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Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life

Wouters, H., Hilmer, S. N., Gnjidic, D., Van Campen, J. P., Teichert, M., Van Der Meer, H. G., Schaap, L. A., Huisman, M., Comijs, H. C., Denig, P., Lamoth, C. J. & Taxis, K., Feb-2020, In : Journal of Gerontology: Medical sciences. 75, 2, p. 357-365 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

Background: Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.

Methods: Older adult participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive Matrices (RCPM, 2 trials). Physical functioning was assessed with the Walking Test (WT), Cardigan Test (CT), Chair Stands Test (CST), Balance Test (BT), and self-reported Functional Independence (FI). Data were analyzed with linear mixed models adjusted for age, education, sex, living with a partner, BMI, depressive symptoms, co-morbidities (cardiovascular disease, diabetes, cancer, COPD, osteoarthritis, CNS diseases), and prescribed medications.

Results: Longitudinal associations were found of the DBI with poorer cognitive functioning (less items correct on the 3 ACT trials, AVLT learning condition, and the 2 RCPM trials) and with poorer physical functioning (longer completion time on the CT, CST, and lower self-reported FI).

Conclusions: This longitudinal analysis of data collected over 20 years, showed that higher long-term cumulative exposure to anticholinergic and sedative medications was associated with poorer cognitive and physical functioning.

Original languageEnglish
Pages (from-to)357-365
Number of pages9
JournalJournal of Gerontology: Medical sciences
Volume75
Issue number2
Early online date21-Jan-2019
Publication statusPublished - Feb-2020

    Keywords

  • Neuropsychology, Mobility impairment, Polypharmacy, Anti-muscarinics, Benzodiazepines, DRUG BURDEN INDEX, BENZODIAZEPINE USE, OLDER, PERFORMANCE, PEOPLE, POLYPHARMACY, ASSOCIATION, POPULATION, DEMENTIA, DECLINE

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