Table 3.
Relation between cumulative exposure to anticholinergic drugs over a 3-year period and z-scores on cognitive function tests (n=34 267)
| Cumulative AC exposure | Episodic memory | Verbal fluency | Executive functions | ||||||||||||
| Immediate free recall | Delayed free recall | Semantic fluency | Phonemic fluency | DSST | TMT-A | TMT-B | |||||||||
| Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | |||||||||
| n | Univariate model | ||||||||||||||
| None | 18 095 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | |||||||
| <3 months | 10 437 | −0.024 (0.012) | −0.025 (0.012) | * | −0.030 (0.012) | * | −0.010 (0.012) | −0.023 (0.012) | −0.019 (0.012) | −0.027 (0.012) | * | ||||
| 3–12 months | 3385 | −0.092 (0.019) | *** | −0.081 (0.019) | *** | −0.073 (0.019) | *** | −0.045 (0.019) | * | −0.100 (0.019) | *** | −0.040 (0.019) | * | −0.073 (0.019) | *** |
| 1–3 years | 1786 | −0.055 (0.025) | * | −0.076 (0.025) | ** | −0.097 (0.025) | *** | −0.055 (0.025) | * | −0.160 (0.025) | *** | −0.112 (0.025) | *** | −0.104 (0.025) | *** |
| >3 years | 564 | −0.189 (0.043) | *** | −0.207 (0.043) | *** | −0.126 (0.043) | ** | −0.151 (0.043) | *** | −0.373 (0.043) | *** | −0.239 (0.043) | *** | −0.275 (0.043) | *** |
| P trend | *** | *** | *** | *** | *** | *** | *** | ||||||||
| n | Adjustment on lifestyle variables† | ||||||||||||||
| None | 18 095 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | |||||||
| <3 months | 10 437 | −0.022 (0.012) | −0.024 (0.012) | * | −0.029 (0.012) | * | −0.007 (0.012) | −0.017 (0.012) | −0.020 (0.012) | −0.027 (0.012) | * | ||||
| 3–12 months | 3385 | −0.085 (0.019) | *** | −0.077 (0.019) | *** | −0.066 (0.019) | *** | −0.031 (0.019) | −0.083 (0.019) | *** | −0.043 (0.019) | * | −0.071 (0.019) | *** | |
| 1–3 years | 1786 | −0.043 (0.025) | −0.067 (0.025) | ** | −0.083 (0.025) | *** | −0.031 (0.025) | −0.131 (0.025) | *** | −0.113 (0.025) | *** | −0.095 (0.025) | *** | ||
| >3 years | 564 | −0.166 (0.043) | ** | −0.189 (0.043) | *** | −0.102 (0.043) | * | −0.108 (0.043) | * | −0.311 (0.043) | *** | −0.241 (0.043) | *** | −0.257 (0.043) | *** |
| n | Adjustment on lifestyle† and health status variables‡ | ||||||||||||||
| None | 18 095 | Ref | Ref | Ref | Ref | Ref | Ref | Ref | |||||||
| <3 months | 10 437 | −0.014 (0.012) | −0.016 (0.012) | −0.022 (0.012) | 0.000 (0.012) | −0.004 (0.012) | −0.013 (0.012) | −0.017 (0.012) | |||||||
| 3–12 months | 3385 | −0.060 (0.019) | ** | −0.050 (0.019) | ** | −0.039 (0.019) | * | −0.006 (0.019) | −0.035 (0.019) | −0.013 (0.019) | −0.032 (0.019) | ||||
| 1–3 years | 1786 | −0.002 (0.025) | −0.022 (0.025) | −0.041 (0.025) | 0.008 (0.025) | −0.050 (0.025) | * | −0.065 (0.025) | * | −0.032 (0.025) | |||||
| >3 years | 564 | −0.103 (0.044) | * | −0.125 (0.043) | ** | −0.040 (0.043) | −0.054 (0.043) | −0.193 (0.043) | *** | −0.167 (0.043) | *** | −0.163 (0.043) | *** | ||
| P trend | ** | ** | ** | *** | *** | *** | |||||||||
Each value is the adjusted cognitive z-score difference between two groups.
P value and p trend: *0.01–0.05, **0.001–0.01, ***<0.001.
P trend: we tested whether there was an ordered relationship between categories of cumulative exposure to AC and cognitive performance (dose–effect).
†Lifestyle variables: living with a partner, smoking status, alcohol consumption, physical activity and body mass index.
‡Health status variables: self-rated health status, depressive symptoms, diabetes, respiratory diseases, cardiovascular diseases, osteoarticular disease, hypercholesterolaemia and cancer.
AC, anticholinergic drug; DSST, Digit Symbol Substitution Test; ref, reference; TMT, A and B, Trail Making Test.