Table 4.
Relation between cumulative exposure to anticholinergic drugs over a 3-year period and z-scores on cognitive function tests according to anticholinergic potency, adjusted on lifestyle and health status variables (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) | Estimated (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | Estimate (SE) | ||||||||
| Adjustment on lifestyle † and health status variables‡ | ||||||||||||||
| None | Ref | Ref | Ref | Ref | Ref | Ref | Ref | |||||||
| ACB-1§ | <3 months | −0.016 (0.012) | −0.010 (0.012) | −0.020 (0.012) | −0.002 (0.012) | 0.002 (0.012) | −0.016 (0.012) | −0.014 (0.012) | ||||||
| 3–12 months | −0.048 (0.020) | * | −0.040 (0.020) | −0.030 (0.020) | −0.011 (0.020) | −0.032 (0.020) | −0.027 (0.020) | −0.037 (0.020) | ||||||
| 1–3 years | 0.041 (0.028) | −0.025 (0.028) | −0.030 (0.028) | 0.037 (0.028) | −0.047 (0.028) | −0.092 (0.028) | ** | −0.043 (0.028) | ||||||
| >3 years | −0.056 (0.052) | −0.040 (0.052) | −0.010 (0.052) | −0.107 (0.052) | * | −0.179 (0.052) | *** | −0.194 (0.052) | *** | −0.145 (0.052) | ** | |||
| P trend | ** | *** | ** | |||||||||||
| None | Ref | Ref | Ref | Ref | Ref | Ref | ||||||||
| ACB-2/3§ | <3 months | −0.028 (0.020) | −0.040 (0.020) | −0.010 (0.020) | −0.002 (0.020) | −0.013 (0.020) | 0.047 (0.020) | * | 0.002 (0.020) | |||||
| 3–12 months | −0.090 (0.042) | * | −0.110 (0.042) | * | −0.070 (0.042) | −0.026 (0.042) | −0.082 (0.041) | * | −0.025 (0.042) | −0.025 (0.042) | ||||
| 1–3 years | −0.141 (0.048) | ** | −0.150 (0.048) | ** | −0.050 (0.048) | −0.081 (0.048) | −0.060 (0.047) | −0.026 (0.048) | −0.045 (0.047) | |||||
| >3 years | −0.159 (0.109) | −0.360 (0.109) | *** | −0.090 (0.109) | 0.138 (0.109) | −0.165 (0.108) | −0.034 (0.109) | −0.160 (0.108) | ||||||
| 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.
§Anticholinergic potency was assessed using the ACB scale, with scores of 2 and 3 (moderate to marked anticholinergic effect) collapsed into a single group (ACB-2/3).
AC, anticholinergic drug; ACB, Anticholinergic Cognitive Burden; DSST, Digit Symbol Substitution Test; ref, reference; TMT, A and B, Trail Making Test.