Moriarty, Frank, Savva, George M, Grossi, Carlota M., Bennett, Kathleen, Fox, Chris, Maidment, Ian, Loke, Yoon K, Steel, Nicholas, Kenny, Rose Anne and Richardson, Kathryn (2021). Cognitive decline associated with anticholinergics, benzodiazepines, and Z-drugs: findings from The Irish Longitudinal Study on Ageing (TILDA). British Journal of Clinical Pharmacology, 87 (7), pp. 2818-2829.
Abstract
Aims: To estimate the association between patterns of anticholinergic, benzodiazepine and Z-drug medication use and change in cognitive function in middle-aged and older adults. Methods: This prospective cohort study used data from the first three waves of The Irish Longitudinal Study on Ageing (TILDA), including community-dwelling adults aged ≥50 years followed for up to 4 years (n = 7027). Cognitive function was assessed using the Mini Mental State Examination, animal naming test and word recall tests. Regular medication use was self-reported at baseline and follow-up interviews at 2 and 4 years. Pharmacy dispensing claims for a subset (n = 2905) allowed assessment of medication use between interviews and cumulative dosage. Medication use at consecutive waves of TILDA was analysed in relation to change in cognitive function between waves. Results: Strongly anticholinergic medications (Anticholinergic Cognitive Burden scale 3), benzodiazepines and Z-drugs were reported by 7.3%, 5.8% and 5.1% of participants, respectively, at any time during the study. Adjusting for potential confounders, new anticholinergic use between interviews was associated with change in recall score (−1.09, 95% confidence interval −1.64, −0.53) over 2 years compared to non-use, but not with MMSE (0.07; 95% CI −0.21, 0.34) or animal naming (−0.70; 95% CI −1.43, 0.03). The pharmacy claims analysis was consistent with this finding. Other hypothesised associations were not supported. Conclusions: Except for new use of anticholinergic medications, no other findings supported a risk of cognitive decline over 2-year periods in this middle-aged and older cohort. Patients and prescribers should weigh this potential risk against potential benefits of commencing anticholinergic medications.
Publication DOI: | https://doi.org/10.1101/2020.05.09.20095661 |
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Divisions: | College of Health & Life Sciences > Aston Pharmacy School College of Health & Life Sciences > Chronic and Communicable Conditions College of Health & Life Sciences Aston University (General) |
Additional Information: | This is the peer reviewed version of the following article: Moriarty, F, Savva, GM, Grossi, CM, et al. Cognitive decline associated with anticholinergics, benzodiazepines, and Z‐drugs: findings from The Irish Longitudinal Study on Ageing (TILDA). Br J Clin Pharmacol. 2020. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/bcp.14687. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving. |
Uncontrolled Keywords: | Z-drugs,anticholinergic medication,benzodiazepines,cognitive function,pharmacoepidemiology,Pharmacology,Pharmacology (medical) |
Publication ISSN: | 1365-2125 |
Last Modified: | 29 Nov 2024 08:15 |
Date Deposited: | 01 Dec 2020 11:39 |
Full Text Link: | |
Related URLs: |
https://bpspubs ... .1111/bcp.14687
(Publisher URL) http://www.scop ... tnerID=8YFLogxK (Scopus URL) |
PURE Output Type: | Article |
Published Date: | 2021-07 |
Published Online Date: | 2020-12-03 |
Accepted Date: | 2020-11-30 |
Authors: |
Moriarty, Frank
Savva, George M Grossi, Carlota M. Bennett, Kathleen Fox, Chris Maidment, Ian ( 0000-0003-4152-9704) Loke, Yoon K Steel, Nicholas Kenny, Rose Anne Richardson, Kathryn |