Table 4.

Association Between Cumulative Anticholinergic Exposure and Memory and Executive Function Adjusted for Concomitant Medications and Other Risk Factors

	Hopkins Verbal Recall Test	Instrumental Activities of Daily Living
Model*	Effect Estimate† (95% Confidence Interval) P-Value; t Ratio‡
4.1	0.28 (0.01–0.55) .04; 2.3	0.10 (0.04–0.17) .002; 158.0
4.2	0.25 (−0.06–0.57) .12; 2.3	0.06 (−0.02–0.13) .13; 0.7
4.3	0.29 (0.01–0.56) .04; 2.9	0.08 (0.02–0.15) .01; 1.3

^*All of the models adjusted for the same set of covariates as Model 4 of Table 3, including age, race, education, living arrangement before enrollment, Center for Epidemiologic Studies-Depression Scale (range 0–63) score, activity of daily living score, tobacco and alcohol use, Charlson Comorbidity Index, level of hypertension, follow-up year, and baseline value of the outcome. In addition, Model 4.1 adjusted for total concomitant antihypertensive medications, which included some anticholinergic drugs; Model 4.2 adjusted for total concomitant psychotropic medications, which included some anticholinergic drugs; and Model 4.3 adjusted for total concomitant non-anticholinergic medications, which included only the non-anticholinergic drugs based on a clinician-rated anticholinergic score of 0.

^†Effect estimate using a mixed-effects linear regression model representing expected decrement in the score of each outcome associated with 1-unit increase in the cumulative anticholinergic exposure per 3 months.

^‡A ratio of the t statistics for the effect of anticholinergic exposure to that of the concomitant medications adjusted in each model (see above), with a value greater than 1 indicating that the anticholinergic exposure has a stronger association with the outcome.