Key result
Anticholinergic cognitive burden shows no link to incident Parkinson disease dementia.
Why the study?
Anticholinergic medication use has been associated with increased dementia incidence in older adults, but its association specifically with Parkinson disease dementia had not been explored.
Does anticholinergic medication use increase the risk of incident dementia in patients with Parkinson disease?
Cohort
Does anticholinergic medication use increase the risk of incident dementia in patients with Parkinson disease?
Anticholinergic cognitive burden was not overall associated with incident dementia in Parkinson's disease, though patient factors like age, motor symptom burden, and psychosis increased risk.
No overall association does not support ACB reduction to prevent Parkinson disease dementia; leaves open risks in high-burden patients with depression or impulse control disorder.
PurposeAnticholinergic medication use measured via the Anticholinergic Cognitive Burden (ACB) scale has been associated with an increased dementia incidence in older adults but has not been explored specifically for Parkinson disease dementia (PDD). We used adjusted Cox models to estimate the risk of incident PDD associated with demographic factors, clinical characteristics, and time-varying total ACB in a longitudinal, deeply-phenotyped prospective PD cohort.Major findings56.5% of study participants were taking ACB-scale drugs at enrollment. Increasing age, motor symptom burden and psychosis were associated with PDD risk. Female sex and educational achievement were protective against PDD. ACB categories were not associated with PDD overall, but depression and impulse control disorder were strongly associated with PDD in a subsample with high baseline ACB.ConclusionsPatient and clinical factors modify PDD risk. PD drug safety and drug-disease interaction studies may require considering multiple mechanisms and including dose-based, prospectively acquired medication exposure measures.
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Nguyen et al. (2025) conducted a cohort in Parkinson disease. Anticholinergic medication (Anticholinergic Cognitive Burden scale) was evaluated on Incident Parkinson disease dementia (PDD). Anticholinergic Cognitive Burden categories were not associated with incident Parkinson disease dementia overall, though depression and impulse control disorder were associated in a high-ACB subsample.
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