NEW YORK (Reuters Health) – Long-term exposure to anticholinergic agents is associated with poor memory and executive function in older men, according to a report in the Journal of the American Geriatrics Society for December.

“Given the established link between acute anticholinergic toxicity and cognitive impairment and the lack of literature addressing the chronic anticholinergics effects in older persons,” Dr. Ling Han and co-researchers write, “the current study was proposed to examine the longitudinal relationship between cumulative anticholinergic exposure and cognitive performance of community-dwelling older adults over a 2-year follow-up period.

In the study, 544 hypertensive men aged at least 65 were tested with the Hopkins Verbal Recall Test (HVRT), a measure of short-term memory, and the instrumental activity of daily living (IADL) scale, a test of executive function, at baseline and during follow-up.

“Anticholinergic medication use was ascertained using participants’ primary care visit records and quantified as total anticholinergic burden using a clinician-rated anticholinergic score,” the investigators explain.

Cumulative anticholinergic exposure in the preceding 12 months was associated with poorer scores on the HVRT and IADL, Dr. Han, from Yale University School of Medicine, New Haven, Connecticut, and colleagues found.

After accounting for age, comorbidities, and other potential correlates of cognitive impairment, each 1-unit increase in the total anticholinergic burden per 3-month period was associated with a 0.32-point drop in the HVRT score and a 0.10-point fall in the IADL score.

Adjustment for concomitant use of non-anticholinergics drugs weakened, but did not eliminate the statistically significant associations.

Further studies are needed to determine if these findings also hold true in women and if they apply to older adults without comorbidities, the researchers state.

In the meantime, they advise, clinicians prescribing drugs with anticholinergic properties should be alert to the potential adverse effects described in this study.

Reference:
J Am Geriatr Soc 2008;56:2203-2210.