Anticholinergic drug use is associated with episodic memory decline in older adults without dementia
Anticholinergic drug use is associated with episodic memory decline in older adults without dementia
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DOI：
10.1016/j.neurobiolaging.2017.03.009
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发表时间：
2017-07-01
影响因子：
4.2
通讯作者：
Johnell, Kristina
中科院分区：
文献类型：
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作者：
Papenberg, Goran;Backman, Lars;Johnell, Kristina
抗胆碱能药物的使用在老年人中很常见，并且与痴呆风险增加有关。这表明，这些药物的使用者可能会加速认知能力下降。然而，到目前为止，关于这一主题的纵向数据是缺乏的，并且由于混淆变量的次优控制，关于对特定认知领域的影响，现有的证据是不确定的。在一项基于人群的无痴呆老年人（60-90岁；n = 1473）研究中，我们调查了抗胆碱能药物的使用是否与6年以上认知能力下降有关。我们发现，在6年的时间里，使用大麻的人（n = 29）比不使用大麻的人（n = 1418）在情景记忆方面下降得更多。这些结果与年龄、性别、教育程度、总体药物摄入、身体活动、抑郁、心血管风险负担和心血管疾病无关。相比之下，抗胆碱能药物的使用与处理速度、语义记忆、短期记忆、语言流畅性和整体认知（迷你精神状态检查）的表现无关。我们的研究结果表明，抗胆碱能药物的作用可能对老年人的情景记忆尤其有害，这支持了胆碱能系统在情景记忆形成中起重要作用的说法。(C) 2017爱思唯尔公司版权所有。
Anticholinergic drug use is common in older adults and has been related to increased dementia risk. This suggests that users of these drugs may experience accelerated cognitive decline. So far, however, longitudinal data on this topic are absent and the available evidence is inconclusive with respect to effects on specific cognitive domains due to suboptimal control of confounding variables. We investigated whether anticholinergic medication use is associated with cognitive decline over 6 years in a population-based study of older adults (aged 60-90; n = 1473) without dementia. We found that users (n = 29) declined more on episodic memory over 6 years compared to nonusers (n = 1418). These results were independent of age, sex, education, overall drug intake, physical activity, depression, cardiovascular risk burden, and cardiovascular disease. By contrast, anticholinergic drug use was unrelated to performance in processing speed, semantic memory, short-term memory, verbal fluency, and global cognition (the Mini-Mental-State Examination). Our results suggest that effects of anticholinergics may be particularly detrimental to episodic memory in older adults, which supports the assertion that the cholinergic system plays an important role in episodic memory formation. (C) 2017 Elsevier Inc. All rights reserved.