Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life

Hans Wouters, Sarah N Hilmer, Danijela Gnjidic, Jos P Van Campen, Martina Teichert, Helene G Van Der Meer, Laura A Schaap, Martijn Huisman, Hannie C Comijs, Petra Denig, Claudine J Lamoth, Katja Taxis

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.

Methods: Older adult participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive Matrices (RCPM, 2 trials). Physical functioning was assessed with the Walking Test (WT), Cardigan Test (CT), Chair Stands Test (CST), Balance Test (BT), and self-reported Functional Independence (FI). Data were analyzed with linear mixed models adjusted for age, education, sex, living with a partner, BMI, depressive symptoms, co-morbidities (cardiovascular disease, diabetes, cancer, COPD, osteoarthritis, CNS diseases), and prescribed medications.

Results: Longitudinal associations were found of the DBI with poorer cognitive functioning (less items correct on the 3 ACT trials, AVLT learning condition, and the 2 RCPM trials) and with poorer physical functioning (longer completion time on the CT, CST, and lower self-reported FI).

Conclusions: This longitudinal analysis of data collected over 20 years, showed that higher long-term cumulative exposure to anticholinergic and sedative medications was associated with poorer cognitive and physical functioning.

Original languageEnglish
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
DOIs
Publication statusE-pub ahead of print - 21 Jan 2019

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Cholinergic Antagonists
Hypnotics and Sedatives
Cognition
Learning
Crows
Verbal Learning
Sex Education
Central Nervous System Diseases
Osteoarthritis
Pharmaceutical Preparations
Chronic Obstructive Pulmonary Disease
Walking
Longitudinal Studies
Linear Models
Cardiovascular Diseases
Pharmacology
Depression
Morbidity
Neoplasms

Cite this

Wouters, Hans ; Hilmer, Sarah N ; Gnjidic, Danijela ; Van Campen, Jos P ; Teichert, Martina ; Van Der Meer, Helene G ; Schaap, Laura A ; Huisman, Martijn ; Comijs, Hannie C ; Denig, Petra ; Lamoth, Claudine J ; Taxis, Katja. / Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life. In: The journals of gerontology. Series A, Biological sciences and medical sciences. 2019.
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title = "Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life",
abstract = "Background: Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.Methods: Older adult participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive Matrices (RCPM, 2 trials). Physical functioning was assessed with the Walking Test (WT), Cardigan Test (CT), Chair Stands Test (CST), Balance Test (BT), and self-reported Functional Independence (FI). Data were analyzed with linear mixed models adjusted for age, education, sex, living with a partner, BMI, depressive symptoms, co-morbidities (cardiovascular disease, diabetes, cancer, COPD, osteoarthritis, CNS diseases), and prescribed medications.Results: Longitudinal associations were found of the DBI with poorer cognitive functioning (less items correct on the 3 ACT trials, AVLT learning condition, and the 2 RCPM trials) and with poorer physical functioning (longer completion time on the CT, CST, and lower self-reported FI).Conclusions: This longitudinal analysis of data collected over 20 years, showed that higher long-term cumulative exposure to anticholinergic and sedative medications was associated with poorer cognitive and physical functioning.",
author = "Hans Wouters and Hilmer, {Sarah N} and Danijela Gnjidic and {Van Campen}, {Jos P} and Martina Teichert and {Van Der Meer}, {Helene G} and Schaap, {Laura A} and Martijn Huisman and Comijs, {Hannie C} and Petra Denig and Lamoth, {Claudine J} and Katja Taxis",
year = "2019",
month = "1",
day = "21",
doi = "10.1093/gerona/glz019",
language = "English",
journal = "Journals of Gerontology. Series A: Biological Sciences & Medical Sciences",
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Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life. / Wouters, Hans; Hilmer, Sarah N; Gnjidic, Danijela; Van Campen, Jos P; Teichert, Martina; Van Der Meer, Helene G; Schaap, Laura A; Huisman, Martijn; Comijs, Hannie C; Denig, Petra; Lamoth, Claudine J; Taxis, Katja.

In: The journals of gerontology. Series A, Biological sciences and medical sciences, 21.01.2019.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life

AU - Wouters, Hans

AU - Hilmer, Sarah N

AU - Gnjidic, Danijela

AU - Van Campen, Jos P

AU - Teichert, Martina

AU - Van Der Meer, Helene G

AU - Schaap, Laura A

AU - Huisman, Martijn

AU - Comijs, Hannie C

AU - Denig, Petra

AU - Lamoth, Claudine J

AU - Taxis, Katja

PY - 2019/1/21

Y1 - 2019/1/21

N2 - Background: Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.Methods: Older adult participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive Matrices (RCPM, 2 trials). Physical functioning was assessed with the Walking Test (WT), Cardigan Test (CT), Chair Stands Test (CST), Balance Test (BT), and self-reported Functional Independence (FI). Data were analyzed with linear mixed models adjusted for age, education, sex, living with a partner, BMI, depressive symptoms, co-morbidities (cardiovascular disease, diabetes, cancer, COPD, osteoarthritis, CNS diseases), and prescribed medications.Results: Longitudinal associations were found of the DBI with poorer cognitive functioning (less items correct on the 3 ACT trials, AVLT learning condition, and the 2 RCPM trials) and with poorer physical functioning (longer completion time on the CT, CST, and lower self-reported FI).Conclusions: This longitudinal analysis of data collected over 20 years, showed that higher long-term cumulative exposure to anticholinergic and sedative medications was associated with poorer cognitive and physical functioning.

AB - Background: Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.Methods: Older adult participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive Matrices (RCPM, 2 trials). Physical functioning was assessed with the Walking Test (WT), Cardigan Test (CT), Chair Stands Test (CST), Balance Test (BT), and self-reported Functional Independence (FI). Data were analyzed with linear mixed models adjusted for age, education, sex, living with a partner, BMI, depressive symptoms, co-morbidities (cardiovascular disease, diabetes, cancer, COPD, osteoarthritis, CNS diseases), and prescribed medications.Results: Longitudinal associations were found of the DBI with poorer cognitive functioning (less items correct on the 3 ACT trials, AVLT learning condition, and the 2 RCPM trials) and with poorer physical functioning (longer completion time on the CT, CST, and lower self-reported FI).Conclusions: This longitudinal analysis of data collected over 20 years, showed that higher long-term cumulative exposure to anticholinergic and sedative medications was associated with poorer cognitive and physical functioning.

U2 - 10.1093/gerona/glz019

DO - 10.1093/gerona/glz019

M3 - Article

JO - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

JF - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

SN - 1079-5006

ER -