Ann Pharmacother 2011;45:596-602.

26. Risacher SL, McDonald BC, Tallman EF, West JD, Farlow MR, Unverzagt FW, Gao S, Boustani M, Crane PK, Petersen RC, Jack CR Jr, Jagust WJ, Aisen PS, Weiner MW, Saykin AJ; Alzheimer’s Disease Neuroimaging Initiative. Association Between Anticholinergic Medication Use and Cognition, Brain Metabolism, and Brain Atrophy in Cognitively Normal Older Adults. JAMA Neurol 2016;73:721-32.

36. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, Yu O, Crane PK, Larson EB7. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med 2015;175:401-7.