The interaction between medical burden and anticholinergic cognitive burden on neuropsychological function in a geriatric primary care sample

Arch Clin Neuropsychol. 2015 Mar;30(2):105-13. doi: 10.1093/arclin/acu073. Epub 2014 Dec 30.

Abstract

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.

Keywords: Assessment; Attention; Geriatrics.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinergic Antagonists / adverse effects*
  • Cognition Disorders* / chemically induced
  • Cognition Disorders* / diagnosis
  • Cognition Disorders* / psychology
  • Cognitive Aging
  • Female
  • Humans
  • Linear Models
  • Male
  • Neuropsychological Tests*
  • Primary Health Care
  • Surveys and Questionnaires

Substances

  • Cholinergic Antagonists