Anticholinergic Burden and Dementia in Older Adults With Subjective Cognitive Decline

Increased risk of incident dementia following use of anticholinergic agents: A systematic literature review and meta‐analysis

“…Cumulative exposure modified the increased risk presented by anticholinergics in the current analysis, with greater increases at higher exposure categories. The strength of anticholinergic activity, which could not be assessed in our analysis, has been found to play a role in the risk of negative effects on cognition 29,33,34 . One study estimated the adjusted hazard ratio for incident dementia in patients with a total ACB score ≥3 versus <3 to be as high as 4.18 (95% CI: 1.43–12.21) 34 .…”

“…The strength of anticholinergic activity, which could not be assessed in our analysis, has been found to play a role in the risk of negative effects on cognition. 29,33,34 One study estimated the adjusted hazard ratio for incident dementia in patients with a total ACB score ≥3 versus <3 to be as high as 4.18 (95% CI: 1.43-12.21). 34 This is particularly relevant to certain populations, such as OAB, as anticholinergic medications for treating OAB (e.g., tolterodine, oxybutynin, darifenacin, fesoterodine, and solifenacin) have the highest anticholinergic burden score.…”

“…29,33,34 One study estimated the adjusted hazard ratio for incident dementia in patients with a total ACB score ≥3 versus <3 to be as high as 4.18 (95% CI: 1.43-12.21). 34 This is particularly relevant to certain populations, such as OAB, as anticholinergic medications for treating OAB (e.g., tolterodine, oxybutynin, darifenacin, fesoterodine, and solifenacin) have the highest anticholinergic burden score. 8,29 Further, when compared to β-3 agonists-a nonantimuscarinic OAB treatment-anticholinergic medications increased the risk of incident dementia (HR = 1.23, 95% CI: 1.12-1.35).…”