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. 2022 Apr 12;8(1):e12290.
doi: 10.1002/trc2.12290. eCollection 2022.

Association between anticholinergic burden and dementia in UK Biobank

Jure Mur  1   2   3 , Tom C Russ  3   4   5 , Simon R Cox  1 , Riccardo E Marioni  6 , Graciela Muniz-Terrera  4   5
Affiliations

Association between anticholinergic burden and dementia in UK Biobank

Jure Mur et al. Alzheimers Dement (N Y). .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Alzheimers Dement (N Y). 2023 May 10;9(2):e12365. doi: 10.1002/trc2.12365. eCollection 2023 Apr-Jun. Alzheimers Dement (N Y). 2023. PMID: 37180634 Free PMC article.

Abstract

Background: Previous studies on the relationship between anticholinergic drugs and dementia have reported heterogeneous results. This variability could be due to different anticholinergic scales and differential effects of distinct classes of drugs.

Methods: Using Cox proportional hazards models, we computed the association between annual anticholinergic burden (AChB) and the risk of dementia in UK Biobank with linked general practitioner prescription records between the years 2000 and 2015 (n = 171,775).

Results: AChB according to most anticholinergic scales (standardized odds ratio range: 1.027-1.125) and the slope of the AChB trajectory (hazard ratio = 1.094; 95% confidence interval: 1.068-1.119) were predictive of dementia. However, the association between AChB and dementia held only for some classes of drugs, especially antidepressants, antiepileptics, and antidiuretics.

Discussion: The heterogeneity in previous findings may partially be due to different effects for different classes of drugs. Future studies should establish differences in more detail and further examine the practicality of a general measure of AChB relating to the risk of dementia.

Keywords: anticholinergic drugs; cohort study; dementia; prescriptions drugs; primary care.

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Conflict of interest statement

REM has received consulting fees from the Epigenetic Clock Development Foundation and speaker fees from Illumina. TCR has received fees for medicolegal work from private solicitors. SRC has received speaker fees from the Society of Biological Psychiatry. GMT has received consulting fees for grants funded by the NIH. JM has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Hazard ratios (HRs) for the association between anticholinergic burden (top panel) or drug count (bottom panel) and dementia. The names on the y‐axis of the top panel refer to the first names of the authors of the original anticholinergic scales; “polypharmacy plus” was additionally controlled for the total number of anticholinergic drugs. CI, confidence interval
FIGURE 2
FIGURE 2
Hazard ratios (HRs) for the association between anticholinergic burden (rank‐based inverse normal transformation) attributable to different classes of drugs and dementia. Left and right panels reflect the same data, but at different levels of granularity, with left panel representing the topmost level, and right panel the third level from the top according to the World Health Organization classification. CI, confidence interval
FIGURE 3
FIGURE 3
Hazard ratios (HRs) for the association between the numbers of anticholinergic drugs (rank‐based inverse normal transformation) of different levels of potency and dementia. CI, confidence interval
See this image and copyright information in PMC

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