Anticholinergic burden and cognitive performance: cross-sectional results from the ELSA-Brasil study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSANTOS, Adriana Nancy Medeiros dos
dc.contributor.authorGIMENEZ JUNIOR, Guilherme Amorim Avilla
dc.contributor.authorBENSENOR, Isabela M.
dc.contributor.authorGOULART, Alessandra C.
dc.contributor.authorBRUNONI, Andre R.
dc.contributor.authorVIANA, Maria Carmen
dc.contributor.authorLOTUFO, Paulo A.
dc.contributor.authorSUEMOTO, Claudia Kimie
dc.date.accessioned2022-10-26T14:15:00Z
dc.date.available2022-10-26T14:15:00Z
dc.date.issued2022
dc.description.abstractObjectives Using multiple drugs with anticholinergic properties is common and might lead to cumulative anticholinergic toxicity and increased risk of cognitive impairment. Therefore, we sought to investigate the association between the Anticholinergic Cognitive Burden (ACB) Scale and cognitive performance among middle-aged and older adults. Methods In this cross-sectional study with 13,065 participants from the baseline visit of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), mean age was 51.7 +/- 9.0 years old, 55% women, and 53% white. The ACB was calculated based on the medications in use. We investigated the association of ACB with global cognition and memory, verbal fluency (VF), and trail-making test version B (TMT-B) z-scores, using multiple linear regression models adjusted for sociodemographic and clinical variables. Results Overall, 16% of participants had an ACB score greater than 0. ACB was associated with poor cognitive performance in all tests in crude analysis. After adjustment for sociodemographic characteristics, the association remained significant for the global cognitive score, as well as the memory and the TMT-B z-scores. However, after further adjustments for clinical variables, only trend associations of ACB with poor memory (beta = - 0.02, 95% Cl = - 0.05, 0.00, p = 0.056) and the TMT-B z-scores (beta = - 0.02, 95% Cl = - 0.04, 0.00, p = 0.054) were found. In stratified analyses by age groups, ACB was associated with poor cognitive performance on the TMT-B (beta = - 0.03, 95% Cl = - 0.05, - 0.01, p = 0.005) in individuals aged less than 65 years old. Conclusion Although the ACB was associated with poor executive function only among middle-aged adults in adjusted analysis, residual confounding may partly explain our results.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipCNPq [01060010.00RS, 01060212.00BA, 01060300.00ES, 01060278.00MG, 01060115.00SP, 01060071.00RJ]
dc.description.sponsorshipBrazilian Ministry of Health
dc.identifier.citationEUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, v.78, n.9, p.1527-1534, 2022
dc.identifier.doi10.1007/s00228-022-03361-8
dc.identifier.eissn1432-1041
dc.identifier.issn0031-6970
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/49104
dc.language.isoeng
dc.publisherSPRINGER HEIDELBERGeng
dc.relation.ispartofEuropean Journal of Clinical Pharmacology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGER HEIDELBERGeng
dc.subjectAnticholinergic burdeneng
dc.subjectCognitioneng
dc.subjectDementiaeng
dc.subjectDrug utilizationeng
dc.subject.othermedicationeng
dc.subject.otherreceptorseng
dc.subject.otherriskeng
dc.subject.wosPharmacology & Pharmacyeng
dc.titleAnticholinergic burden and cognitive performance: cross-sectional results from the ELSA-Brasil studyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalVIANA, Maria Carmen:Univ Fed Espirito Santo, Ctr Psychiat Epidemiol CEPEP, Dept Social Med, Postgrad Program Publ Hlth, Vitoria, ES, Brazil
hcfmusp.citation.scopus2
hcfmusp.contributor.author-fmusphcADRIANA NANCY MEDEIROS DOS SANTOS
hcfmusp.contributor.author-fmusphcGUILHERME DE AMORIM AVILLA GIMENEZ JUNIOR
hcfmusp.contributor.author-fmusphcISABELA JUDITH MARTINS BENSEñOR
hcfmusp.contributor.author-fmusphcALESSANDRA CARVALHO GOULART
hcfmusp.contributor.author-fmusphcANDRE RUSSOWSKY BRUNONI
hcfmusp.contributor.author-fmusphcPAULO ANDRADE LOTUFO
hcfmusp.contributor.author-fmusphcCLAUDIA KIMIE SUEMOTO
hcfmusp.description.beginpage1527
hcfmusp.description.endpage1534
hcfmusp.description.issue9
hcfmusp.description.volume78
hcfmusp.origemWOS
hcfmusp.origem.pubmed35764818
hcfmusp.origem.scopus2-s2.0-85133002420
hcfmusp.origem.wosWOS:000817831700002
hcfmusp.publisher.cityHEIDELBERGeng
hcfmusp.publisher.countryGERMANYeng
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hcfmusp.scopus.lastupdate2024-06-09
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