Table 2:
Association Between Anticholinergic Exposure and Neuropathologic Outcomes
| Cumulative Anticholinergic Exposure | |||||
|---|---|---|---|---|---|
| No use N=85 |
1–90 TSDD N=113 |
91–1095 TSDD N=137 |
≥1096 TSDD N=85 |
||
| n (%) | n (%) | n (%) | n (%) | p-value | |
| AD-related neuropathology | |||||
| Neuritic plaque scores* | |||||
| None/sparse | 45 (53) | 55 (49) | 63 (46) | 43 (51) | |
| Intermediate/frequent | 40 (47) | 58 (51) | 74 (54) | 42 (49) | |
| RR (95% CI)† | Ref. | 1.15 (0.80, 1.74) | 1.29 (0.90, 1.91) | 1.22 (0.81, 1.88) | 0.59 |
| Neurofibrillary degeneration | |||||
| Braak stage 0-IV | 57 (67) | 80 (71) | 89 (65) | 64 (75) | |
| Braak stage V-VI | 28 (33) | 33 (29) | 48 (35) | 21 (25) | |
| RR (95% CI)† | Ref. | 0.88 (0.52, 1.51) | 1.21 (0.75, 2.00) | 0.89 (0.47, 1.66) | 0.49 |
| Amyloid angiopathy | |||||
| None | 52 (61) | 90 (80) | 89 (65) | 58 (70) | |
| Any | 33 (39) | 22 (20) | 48 (35) | 25 (30) | |
| RR (95% CI)† | Ref. | 0.53 (0.29, 0.99) | 0.84 (0.53, 1.38) | 0.97 (0.56, 1.71) | 0.18 |
| Vascular brain injury-related neuropathology | |||||
| Cerebral microinfarcts | |||||
| 0–2 | 67 (81) | 95 (84) | 116 (85) | 75 (89) | |
| 3 or more | 16 (19) | 18 (16) | 21 (15) | 9 (11) | |
| RR (95% CI)† | Ref. | 0.51 (0.24, 1.14) | 0.44 (0.21, 0.89) | 0.24 (0.09, 0.62) | 0.02 |
| Macroscopic infarcts†† | |||||
| 0 | 54 (64) | 76 (68) | 85 (63) | 49 (60) | |
| ≥ 1 | 30 (36) | 35 (32) | 49 (37) | 33 (40) | |
| RR (95% CI) ** | Ref. | 0.80 (0.48, 1.37) | 0.91 (0.58, 1.44) | 0.90 (0.55, 1.53) | 0.87 |
| Atherosclerosis | |||||
| None/mild | 33 (40) | 48 (44) | 56 (42) | 25 (31) | |
| Moderate/severe | 49 (60) | 61 (56) | 77 (58) | 56 (69) | |
| RR (95% CI)† | Ref. | 0.92 (0.68, 1.27) | 0.99 (0.72, 1.36) | 1.11 (0.80, 1.53) | 0.64 |
Abbreviations: ACT, Adult Changes in Thought; AD, Alzheimer’s Disease; CI, confidence interval; HR, hazard ratio; TSDD, Total Standardized Daily Doses
*
Consortium to Establish a Registry for Alzheimer’s Disease scoring system.
†
Adjusted for ACT study cohort, age at death, sex, education, treated hypertension, diabetes, stroke and coronary artery disease
††
Cystic infarcts and acute or subacute infarcts.
**
Adjusted for ACT study cohort, age at death, sex, education, treated hypertension, diabetes and coronary artery disease