Use of drugs with anticholinergic effect and impact on cognition in Parkinson's disease: a cohort study

Abstract

Our findings suggest that there is an association between anticholinergic drug use and cognitive decline in PD. This may provide an important opportunity for clinicians to avoid increasing progression of cognitive decline by avoiding drugs with AA. Increased awareness by clinicians is required about the classes of drugs that have anticholinergic properties.

Muscarinic Receptors: Their Roles in Disorders of the Central Nervous System and Potential as Therapeutic Targets

“…With the role played by the striatal interneurons in the development of motor symptoms, anticholinergic drugs were one of the original treatments for Parkinson's disease; indeed they are still used as an adjunct treatment to the dopamine precursor, levadopa, because they ameliorate the movement disorder associated with the disease [123]. However, due to their nonspecific nature these drugs have a number of side effects-including exacerbation of cognitive decline [123].…”

Cognitive deficits in Parkinson’s disease: current perspectives

“…Regression analysis adjusting for age, depression and baseline cognition suggested that duration and load of anti-cholinergic drugs were both significantly associated with decline on MMSE score. 68 Conversely, cholinesterase inhibitors (ChEIs) -drugs that indirectly increase the availability of ACh -are the only proven treatment to enhance cognitive function in PDD according to meta-analysis. 69 …”

<b>Analysis of physicochemical properties of drugs included in anticholinergic rating scales</b>

“…We obtained data on drugs published in anticholinergic rating scales from seven articles [7][8][9][10][11][12][13] used in a systematic review [3] that evaluated the differences between each anticholinergic rating scale and the relation between anticholinergic burden and adverse effects. In these articles, drugs were ranked by the strength of their anticholinergic effects.…”

“…In total, we obtained 545 drugs from seven articles [7][8][9][10][11][12][13]. Bismuth subsalicylate was excluded due to the many missing values in its calculated descriptors.…”