Key result
Higher anticholinergic cognitive burden links to poorer neuropsychological performance, especially with lower medical burden.
Why the study?
The interaction between medical burden and anticholinergic cognitive burden on neuropsychological performance in elderly patients was unknown.
Does the interaction between medical burden and anticholinergic cognitive burden affect neuropsychological performance in elderly primary care patients?
Cross-Sectional (n=290)
Does the interaction between medical burden and anticholinergic cognitive burden affect neuropsychological performance in elderly primary care patients?
In older patients, the negative cognitive effects of medical burden may overshadow the effects of anticholinergic medications, though anticholinergic burden significantly impairs cognition in those with lower medical burden.
Anticholinergic effects on cognition may be masked by high medical burden; hypothesis-generating for interaction in cross-sectional elderly data.
Poorer neuropsychological function is associated with increased medical burden (MB) and the use of more anticholinergic medications. However, the interaction between MB and anticholinergic cognitive burden (AB) on neuropsychological performance is unknown. In a sample of 290 elderly primary care patients, those with a greater level of AB demonstrated poorer Total Index performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Further, an interaction effect was noted such that there was a greater anticholinergic effect on RBANS Total, Attention, and Delayed Memory Index scores for participants with fewer MB. Participants with more MB demonstrated poorer performance irrespective of their level of AB. These results indicate that MB effects may be overshadowed by anticholinergic effects in older patients.
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Block et al. (2014) conducted a cross-sectional in Elderly primary care patients (n=290). Anticholinergic cognitive burden (AB) and medical burden (MB) vs. Lower levels of AB and MB was evaluated on Neuropsychological performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Greater anticholinergic cognitive burden was associated with poorer neuropsychological performance, with a stronger effect observed in patients with lower medical burden.
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