Long-term anticholinergic use and the aging brain.
Long-term anticholinergic use and the aging brain.
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DOI：
10.1016/j.jalz.2012.02.005
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Boustani M
中科院分区：
文献类型：
--
作者：
Cai X;Campbell N;Khan B;Callahan C;Boustani M
美国老年人正面临慢性疾病的流行，因此暴露于抗胆碱能药物（AC），这可能会对他们患轻度认知障碍（MCI）或痴呆症的风险产生负面影响。研究认知功能损害与既往AC暴露之间的相关性。回顾性队列研究。印第安纳州印第安纳波利斯的初级保健诊所。3690名老年人接受了认知评估，并有一年的药物分配记录。认知功能的测量分为两个连续的步骤;一个两步筛选过程，然后是一个正式的诊断过程的参与者与积极的筛选结果。根据AC暴露持续时间、同时分发的AC药物数量以及抗胆碱能认知负荷列表确定的AC效应严重程度定义了三种AC暴露模式。与未暴露于抗胆碱能药物的老年人相比，在调整年龄、种族、性别和潜在合并症后，诊断为MCI的比值比（OR）为2.73（95%置信区间，CI; 1.27，5.87）暴露于至少三种可能的抗胆碱能药物至少90天的老年人;患痴呆的OR为0.43（95%CI; 0.10，1.81）。暴露于具有严重抗胆碱能认知负担的药物可能是发生MCI的危险因素。
Older Americans are facing an epidemic of chronic diseases and are thus exposed to anticholinergics (AC) that might negatively affect their risk of developing mild cognitive impairment (MCI) or dementia. Investigate the association between impairment in cognitive function and previous AC exposure. A retrospective cohort study. Primary care clinics in Indianapolis, Indiana. 3690 older adults who have undergone cognitive assessment and had a one-year medication dispensing record. Cognitive function was measured in two sequential steps; a two-step screening process followed by a formal diagnostic process for participants with positive screening results. Three patterns of AC exposure were defined by the duration of AC exposure, the number of AC medications dispensed at the same time, and the severity of AC effects as determined by the Anticholinergic Cognitive Burden List. In comparison to older adults with no anticholinergic exposure and after adjusting for age, race, gender, and underlying comorbidity, the odds ratio (OR) for having a diagnosis of MCI was 2.73 (95% confidence interval, CI; 1.27, 5.87) among older adults who were exposed to at least three possible anticholinergic for at least 90 days; and the OR for having dementia was 0.43 (95% CI; 0.10, 1.81). Exposure to medications with severe anticholinergic cognitive burden may be a risk factor for developing MCI.
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影响因子：
7.2
作者：
VONKORFF, M;WAGNER, EH;SAUNDERS, K
通讯作者：
SAUNDERS, K
影响因子：
4
作者：
Boustani, Malaz;Perkins, Anthony J.;Hendrie, Hugh C.
通讯作者：
Hendrie, Hugh C.
影响因子：
2.6
作者：
Andrade, Susan E.;Kahler, Kristijan H.;Chan, K. Arnold
通讯作者：
Chan, K. Arnold
影响因子：
6.3
作者：
American Geriatrics Society 2012 Beers Criteria Update Expert Panel
通讯作者：
American Geriatrics Society 2012 Beers Criteria Update Expert Panel
DOI：
10.1111/j.1532-5415.2005.00543.x
发表时间：
2006-01-01
影响因子：
6.3
作者：
Schubert, CC;Boustani, M;Hendrie, HC
通讯作者：
Hendrie, HC