Table 2.
Crude and adjusted odds ratios of dementia by prescription of any, defined daily doses (DDDs), and total burden of anticholinergics measured with the Anticholinergic Cognitive Burden (ACB) score
| Exposure during DEP | No of cases (%) | No of controls (%) | Odds ratio (95% CI) | |||
|---|---|---|---|---|---|---|
| Unadjusted | Adjusted at start of DEP* † | Adjusted at end of DEP* ‡ | ||||
| Any use | ||||||
| Prescriptions (ACB score): | ||||||
| None | 4295 (10.5) | 36 329 (12.8) | 1.00 | 1.00 | 1.00 | |
| 1 | 36 437 (89.4) | 247 406 (87.1) | 1.25§ (1.21 to 1.29) | 1.11§ (1.07 to 1.15) | 1.10§ (1.06 to 1.15) | |
| 2 | 1429 (3.5) | 7909 (2.8) | 1.27§ (1.20 to 1.35) | 1.10§ (1.03 to 1.17) | 1.10§ (1.03 to 1.16) | |
| 3 | 14 453 (35.5) | 86 403 (30.4) | 1.27§ (1.24 to 1.30) | 1.16§ (1.13 to 1.19) | 1.11§ (1.08 to 1.14) | |
| Number of DDDs (ACB score) | ||||||
| 1: | ||||||
| 0 | 4333 (10.6) | 36 527 (12.9) | 1.00 | 1.00 | 1.00 | |
| >0-13 | 3000 (7.4) | 20 530 (7.2) | 1.24§ (1.18 to 1.30) | 1.16§ (1.11 to 1.22) | 1.14§ (1.08 to 1.20) | |
| 14-89 | 2530 (6.2) | 17 088 (6.0) | 1.25§ (1.19 to 1.32) | 1.15§ (1.09 to 1.21) | 1.13§ (1.07 to 1.19) | |
| 90-364 | 4253 (10.4) | 28 497 (10.0) | 1.26§ (1.21 to 1.32) | 1.12§ (1.07 to 1.18) | 1.09§ (1.04 to 1.15) | |
| 365-1459 | 8549 (21.0) | 56 607 (19.9) | 1.28§ (1.23 to 1.33) | 1.12§ (1.07 to 1.17) | 1.10§ (1.05 to 1.15) | |
| >1460 | 18 105 (44.4) | 124 684 (43.9) | 1.23§ (1.19 to 1.28) | 1.05 (1.01 to 1.10) | 1.05 (1.01 to 1.10) | |
| 2: | ||||||
| 0 | 39 341 (96.5) | 276 024 (97.2) | 1.00 | 1.00 | 1.00 | |
| >0-13 | 704 (1.7) | 4301 (1.5) | 1.15§ (1.06 to 1.25) | 1.01 (0.93 to 1.10) | 1.02 (0.94 to 1.11) | |
| 14-89 | 266 (0.7) | 1533 (0.5) | 1.22§ (1.07 to 1.39) | 1.08 (0.94 to 1.23) | 1.07 (0.94 to 1.23) | |
| 90-364 | 218 (0.5) | 1035 (0.4) | 1.48§ (1.28 to 1.72) | 1.23§ (1.06 to 1.43) | 1.20 (1.03 to 1.40) | |
| 365-1459 | 176 (0.4) | 826 (0.3) | 1.50§ (1.27 to 1.76) | 1.23 (1.04 to 1.45) | 1.18 (0.99 to 1.39) | |
| >1460 | 65 (0.2) | 214 (0.1) | 2.15§ (1.63 to 2.83) | 1.62§ (1.22 to 2.15) | 1.57§ (1.18 to 2.09) | |
| 3: | ||||||
| 0 | 26 317 (64.5) | 197 530 (69.6) | 1.00 | 1.00 | 1.00 | |
| >0-13 | 5663 (13.9) | 38 084 (13.4) | 1.13§ (1.10 to 1.17) | 1.07§ (1.04 to 1.11) | 1.04 (1.01 to 1.08) | |
| 14-89 | 2440 (6.0) | 15 154 (5.3) | 1.23§ (1.17 to 1.28) | 1.13§ (1.08 to 1.18) | 1.07§ (1.02 to 1.12) | |
| 90-364 | 2786 (6.8) | 15 462 (5.4) | 1.37§ (1.31 to 1.43) | 1.24§ (1.19 to 1.30) | 1.17§ (1.12 to 1.22) | |
| 365-1459 | 2512 (6.2) | 12 626 (4.4) | 1.51§ (1.45 to 1.58) | 1.35§ (1.29 to 1.42) | 1.27§ (1.21 to 1.33) | |
| >1460 | 1052 (2.6) | 5077 (1.8) | 1.59§ (1.49 to 1.71) | 1.40§ (1.30 to 1.50) | 1.31§ (1.22 to 1.41) | |
| Average ACB score | ||||||
| <0.1 | 9517 (23.3) | 74 445 (26.2) | 1.00 | 1.00 | 1.00 | |
| 0.1-0.4 | 6084 (14.9) | 41 528 (14.6) | 1.15§ (1.11 to 1.19) | 1.09§ (1.05 to 1.13) | 1.07§ (1.03 to 1.11) | |
| 0.5-0.9 | 5781 (14.2) | 40 413 (14.2) | 1.12§ (1.08 to 1.16) | 1.06§ (1.02 to 1.10) | 1.06§ (1.02 to 1.10) | |
| 1.0-1.9 | 9030 (22.2) | 62 348 (22.0) | 1.14§ (1.10 to 1.17) | 1.06§ (1.03 to 1.10) | 1.07§ (1.01 to 1.09) | |
| 2.0-2.9 | 4914 (12.1) | 33 113 (11.7) | 1.17§ (1.13 to 1.21) | 1.07§ (1.03 to 1.12) | 1.07§ (1.02 to 1.12) | |
| 3.0-4.9 | 3874 (9.5) | 23 954 (8.4) | 1.28§ (1.23 to 1.33) | 1.13§ (1.08 to 1.19) | 1.12§ (1.07 to 1.18) | |
| >5.0 | 1570 (3.9) | 8132 (2.9) | 1.53§ (1.44 to 1.62) | 1.31§ (1.23 to 1.40) | 1.28§ (1.19 to 1.36) | |
DEP=drug exposure period
Adjusted for age, region, any falls, any fractures, and number of doctor consultations in the 12 months before the DEP. Also adjusted for the number of prescriptions during the DEP for the following drugs not rated as anticholinergic: benzodiazepines, z drugs, antidepressants, antinausea and antivertigo preparations, antiepileptics, and antiparkinson drugs.
Adjusted for the following variables measured at the start of the DEP: body mass index, smoking status, harmful alcohol use, depression duration (0, 0-2, 2-5, 5-10, 10-20, and >20 years), and all diagnoses listed in table 1.
Adjusted for the following variables measured at the end of the DEP: body mass index, smoking status, harmful alcohol use, depression duration (0, 0-5, 5-10, 10-15, 15-20, and >20 years), and all diagnoses listed in table 1.
P<0.01.