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Anticholinergic drug exposure and the risk of dementia: A nested case-control study

JAMA Jun 29, 2019

Coupland CAC, et al. - Via performing a nested case-control study involving 58,769 patients with dementia and 225,574 matched controls, researchers investigated associations between anticholinergic drug treatments and dementia risk in older adults (aged 55 years or older). Significant increases in dementia risk for the anticholinergic antidepressants, anti-Parkinson drugs, antipsychotics, bladder antimuscarinic drugs, and antiepileptic drugs for more than 1,095 total standardized daily doses (TSDDs) were observed. Similar outcomes for more than 1,095 TSDDs were observed when exposures were limited to exposure windows of 3-13 years and 5-20 years prior to the index date. In cases identified before the age of 80 years, associations were stronger. Thus an association of exposure to numerous types of strong anticholinergic drugs with an elevated risk of dementia was identified. Further, in middle-aged and older adults, the importance of diminishing exposure to anticholinergic drugs was suggested.

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